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Using mobile phones to improve delivery and uptake of Medical Male Circumcision
Bas Hoefman [email protected]
+256 779890945
Experiences from North Tanzania
By: Bas HOEFMAN1, Eunice NAMIREMBE1, Hally MAHLER2, James BON TEMPO2, Jan-Willem LOGGERS1, Joshua KAYIWA1
M4D2012 , Feb 28-29, New Delhi, India
NGO founded in 2007 in Amsterdam
Social Mobile Service & Content provider
TTC develops Interactive and Incentive based mobile programs
Pioneer in mHealth in Africa
Mobile Tools for Health, Education & Social Impact: SMS, Voice, Data
NGO founded in 2007 in Amsterdam
Social Mobile Service & Content provider
TTC develops Interactive and Incentive based mobile programs
Pioneer in mHealth in Africa
Mobile Tools for Health, Education & Social Impact: SMS, Voice, Data
Text to Change Text to Change
• On-going MMC campaign by the Maternal and Child Health Integrated program (MCHIP)
• First voluntary medical male circumcision (VMMC) services launched in October 2009
• National target: 2.8 million circumcisions
• Target age: 10- to 34-year-olds• Earlier clinical trials demonstrated
that MMC has ability to revert between 40% to 60% female-to-male HIV infections
BackgroundBackground
1. 3 MC campaigns held in Iringa (June/July 2010, Nov/Dec 2010, June/July/August 2011)
2. SMS service added to the campaigns in November 2010 – Text to Change
3. Study explains the experiences of using mobile phone technology to influence uptake and delivery of MMC
4. Project funded by JHPIEGO
1. 3 MC campaigns held in Iringa (June/July 2010, Nov/Dec 2010, June/July/August 2011)
2. SMS service added to the campaigns in November 2010 – Text to Change
3. Study explains the experiences of using mobile phone technology to influence uptake and delivery of MMC
4. Project funded by JHPIEGO
VMMC Project aka ‘’Peel the Mango Campaign’’VMMC Project aka ‘’Peel the Mango Campaign’’
Why use SMS?Why use SMS?
Program managers sought way to:- Make info about VMMC more widely available- Keep communities up-to-date on newly opened sites- Improve post-operative adherence
Program managers sought way to:- Make info about VMMC more widely available- Keep communities up-to-date on newly opened sites- Improve post-operative adherence
Location
•Over 20 million mobile subscribers in TZ by March 2011• 7 Telecom Companies
•Over 20 million mobile subscribers in TZ by March 2011• 7 Telecom Companies
In partnership with Text to Change, MCHIP established a toll-free SMS short code available on all mobile phone networks in TZ
Text is free to the user Three key words: TOHARA
(Circumcision), WAPI (Where), BAADA (After)
Service was launched with November 2010 mini-campaign in seven sites in northern Iringa
MethodsMethods
TOHARA (Circumcision)TOHARA (Circumcision)
Male circumcision can reduce your chances of HIV infection by up to 60%. It should be combined with other HIV prevention measures.
Male circumcision can reduce your chances of HIV infection by up to 60%. It should be combined with other HIV prevention measures.
WAPI (Where)WAPI (Where)
Male circumcision services are currently offered free of charge at IRH and Ngome Health centre in Iringa town, Tosamaganga Hospital, Mafinga district Hospital and Lugoda Hospital in Mufindi.
Male circumcision services are currently offered free of charge at IRH and Ngome Health centre in Iringa town, Tosamaganga Hospital, Mafinga district Hospital and Lugoda Hospital in Mufindi.
Eight text messages delivered over six weeks to remind clients about: Incision care Return visits The abstinence
period Need to maintain
ABCs of prevention
BAADA (After)BAADA (After)
If you notice severe pain, soaking blood of the bandage, inability to pass urine or severe swelling of the penis please go back to the Male
Circumcision service center.
If you notice severe pain, soaking blood of the bandage, inability to pass urine or severe swelling of the penis please go back to the Male
Circumcision service center.
Radio, Posters, Billboards, Community Activities
13
Data FindingsData Findings
• Hits to all three key words were analyzed to learn if there is a relation between those seeking information about circumcision and those who received services, and the general uptake of the SMS service.
Data points include:• Phone number• Information service
requested• Information sent• Date
• Hits to all three key words were analyzed to learn if there is a relation between those seeking information about circumcision and those who received services, and the general uptake of the SMS service.
Data points include:• Phone number• Information service
requested• Information sent• Date
ResultsResults
Number of individuals requesting for Medical Male Circumcision (MMC) information Keyword used in the request At least one of the
three keywords
TOHARA(circumcision)
WAPI(where)
BAADA(After)
Total requests made 20063 14434 2625 37122
Number of unique individuals 11401 7606 1389 14639
Average number of requests per individual 1.76 1.90 1.89 2.54
1. 14639 unique individuals requested for MMC information at least once;2. 2,54 request on average per individual 3. Most individuals requested to know the advantages of MMC (TOHARA
40.6%) and a combination of the advantages and where to access MMC services (TOHARA and WAPI, 34.4%)
4. 14639 unique individuals requested for MMC information , of these 1389 (9.5%) requested for post operation circumcision information, and indication they had undergone MMC.
5. Individuals seeking general info about VMMC were not necessarily motivated to seek services
6. Strong association between those who sought “where” and those who received services
1. 14639 unique individuals requested for MMC information at least once;2. 2,54 request on average per individual 3. Most individuals requested to know the advantages of MMC (TOHARA
40.6%) and a combination of the advantages and where to access MMC services (TOHARA and WAPI, 34.4%)
4. 14639 unique individuals requested for MMC information , of these 1389 (9.5%) requested for post operation circumcision information, and indication they had undergone MMC.
5. Individuals seeking general info about VMMC were not necessarily motivated to seek services
6. Strong association between those who sought “where” and those who received services
ResultsResults
Response
1. The key words : • Hard to know the gender of the mobile user• A possibility of users switching mobile numbers
2. Short duration between sending out of the text messages and the evaluation of its impact on MMC uptake (Behavioral change takes longer)
3. The Lack of baseline comparative data to assess the real impact on the MMC uptake.
1. The key words : • Hard to know the gender of the mobile user• A possibility of users switching mobile numbers
2. Short duration between sending out of the text messages and the evaluation of its impact on MMC uptake (Behavioral change takes longer)
3. The Lack of baseline comparative data to assess the real impact on the MMC uptake.
Limitations Limitations
1. It is demonstrated that it is possible to use sms as a measure to increase uptake of MMC and improve post-operative adherence.
2. It is undeniable that with mass sensitization a client is armed with information that will help them to seek MMC services.
1. It is demonstrated that it is possible to use sms as a measure to increase uptake of MMC and improve post-operative adherence.
2. It is undeniable that with mass sensitization a client is armed with information that will help them to seek MMC services.
Conclusions Conclusions
2 years programme extension
Intend to incorporate the use of the call centre
Other countries interested to adapt the model
2 years programme extension
Intend to incorporate the use of the call centre
Other countries interested to adapt the model
Way ForwardWay Forward
