Mobile health treatment support intervention for HIV and tuberculosis in Mozambique: Perspectives of patients and healthcare workers

Nhavoto, José António; Grönlund, Åke; Klein, Gunnar O.

doi:10.1371/journal.pone.0176051

Cited by 91Mobile Health and mHealth ApplicationsHIV/AIDS Research and InterventionsICT in Developing Communities

Mobile health treatment support intervention for HIV and tuberculosis in Mozambique: Perspectives of patients and healthcare workers

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Nhavoto, José António, Grönlund, Åke, Klein, Gunnar O.·2017·PLOS ONE

DOI 10.1371/journal.pone.0176051PMC PMC5395223

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Abstract

BACKGROUND: Studies have been conducted in developing countries using SMS to communicate with patients to reduce the number of missed appointments and improve retention in treatment, however; very few have been scaled up. One possible reason for this could be that patients or staff are dissatisfied with the method in some way. This paper reports a study of patients' and healthcare workers' (HCW) views on an mHealth intervention aiming to support retention in antiretroviral therapy (ART) and tuberculosis (TB) treatment in Mozambique. METHODS: The study was conducted at five healthcare centres in Mozambique. Automated SMS health promotions and reminders were sent to patients in a RCT. A total of 141 patients and 40 HCWs were interviewed. Respondents rated usefulness, perceived benefits, ease of use, satisfaction, and risks of the SMS system using a Likert scale questionnaire. A semi-structured interview guide was followed. Interviews were transcribed and thematic analysis was conducted. RESULTS: Both patients and HCW found the SMS system useful and reliable. Most highly rated positive effects were reducing the number of failures to collect medication and avoiding missing appointments. Patients' confidence in the system was high. Most perceived the system to improve communication between health-care provider and patient and assist in education and motivation. The automatic recognition of questions from patients and the provision of appropriate answers (a unique feature of this system) was especially appreciated. A majority would recommend the system to other patients or healthcare centres. Risks also were mentioned, mostly by HCW, of unintentional disclosure of health status in cases where patients use shared phones. CONCLUSIONS: The results suggest that SMS technology for HIV and TB should be used to transmit reminders for appointments, medications, motivational texts, and health education to increase retention in care. Measures must be taken to reduce risks of privacy intrusion, but these are not a main obstacle for scaling up systems of this kind.

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The use of SMS only was mentioned in 16 of 26 interventions (62%).
“The use of SMS only was mentioned in 16 of 26 interventions (62%) [28-31,35,37,38,40-43,45-47,50,52].”
From Barriers to the Use of Mobile Health in Improving Health Outcomes in Developing Countries: Systematic Review (2019) · cites this paper as [37]

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Additional file 2 of Implementing SMS reminders for routine immunization in Northern Nigeria: a qualitative evaluation using the RE-AIM framework
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Additional file 1 of Mapping evidence of mobile health technologies for disease diagnosis and treatment support by health workers in sub-Saharan Africa: a scoping review
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Additional file 2 of Mapping evidence of mobile health technologies for disease diagnosis and treatment support by health workers in sub-Saharan Africa: a scoping review
Osei, E., Kuupiel, D., Vezi, P. N., & Mashamba-Thompson, T. P. (2021) · Figshare · doi:10.6084/m9.figshare.13532027
Additional file 3 of Implementing SMS reminders for routine immunization in Northern Nigeria: a qualitative evaluation using the RE-AIM framework
Obi‐Jeff, C., Garcia, C., Adewumi, F., Bamiduro, T., David, W., Labrique, A., & Wonodi, C. B. (2024) · Figshare · doi:10.6084/m9.figshare.26555465
Additional file 1 of Implementing SMS reminders for routine immunization in Northern Nigeria: a qualitative evaluation using the RE-AIM framework
Obi‐Jeff, C., Garcia, C., Adewumi, F., Bamiduro, T., David, W., Labrique, A., & Wonodi, C. B. (2024) · Figshare · doi:10.6084/m9.figshare.26555459
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SMSaúde: Evaluating mobile phone text reminders to improve retention in HIV care for patients on antiretroviral therapy in Mozambique
Davey, D. J. J., Nhavoto, J. A., Augusto, O., Ponce, W., Traca, D., Nguimfack, A., & de Sousa, C. A. D. P. (2016) · Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0000000000001115 · Cited by 31 · see citing works
Self-citation
Patient and health-care worker experiences of an HIV viral load intervention using SMS: A qualitative study
Venables, E. C., Ndlovu, Z., Munyaradzi, D., Martínez‐Pérez, G. Z., Mbofana, E., Nyika, P., Chidawanyika, H., Garone, D., & Bygrave, H. (2019) · PLoS ONE · doi:10.1371/journal.pone.0215236 · Cited by 26 · see citing works
*all authors contributed equally Corresponding Author:
Nhavoto, J. A., Grönlund, M. Å., Walter, P., Chaquilla, P., & Nhavoto, J. A. (2015)
Self-citation

Authors: Nhavoto, J. A., Grönlund, Å., & Klein, G. O.
Affiliations: Eduardo Mondlane University (MZ)
Örebro University (SE)
Corresponding author: Nhavoto, José António
ORCID: Nhavoto, José António
Grönlund, Åke
Klein, Gunnar O.
Venue: PLOS ONE
Publisher: Public Library of Science (PLoS)
Published: 2017-04-18
Volume: 12
Issue: 4
Pages: e0176051
ISSN: 1932-6203 (ISSN-L)
DOI: 10.1371/journal.pone.0176051
PMC: PMC5395223
OpenAlex: W2605416169
Cited by: 91
References: 34
Citations by year: 2026: 3 · 2025: 7 · 2024: 10 · 2023: 7 · 2022: 9 · 2021: 12 · 2020: 14 · 2019: 12 · 2018: 14 · 2017: 3
FWCI: 18.98
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (vor)
Locations: PLoS ONE (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Figshare (submittedVersion, cc-by)
Funders: Styrelsen för Internationellt Utvecklingssamarbete
Topics: Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Physical Sciences › Computer Science › Information Systems › ICT in Developing Communities
Keywords: mobile health, SMS reminders, HIV, tuberculosis, antiretroviral therapy, retention in care, missed appointments, medication adherence, patient satisfaction, healthcare worker perspectives, health education, privacy risks, Mozambique
MeSH terms: Adult, Antitubercular Agents, Appointments and Schedules, Female, Humans, Male, Middle Aged, Mozambique, Tuberculosis, HIV Infections, Reminder Systems, Telemedicine, Anti-Retroviral Agents, Text Messaging

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Mobile health treatment support intervention for HIV and tuberculosis in Mozambique: Perspectives of patients and healthcare workers

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