Effectiveness of SMS Technology on Timely Community Health Worker Follow-Up for Childhood Malnutrition: A Retrospective Cohort Study in sub-Saharan Africa
Open accessAbstract
BACKGROUND: The Millennium Villages Project facilitated technology-based health interventions in rural under-resourced areas of sub-Saharan Africa. Our study examined whether data entry using SMS compared with paper forms by community health workers (CHWs) led to higher proportion of timely follow-up visits for malnutrition screening in under-5 children in Ghana, Rwanda, Senegal, and Uganda. METHODS: Children under 5 years were screened for malnutrition every 90 days by CHWs using mid-upper arm circumference (MUAC) readings. CHWs used either SMS texts or paper forms to enter MUAC data. Reminder texts were sent at 15 days before follow-up was needed. Chi-square tests assessed proportion of timely follow-up visits within 90 days between SMS and paper groups. Logistic regression analysis was conducted in a step-wise multivariate model. Post-hoc power calculations were conducted to verify strength of associations. RESULTS: SMS data entry was associated with a higher proportion of timely malnutrition follow-up visits compared with paper forms across all sites. The association was strongest with consistent SMS use over consecutive visits. SMS use at the first of 2 consecutive visits was most effective, highlighting the importance of SMS reminder alerts. CONCLUSIONS: SMS technology with reminders increased timely CHW malnutrition screening visits for under-5 children in Ghana, Rwanda, Senegal, and Uganda, highlighting the importance of such technology for improving health worker behavior in low-resource settings.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Most SMS-based interventions are pilot tested (stage 3) or at large scale implementation stage (stage 4).
“most SMS based interventions are pilot tested (stage 3) [31,34,37,38,42,71] or at large scale implementation stage (stage 4) [28 -30,32,35].”
From Current evidence on the use of mHealth approaches in Sub-Saharan Africa: A scoping review (2023) · cites this paper as [28]
The Introduction describes an SMS intervention deployed through the Millennium Villages Project, and Methods (Study Sites) identifies four study sites across four countries with a combined catchment population of approximately 155,740. This supports citing the paper as an example of a deployed SMS intervention, but it does not classify interventions as stage 3 or stage 4 or establish that most SMS interventions fall into those stages. (LLM, conf=0.78)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
The citation lists haven’t been fetched yet
References 21 · Cited by 9
Research works printed but not linked: 17
- [5]Mitchell S Gelman A Ross R. The Millennium Villages Project: a retrospective, observational, endline evaluation. Lancet Glob Health. 2018; 6(5): e500– e513. 10.1016/S2214-109X(18)30065-2. 29653625 · DOI
- [7]Kanter AS Negin J Olayo B Bukachi F Johnson E Sachs SE. Millennium Global Village-Net: bringing together Millennium Villages throughout sub-Saharan Africa. Int J Med Inform. 2009; 78: 802– 807. 10.1016/j.ijmedinf.2009.08.002. 19766532 · DOI
- [10]Mushamiri I Luo C Iiams-Hauser C Ben Amor Y. Evaluation of the impact of a mobile health system on adherence to antenatal and postnatal care and prevention of mother-to-child transmission of HIV programs in Kenya. BMC Public Health. 2015; 15(1): 102. 10.1186/s12889-015-1358-5. 25886279 PMC4328364 · DOI
- [11]Quan V Hulth A Kok G Blumberg L. Timelier notification and action with mobile phones–towards malaria elimination in South Africa. Malar J. 2014; 13(1): 151. 10.1186/1475-2875-13-151. 24745657 PMC3999506 · DOI
- [12]Githinji S Kigen S Memusi D. Using mobile phone text messaging for malaria surveillance in rural Kenya. Malar J. 2014; 13(1): 107. 10.1186/1475-2875-13-107. 24642130 PMC3995152 · DOI · Paper page
- [14]Sieverdes JC Treiber F Jenkins C Hermayer K. Improving diabetes management with mobile health technology. Am J Med Sci. 2013; 345(4): 289– 295. 10.1097/MAJ.0b013e3182896cee. 23531961 · DOI · Paper page
