Exploring the use of mobile phone technology for the enhancement of the prevention of mother-to-child transmission of HIV program in Nyanza, Kenya: a qualitative study

BMC Public Health

Seble Kassaye¹  Martin Sirengo⁴  Rogers Simiyu²  John Ong’ech³  Larissa Jennings⁵ 

[1] Department of Medicine, Division of Infectious Diseases, Georgetown University, 3800 Reservoir Road, 5th Floor PHC Building, Washington, D.C. 20007, USA;Elizabeth Glaser Pediatric AIDS Foundation, ABC Place, 4th Floor Building 2, Waiyaki Way Westlands, P. O. Box 13612-00800, Nairobi, Kenya;Kenyatta National Hospital, University of Nairobi, Hospital Road, P.O. Box 20723, Nairobi, Kenya;National AIDS/STD Control Programme, Ministry of Health, P.O. Box 19361–00200, Nairobi, Kenya;Department of International Health, Social and Behavioral Interventions, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E5038, Baltimore, MD 21205, USA

关键词: Male involvement;    PMTCT;    Prevention of mother-to-child transmission;    HIV;    SMS;    Short message service;    mHealth;    Mobile phone;   

Others  :  1161502
DOI  :  10.1186/1471-2458-13-1131

 received in 2013-04-06, accepted in 2013-11-26,  发布年份 2013

【 摘 要 】

Background

Community-based mobile phone programs can complement gaps in clinical services for prevention of mother-to-child transmission (PMTCT) of HIV in areas with poor infrastructure and personnel shortages. However, community and health worker perceptions on optimal mobile phone communication for PMTCT are underexplored. This study examined what specific content and forms of mobile communication are acceptable to support PMTCT.

Methods

Qualitative methods using focus groups and in-depth interviews were conducted in two district hospitals in Nyanza Province, Kenya. A total of 45 participants were purposefully selected, including HIV-positive women enrolled in PMTCT, their male partners, community health workers, and nurses. Semi-structured discussion guides were used to elicit participants’ current mobile phone uses for PMTCT and their perceived benefits and challenges. We also examined participants’ views on platform design and gender-tailored short message service (SMS) messages designed to improve PMTCT communication and male involvement.

Results

Most participants had access to a mobile phone and prior experience receiving and sending SMS, although phone sharing was common among couples. Mobile phones were used for several health-related purposes, primarily as voice calls rather than texts. The perceived benefits of mobile phones for PMTCT included linking with health workers, protecting confidentiality, and receiving information and reminders. Men and women considered the gender-tailored SMS as a catalyst for improving PMTCT male involvement and couples’ communication. However, informative messaging relayed safely to the intended recipient was critical. In addition, health workers emphasized the continual need for in-person counseling coupled with, rather than replaced by, mobile phone reinforcement. For all participants, integrated and neutral text messaging provided antenatally and postnatally was most preferred, although not all topics or text formats were equally acceptable.

Conclusions

Given the ubiquity of mobile phones in Kenya and current health-related uses of mobile phones, a PMTCT mobile communications platform holds considerable potential. This pre-intervention assessment of community and health worker preferences yielded valuable information on the complexities of design and implementation. An effective PMTCT mobile platform engaging men and women will need to address contexts of non-disclosure, phone sharing, and linkages with existing community and facility-based services.

