IntroductionIn 2015, as part of the WHO and International Telecommunication Union’s ‘Be Healthy Be Mobile’ initiative using mobile technology to combat non-communicable diseases, the Ministry of Health and Family Welfare and the Ministry of Communication and Information Technology in India developed a short text message-based mobile health programme (the ‘mCessation’ programme) to support tobacco users to quit tobacco use.ObjectivesTo evaluate the effectiveness of the mCessation programme by estimating quit rates and quit attempts among registered subscribers of the programme and to understand subscriber perceptions of the programme.MethodsSubscribers to the mCessation (QuitNow) programme were telephonically interviewed 4–6 months after registration. A total of 12 502 calls were made, and completed responses recorded from 3362 ever tobacco users. A total of 6978 respondents either gave very few responses or refused to participate in the telephonic survey. Never tobacco users (1935) and subscribers to the mDiabetes programme (227) were excluded from the sample.ResultsA large proportion of registrants (1935 out of 12 502 respondents) were found to be never users. The quit rate (estimated as those who stated they had not had any tobacco in the past 30 days at 4–6 months after registering with the programme from the total sample (excluding never smokers and mDiabetes registrants)) was 19%. Sixty-six per cent of registered subscribers who were current tobacco users had made quit attempts in the period between registration and survey. Seventy-seven per cent of respondents reported that the programme was helpful/very helpful to quit tobacco.ConclusionThe mCessation programme has successfully helped tobacco users in India to quit tobacco by motivating and supporting registered participants through mobile text messages.

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Background Tobacco use is associated with exacerbation of tuberculosis (TB) and poor TB treatment outcomes. Integrating tobacco use cessation within TB treatment could improve healing among TB patients. The aim was to explore perceptions of health workers on where and how to integrate tobacco use cessation services into TB treatment programs in Uganda. Methods Between March and April 2019, nine focus group discussions (FGDs) and eight key informant interviews were conducted among health workers attending to patients with tuberculosis on a routine basis in nine facilities from the central, eastern, northern and western parts of Uganda. These facilities were high volume health centres, general hospitals and referral hospitals. The FGD sessions and interviews were tape recorded, transcribed verbatim and analysed using content analysis and the Chronic Care Model as a framework. Results Respondents highlighted that just like TB prevention starts in the community and TB treatment goes beyond health facility stay, integration of tobacco cessation should be started when people are still healthy and extended to those who have been healed as they go back to communities. There was need to coordinate with different organizations like peers, the media and TB treatment supporters. TB patients needed regular follow up and self-management support for both TB and tobacco cessation. Patients needed to be empowered to know their condition and their caretakers needed to be involved. Effective referral between primary health facilities and specialist facilities was needed. Clinical information systems should identify relevant people for proactive care and follow up. In order to achieve effective integration, the health system needed to be strengthened especially health worker training and provision of more space in some of the facilities. Conclusions Tobacco cessation activities should be provided in a continuum starting in the community before the TB patients get to hospital, during the patients’ interface with hospital treatment and be given in the community after TB patients have been discharged. This requires collaboration between those who carry out health education in communities, the TB treatment supporters and the health workers who treat patients in health facilities.

Background: Cervical cancer screening rates in Zambia have remained low for women 25 - 59 years old despite efforts to raise awareness among women using different communication platforms. The mHealth for cervical cancer used mass messaging and was implemented to complement already existing interventions aimed at increasing knowledge levels and the number of women accessing screening services. Methods: A concurrent mixed methods design was used. Quantitative data was collected using telephone interviews with both women and men to whom text messages on cervical cancer screening had been sent. The qualitative data was collected using focus group discussions and key informant interviews, and focused on the implementation process as well as the perceptions and experiences of the users. Qualitative data was analyzed using thematic analysis while quantitative data was analyzed using descriptive statistics (proportions). Results: From the 990 (473 men and 517 women) participants sampled in the survey, only 46% of the women and 34% of men had received the short message services (SMSs). The SMSs resulted into 14% (72) of women going for screening for the first time, and 4% (22) for follow-up screening, totaling 18% (94). The intervention was described as appropriate because it resulted in more awareness about cervical cancer; and the frequency, time of day of transmission, the language and content of the SMSs were perceived good. The challenges experienced include low number of SMSs successfully delivered to the target population (50%), and the high cost of transmission. Conclusion: Despite the challenges experienced, the mCervical cancer intervention showed moderate effectiveness in reaching women and encouraging them to go for first time and follow-up screening.