- [16]Clifford GD Clifton D. Wireless technology in disease management and medicine. Annu Rev Med. 2012; 63(1): 479– 492. 10.1146/annurev-med-051210-114650. 22053737 · DOI
- [18]Watterson JL Walsh J Madeka I. Using mhealth to improve usage of antenatal care, postnatal care, and immunization: a systematic review of the literature. BioMed Res Int. 2015; 2015: 1– 9. 10.1155/2015/153402. 26380263 PMC4561933 · DOI · Paper page
- [19]Kaplan WA. Can the ubiquitous power of mobile phones be used to improve health outcomes in developing countries? Glob Health. 2006; 2: 9. 10.1186/1744-8603-2-9. 16719925 PMC1524730 · DOI · Paper page
- [20]Kahn JG Yang JS Kahn JS. ‘Mobile’ health needs and opportunities in developing countries. Health Aff. 2010; 29(2): 252– 258. 10.1377/hlthaff.2009.0965. 20348069 · DOI · Paper page
- [21]Etzo S Collender G. The mobile phone ‘revolution’ in Africa: rhetoric or reality? Afr Aff (Lond). 2010; 109(437): 659– 668. 10.1093/afraf/adq045 · DOI
- [22]Al Dahdah M Desgrées Du Loû A Méadel C. Mobile health and maternal care: a winning combination for healthcare in the developing world? Health Policy Tech. 2015; 4(3): 225– 231. 10.1016/j.hlpt.2015.04.002 · DOI
- [27]World Health Organization (WHO); UNICEF. WHO child growth standards and the identification of severe acute malnutrition in infants and children: a joint statement by the World Health Organization and the United Nations Children's Fund. Geneva: WHO; 2009. http://www.who.int/nutrition/publications/severemalnutrition/9789241598163/en/. Accessed May 23, 2018. 24809116
- [28]Berkley J Mwangi I Griffiths K. Assessment of severe malnutrition among hospitalized children in rural Kenya: comparison of weight for height and mid upper arm circumference. JAMA. 2005; 294(5): 591– 597. 10.1001/jama.294.5.591. 16077053 · DOI
- [29]Myatt M Khara T Collins S. A review of methods to detect cases of severely malnourished children in the community for their admission into community-based therapeutic care programs. Food Nutr Bull. 2006; 27(3 suppl): S7– S23. 10.1177/15648265060273S302. 17076211 · DOI
- [30]Rasmussen J Andersen A Fisker AB. Mid-upper-arm-circumference and mid-upper-arm circumference z-score: the best predictor of mortality? Eur J Clin Nutr. 2012; 66(9): 998– 1003. 10.1038/ejcn.2012.95. 22805497 · DOI
- [31]Onwuegbuzie AJ Leech NL. Post-hoc power: a concept whose time has come. Underst Stat. 2004; 3(4): 201– 230. 10.1207/s15328031us0304_1 · DOI
- Authors
- Sarma, S., Nemser, B., Cole-Lewis, H., Kaonga, N., Negin, J., Namakula, P., Ohemeng-Dapaah, S., & Kanter, A. S.
- Affiliations
- Columbia University (US)
- Yale University (US)
- Tufts University (US)
- The University of Sydney (AU)
- Columbia Global Center (KE)
- Corresponding author
- Sarma, Shohinee
- Venue
- Global Health: Science and Practice
- Published
- 2018-06-27
- Volume
- 6
- Issue
- 2
- Pages
- 345-355
- ISSN
- 2169-575X (ISSN-L)
- PMC
- PMC6024632
- OpenAlex
- W2810943987
- Cited by
- 9
- References
- 21
- Citations by year
- 2025: 1 · 2023: 3 · 2022: 2 · 2021: 1 · 2020: 1 · 2018: 1
- FWCI
- 1.15
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by
- Locations
- Global Health Science and Practice (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UWC Research Repository (University of the Western Cape) (submittedVersion)
- Funders
- Novartis Foundation for Sustainable Development
- Novartis Foundation
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Physical Sciences › Computer Science › Information Systems › ICT in Developing Communities
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Keywords
- community health workers, child malnutrition, malnutrition screening, mid-upper arm circumference, paper forms, Millennium Villages Project, children under five, resource-limited settings, health worker behavior
- MeSH terms
- Child, Preschool, Community Health Workers, Female, Follow-Up Studies, Health Services Research, Humans, Infant, Male, Mass Screening, Paper, Retrospective Studies, Technology, Time Factors, Child Nutrition Disorders, Africa South of the Sahara, Rural Health Services, Text Messaging
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