【 授权许可】

   
2013 Jennings et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Global Report: UNAIDS Report on the Global AIDS Epidemic. 2010. [Joint United Nations Programme on HIV/AIDS (UNAIDS)] http://www.unaids.org/documents/20101123_GlobalReport_em.pdf webcite
• [2]Townsend CL, Cortina-Borja M, Peckham CS, de Ruiter A, Lyall H, Tookey P: Low rates of mother-to-child transmission of HIV following effective pregnancy interventions in the United Kingdom and Ireland, 2000–2006. AIDS 2008, 22:973-981.
• [3]Towards universal access: scaling up priority HIV/AIDS interventions in the health sector. Progress Report 2009. [World Health Organization, United Nations Children’s Fund] http://www.who.int/hiv/pub/tuapr_2009_en.pdf webcite
• [4]Brown T, Bukenya G, Ostfeld S: Empowering health workers with new technologies to end pediatric HIV/AIDS. 2009. [Global AIDS Alliance] http://aidsalliance.3cdn.net/fc361fa6298013c139_flm6bxttf.pdf webcite
• [5]GSMA: Sub-Saharan Africa Mobile Observatory 2012. 2013. GSMA. Deloitte. Pgs. 1–85. http://www.gsma.com/publicpolicy/wp-content/uploads/2013/01/gsma_ssamo_full_web_11_12-1.pdf webcite
• [6]Chang LW, Kagaayi J, Nakigozi G, Packer AH, Serwadda D, Quinn TC, Gray RH, Bollinger RC, Reynolds SJ: Responding to the human resource crisis: peer health workers, mobile phones, and HIV care in Rakai, Uganda. AIDS Patient Care STDS 2008, 22(3):173-174.
• [7]Lester RT, Gelmon L, Plummer FA: Cell phones: tightening the communication gap in resource-limited antiretroviral programmes? AIDS 2006, 20:2242-2244.
• [8]Puccio J, Belzer M, Olson J, Martinez M, Salata C, Tucker D, Tanaka D: The use of cell phone reminder calls for assisting HIV-infected adolescents and young adults to adhere to highly active antiretroviral therapy: a pilot study. AIDS Patient Care STDS 2006, 20(6):438-444.
• [9]Lester R, Ritvo P, Mills E, Kariri A, Karanja S, Chung MH, Jack W, Habyarimana J, Sadatsafavi M, Najafzadeh M, Marra CA, Estambale B, Ngugi E, Ball TB, Thabane L, Gelmon LJ, Kimani J, Ackers M, Plummer FA: Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1): a randomized trial. Lancet 2010, 376(9755):1838-1845.
• [10]Pop-Eleches C, Thirumurthy H, Habyarimana J, Zivin JG, Goldstein MP, de Walque D, MacKeen L, Haberer J, Kimaiyo S, Sidle J, Ngare D, Bangsberg DR: Mobile phone technologies improve adherence to antiretroviral treatment in a resource-limited setting: a randomized controlled trial of text message reminders. AIDS 2011, 25(6):825-834.
• [11]Crankshaw T, Corless I, Giddy J, Nicholas PK, Eichbaum Q, Butler LM: Exploring the patterns of use and feasibility of using cellular phones for clinic appointment reminders and adherence messages in an antiretroviral treatment clinic, Durban, South Africa. AIDS Patient Care and STDS 2010, 24(11):729-734.
• [12]Shet A, Arumugam K, Rodrigues R, Rajagopalan N, Shubha K, Raj T, D’Souza G, De Costa A: Designing a mobile phone-based intervention to promote adherence to antiretroviral therapy in South India. AIDS Behav 2010, 14(3):716-720.
• [13]Msuya SE, Mbizvo EM, Hussain A, Uriyo J, Sam NE, Stray‒Pedersen B: Low male partner participation in antenatal HIV counselling and testing in northern Tanzania: implications for preventive programs. AIDS Care 2008, 20(6):700-709.
• [14]Reece M, Hollub A, Nagami M, Lane K: Assessing male spousal engagement with prevention of mother‒to‒child transmission (pMTCT) programs in western Kenya. AIDS Care 2010, 22(6):743-750.
• [15]Aarnio P, Olsson P, Chimbiri A, Kulmala T: Male involvement in antenatal HIV counseling and testing: exploring men’s perceptions in rural Malawi. AIDS Care 2009, 21(12):1537-1546.
• [16]Kenya National Bureau of Statistics (KNBS) and ICF Macro. 2010: Kenya Demographic and Health Survey 2008–09. Calverton, Maryland: KNBS and ICF Macro; http://www.measuredhs.com/pubs/pdf/FR229/FR229.pdf webcite
• [17]2009 HIV Service Statistics: based on in-depth review of HIV Data Sources, February-June 2010. Kenya Ministries of Health; 2010. [National AIDS & STI Control Programme M&E Department Report]
• [18]Kenya Economic Update. Still standing: Kenya’s slow recovery from a quadruple shock. 1st edition. 2009. http://siteresources.worldbank.org/INTKENYA/Resources/ webcite Kenya_Economic_Update_Dec_2009-full.pdf
• [19]Boyen H: Information at the Grassroots: Analyzing the media use and communication habits of Kenyans to support effective development. Kenya: Africa Development Research Series; [Audience Scapes] http://audiencescapes.org/sites/default/files/AudienceScapes%20Kenya%20 webcite Survey%20Research%20Report%202010.pdf