Cited by 403Mobile Health and mHealth ApplicationsMalaria Research and ControlICT in Developing Communities

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The effect of mobile phone text-message reminders on Kenyan health workers' adherence to malaria treatment guidelines: a cluster randomised trial

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Zurovac, Dejan, Sudoi, Raymond K, Akhwale, Willis S, Ndiritu, Moses, Hamer, Davidson H, Rowe, Alexander K, Snow, Robert W·2011·The Lancet

DOI 10.1016/s0140-6736(11)60783-6PMC PMC3163847

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Abstract

Background Health workers' malaria case-management practices often differ from national guidelines. We assessed whether text-message reminders sent to health workers' mobile phones could improve and maintain their adherence to treatment guidelines for outpatient paediatric malaria in Kenya.Methods From March 6, 2009, to May 31, 2010, we did a cluster-randomised controlled trial at 107 rural health facilities in 11 districts in coastal and western Kenya. With a computer-generated sequence, health facilities were randomly allocated to either the intervention group, in which all health workers received text messages on their personal mobile phones on malaria case-management for 6 months, or the control group, in which health workers did not receive any text messages. Health workers were not masked to the intervention, although patients were unaware of whether they were in an intervention or control facility. The primary outcome was correct management with artemether-lumefantrine, defined as a dichotomous composite indicator of treatment, dispensing, and counselling tasks concordant with Kenyan national guidelines. The primary analysis was by intention to treat. The trial is registered with Current Controlled Trials, ISRCTN72328636.Findings 119 health workers received the intervention. Case-management practices were assessed for 2269 children who needed treatment (1157 in the intervention group and 1112 in the control group). Intention-to-treat analysis showed that correct artemether-lumefantrine management improved by 23·7 percentage-points (95% CI 7·6-40·0; p=0·004) immediately after intervention and by 24·5 percentage-points (8·1-41·0; p=0·003) 6 months later.Interpretation In resource-limited settings, malaria control programmes should consider use of text messaging to improve health workers' case-management practices.Funding The Wellcome Trust.

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Authors: Zurovac, D., Sudoi, R. K., Akhwale, W. S., Ndiritu, M., Hamer, D. H., Rowe, A. K., & Snow, R. W.
Affiliations: Boston University (US)
Kenya Medical Research Institute (KE)
Ministry of Health (KE)
Centers for Disease Control and Prevention (US)
John Radcliffe Hospital (GB)
Corresponding author: Zurovac, Dejan
ORCID: Zurovac, Dejan
Sudoi, Raymond K
Ndiritu, Moses
Hamer, Davidson H
Rowe, Alexander K
Snow, Robert W
Venue: The Lancet
Publisher: Elsevier BV
Published: 2011-08
Volume: 378
Issue: 9793
Pages: 795-803
ISSN: 0099-5355 (ISSN-L)
0140-6736
DOI: 10.1016/s0140-6736(11)60783-6
PMC: PMC3163847
OpenAlex: W2160800204
Cited by: 403
References: 25
Citations by year: 2026: 5 · 2025: 8 · 2024: 30 · 2023: 11 · 2022: 17 · 2021: 30 · 2020: 26 · 2019: 29 · 2018: 25 · 2017: 32 · 2016: 38 · 2015: 30 · 2014: 52 · 2013: 40 · 2012: 23
FWCI: 71.82
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
doi.org/10.15223/policy-017 (stm-asf)
doi.org/10.15223/policy-037 (stm-asf)
doi.org/10.15223/policy-012 (stm-asf)
doi.org/10.15223/policy-029 (stm-asf)
doi.org/10.15223/policy-004 (stm-asf)
Locations: The Lancet (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: the Wellcome Trust, UK through a project grant to RWS ((grant number 084253))
the Wellcome Trust as Principal Research Fellow ((grant number 079080))
Topics: Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
Physical Sciences › Computer Science › Information Systems › ICT in Developing Communities
Keywords: SMS reminders, mobile phone intervention, malaria treatment guidelines, pediatric malaria, artemether-lumefantrine, malaria case management, health worker education, rural health facilities, Kenya
MeSH terms: Artemether, Lumefantrine Drug Combination, Antimalarials, Child, Child, Preschool, Drug Combinations, Ethanolamines, Fluorenes, Health Personnel, Humans, Infant, Kenya, Malaria, Quality Assurance, Health Care, Cluster Analysis, Reminder Systems, Rural Health Services, Guideline Adherence, Artemisinins, Cell Phone

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The effect of mobile phone text-message reminders on Kenyan health workers' adherence to malaria treatment guidelines: a cluster randomised trial

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