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How Text Messaging Helps the Fight Against Malaria

Could text messaging help the fight against malaria? Recent studies and applications of SMS to efforts against malaria in afflicted regions of African countries suggest that it just might.

Basic supplies like bed nets that have been treated with insecticide are staples in malaria prevention in areas where the disease is found. Organizations like Canada's MEDA work to run programs that make these nets accessible to families in at-risk areas, and one necessity of these programs is tracking their supplies. Retailers must be able to update local clinics on supply levels and to share statistics on net use with organizations like MEDA, often quickly, in order for the aid programs to function. And what better vehicle for the rapid transfer of information than texting?

Texting to track supply stocks ensures that retailers are always able to provide life-saving nets to families who need them. It also expedites processes that used to be paper-based, such as the sharing of statistics between retailers and groups like MEDA, allowing the program to function better and more efficiently. This application of texting is not the end of SMS in malaria supply tracking, too: while nets are traditionally purchased by families with paper vouchers, work is being done to create text message vouchers, speeding up reimbursement of retailers and thus encouraging their participation.

Texting is also being used to improve the performance of health workers who aid in the treatment of malaria. A lapse in communication has emerged between supervisors and field health workers, who often give care in rural areas, and it has potentially serious consequences. Without frequent contact with supervisors, and with written protocols unlikely to be revisited by workers, there has been growing concern that health workers are faltering on their adherence to government protocol for treatment of the disease.

A study in Kenya held that texting might assuage this problem. The study, which involved 119 health workers and lasted six months, involved a group of workers receiving texts twice daily on five days per week offering tips and information, such as correct prescriptions of anti-malarial drugs. At the end of the study, more than double the amount of children afflicted by malaria were receiving correct treatment than before; when the study began, 20.5% of the children were treated correctly, as opposed to 49.6% at its conclusion.

Interestingly, six months after the study ended, the proportion of children who were receiving correct treatment had slightly increased, with 51.4% of children being managed correctly. While it is possible that other factors may be behind this slight increase, the maintenance of a roughly similar proportion six months after the study ended demonstrates that this application of SMS to the management of health workers may stand the test of (at least some) time.

Notably, text messaging is also an incredibly cost-effective mode of managing workers remotely. During the six months in which the study was conducted, texting each worker cost an estimated total of 1.59, or $2.52, per worker.

Another important feature of the fight against malaria is surveillance systems that effectively track testing and treatment practices, and, you guessed it, texting represents a useful and cost-effective option to this end. In a trial study published in Malaria Journal in 2014, health workers in 87 public health facilities were asked to follow guidelines to text weekly reports on testing and treatment procedures, and the facilities were evaluated simultaneously so that the data reported by the health workers could be tested for accuracy.

The trial found a 96% rate of response, with 87% of the facilities reporting their data by the set deadlines. This high response rate and fairly good punctuality indicates that the use of texting as a vehicle for this type of surveillance is indeed feasible. However, only 58% of the data reported was done so accurately; while texting is a promising medium for this sort of work, the way it is applied must be further developed so as to promote higher accuracy of data.

While some developments stand to be made, it's clear that text messaging represents a promising resource for organizations that aim to treat malaria and fight the disease's spread. We look forward to seeing what else texting will do for medicine in the coming years.

About the Author -
Sharon Housley is the VP of Marketing for NotePage, Inc. a software company for communication software solutions. http://www.notepage.net

 


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