Mobile Health Around the Globe: Good work in Africa; Cell Phones Improve Health Education in Family Planning.

The growing use of mobile phones and text messaging in developing countries prompted FHI 360 to develo

The growing use of mobile phones and text messaging in developing countries prompted FHI 360 to develop and begin testing innovative ways to use this technology to improve family planning services. In 2009, with funding from USAID, PROGRESS began developing the Mobile for Reproductive Health (m4RH) project, which has developed a set of text messages on family planning methods that users can access via their mobile phones. You can view an interactive demonstration of the text message system (Adobe Flash Player required). We welcome any feedback you have on the system.

This low-cost approach to reaching contraceptive users is being deployed in Kenya and Tanzania as part of a research study aimed at determining the feasibility of providing FP information via text message, the reach of this communication channel and suggested impact on FP use.

The m4RH messages were developed using evidence-based content, including the World Health Organization family planning handbook for providers, and crafted specifically for short message service (SMS) or text message use. Each message was designed and tested to ensure user comprehension within the 160 character limit. The m4RH service provides information on long- and short-acting family planning methods including: implants, IUDs, permanent methods, injectables, oral contraceptive pills, emergency contraception, condoms and natural methods including LAM.  The messages address side effects, method effectiveness, duration of use and ability to return to fertility. The service also lists local clinics in a database that is searchable by Province (Kenya) or Ward (Tanzania). 

• Formative research results for m4RH
• Implementation and evaluation of m4RH — Kenya and Tanzania
• Related FHI 360 projects

Formative research results for m4RH
Using in-depth interviews in Nairobi and Dar es Salaam, FHI 360 researchers found that texting is prevalent, that users would welcome and trust messages on family planning options via text, and that they would share such messages with their partners and friends. This indicated that an mHealth service providing FP information could be successful and prompted the development of m4RH. View the full research findings (PDF, 70 KB). 

Implementation and evaluation of m4RH service — Kenya and Tanzania
m4RH has been operational in Kenya and Tanzania since 2010. Many organizations have been involved in its development, deployment and promotion including: Text to Change, Sliced Bread Design, Marie Stopes, Family Health Options of Kenya, PSI, Pathfinder, FHI 360 ROADS Project, GIZ, ISHI Project, CCBRT, the Department of Reproductive Health of the Ministry of Public Health and Sanitation in Kenya, and the Ministry of Health and Social Welfare in Tanzania.

 

 

If you are in Kenya, you can access the m4RH system from any mobile phone in the country by texting “m4RH” to the short code “4127.” Similarly, the system can be accessed (in Swahili) in Tanzania by texting “m4RH” to the short code “15014.”

For more information on the work in Kenya and Tanzania, click here (PDF, 119 KB).

To date, the m4RH program has reached over 13,000 users in Kenya and Tanzania. Preliminary data results suggest m4RH is reaching four key populations: women, youth, community health workers and men.  Electronic data collection reveals that users have accessed  67,551 messages. 

Phone interviews with m4RH users indicate that:

• Users are learning new information about the full range of contraceptive methods, thereby increasing their family planning knowledge, as a result of using m4RH. 
• Many users are changing their behavior after viewing m4RH messages (self-reported).
• m4RH users are sharing messages with others, and
• m4RH seems to promote communication among couples.

The m4RH team is continuing to collect data from users to assess the full program impact. Discussions about sustainability and scaling up are currently underway.

 

This Africa based study is very similar to our current clinical trial, an adjunct to the Text in the City program, BC 2U. 

BC 2U is a randomized controlled trial assessing the use of educational text messages to improve continuation of a birth control method. Currently, of females initiating a birth control method in our clinic, only 12% return for a refill of their chosen method. We hope that by sending them text messages that explain how the birth control works, how to use it effectively, what side effects to expect, plus useful tips for remembering to take their birth control, and more…girls will continue to take their birth control for longer and unwanted pregnancies will be fewer.
So far we have 120 15-19 year old girls enrolled in the study; we are aiming for 300 in total.
Watch this space for future updates!

To read other posts in this exclusive ongoing series, please visit the Mobile Health Around the Globe main page.

And if you have a Mobile Health Around the Globe story to tell, please email me at joan@socialmediatoday.com