Can We Text Our Way to Behavior Change?

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Jason Hahn is Business Development Manager ICT Innovation, at Grameen Foundation Seattle.

Randomized Control Trials (RCTs) that show the evidence of mobile phone based development interventions do not come out every day.  At Grameen Foundation we look forward to them as they can help us shape our interventions with fact-based evidence of other interventions that worked – especially when they show an almost 25% change in behavior.

It was with great interest to read about one that did just that in a recent Lancent article on "the effect of mobile phone text-message reminders on Kenyan health worker’s adherence to malaria treatment guidelines".  The article written by Dejan Zurovac, Raymond Sudoi, Willis Akhwale, Moses Ndiritu, Davidson Hamer, Alexander Rowe, Robert Snow from the Kenya Medical Research Institute – Wellcome Trust Research Program in Nairobi illustrated their findings after they text messages to health care workers encouraging them to follow treatment guidelines for pediatric malaria.  They sent two messages every work day for six months to rural health workers in 11 districts in Kenya.  The messages contained treatment guidance and an inspirational quote.  I’ve excerpted from the article one of the messages that was sent on Monday mornings:

Check ALL sick children

Health care workers who received the messages improved their management of pedatric malaria by 23.7% immediately after they received the six month intervention and by 24.5% when researchers went back 6 months later to check on them.  This compares favorable with a 9% success rate for traditional health care worker performance improvement programs which don’t use SMS.   The research this team did builds on other research that showed behavior change triggered by SMS messages among people living with HIV who were taking anti-retroviral medication for HIV.


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