If you’ve never pondered the question of whether mobile phones can improve the quality and uptake of sexual and reproductive health services among teenagers, then you’re not alone. Fortunately, however, Liverpool School of Tropical Medicine have considered the question and are using a grant from Indigo to test an SMS sexual health referral system for adolescents in Tanzania. Working in the Mwanza region, the system aims to improve communication between informal village drug stores and local health centres and dispensaries. When a young person turns up at a drug store seeking reproductive or sexual health services, an SMS will be sent to the local health centre or dispensary with details of the service to be provided. A unique passcode will then be sent automatically to the drug store owner for them to pass on to the client. When the client presents this referral code at the health centre or dispensary, they receive a confidential, fast-track service. A text message is then sent by the health centre or dispensary to the National Institute for Medical Research (NIMR). This SMS contains patient data (age, gender and medical condition), as well as information on the medical procedure or treatment provided. NIMR and Liverpool School of Tropical Medicine can then use this data and compare it with data collected in a control community which doesn’t have the SMS referral system.
The SMS referral system is part of a much larger, four-year cluster randomised control intervention known as IntHEC. The study, which is taking place in Tanzania and Niger, and covers a total population of more than 700,000 aims to develop evidence-based strategies to increase equity, integration and effectiveness of reproductive health services for poor communities in sub-Saharan Africa. It brings together a multitude of partners, including: the Université Catholique de Louvain (Belgium), the Laboratoire d’Etudes et de Recherches sur les Dynamiques Sociales et le Developpement (Niger), the Ministry of Health and Social Welfare (Tanzania), the Ministry of Education and Vocational Training (Tanzania), the Ministry of Public Health (Niger) and UNFPA (Niger).
Indigo have provided a grant of £14,920 to Liverpool School of Tropical Medicine to help them build, develop and deploy the SMS referral system. If successful, such a referral system could be deployed in other countries where appropriate. What is certain is that with the rigorous evaluative skills of all partners involved in the IntHEC consortium, this system will help build the evidence base for mhealth initiatives in sub-Saharan Africa.
Mobile phones offer significant advantages to organisations involved in the delivery of sexual health services to teenagers. Not only can they improve take up and use of services through SMS reminders, but they can also be used for education and as a tool to provide advice remotely – an important consideration in environments where lack of formal services, stigma and social values may prevent or discourage people from seeking treatment. This Guardian article has more information on LSTM’s SMS referral system, as well as the growing popularity of mobile advice services in the UK.