A high number of respondents to a recent study have welcomed a new unique intervention Short Message Service (SMS) technology used to send messages to HIV patients in rural communities in Zimbabwe about their viral load (VL).
The Mobile Health or mHealth intervention is a project that was recently initiated in rural areas by the Ministry of Health with financial and technical support from Medicins San Frontieres and the Research Triangle Institute International.
The programme seeks to help patients adopt a more active role in the self-management of their HIV and become more aware of the importance of adherence and VL monitoring and seek follow-up at clinics when their VL results are high.
"Mobile Health or mHealth interventions, including Short Message Service (SMS), can help increase access to care, enhance the efficiency of health service delivery and improve diagnosis and treatment for HIV," the study, in districts where the project was undertaken, says.
"Messages such as those described above have the potential to empower patients through giving them control over when they can come to the clinic, as well as reducing congestion and waiting time in clinics," the study added.
"After completion of the HIV VL testing at the National Microbiology Reference Laboratory in Harare, results were sent to health facilities via SMS. Consenting patients were also sent an SMS informing them that their VL results were ready for collection at their nearest health facility. No actual results were sent to patients.
"SMS allows for the low-cost transmission of information, has been used to send appointment reminders, information about HIV counselling and treatment, messages to encourage adherence and information on nutrition and side-effects. HIV viral load monitoring is recommended by the World Health Organisation (WHO) and has been progressively adopted in many settings," the study says.
The SMS intervention was perceived by health care workers as improving adherence and the well-being of patients as well as improving the management of VL results at health facilities.
However, there were some concerns from the participants about the intervention, including challenges in understanding the purpose of the programme, language used in transmitting the messages and patients coming to the health facilities unnecessarily.
English was used in sending the message to the patients and some of them failed to understand. The patients felt the intervention would have more impact if indigenous languages were used.
The health workers, interviewed in the study, were also more concerned than the patients about unintended HIV disclosure relating to the content of the messages or phone-sharing in families and communities.
"Health care workers and patients found the intervention acceptable and there were relatively few concerns from patients. More emphasis needs to be placed on explaining the purpose and content of messages so that patients understand why they are going to be receiving messages, what the messages mean and what - if any - action should be taken. Messages such as those above have the potential to empower patients through giving them more control".
Approximately 1.3 million people are estimated to be living with HIV in Zimbabwe, with a reported 1 058 293 accessing anti-retroviral drugs by the end of December 2017.