Improving Health Worker Adherence to Malaria Treatment Guidelines in Papua New Guinea: Feasibility and Acceptability of a Text Message Reminder Service

Abstract

The aim of this study is to assess whether a text message reminder service designed to support health worker adherence to a revised malaria treatment protocol is feasible and acceptable in Papua New Guinea (PNG). The study took place in six purposively selected health facilities located in the Eastern Highlands Province (EHP) of PNG. Ten text messages designed to remind participants of key elements of the new NMTP were transmitted to 42 health workers twice over a two week period (two text messages per day, Monday to Friday) via the country’s largest mobile network provider. The feasibility and acceptability of the text message reminder service was assessed by transmission reports, participant diaries and group discussions. Findings indicate that the vast majority of text messages were successfully transmitted, participants’ had regular mobile phone access and that most text messages were read most of the time and were considered both acceptable and clinically useful. Nevertheless, the study found that PNG health workers may tire of the service if the same messages are repeated too many times and that health workers may be reluctant to utilize more comprehensive, yet complementary, resources. In conclusion, a text message reminder service to support health worker adherence to the new malaria treatment protocol is feasible and acceptable in PNG. A rigorous pragmatic, effectiveness trial would be justified on the basis of these findings.

Developing and Pretesting a Text Messaging Program for Health Behavior Change: Recommended Steps

“…Consideration also needs to be given to what will trigger the messages (ie, date of enrollment or behavior change, in a weekly cycle). In Papua New Guinea, a text messaging program aimed at providers treating malaria patients was found to be most acceptable in the mornings and during work hours, to help facilitate the usefulness of the reminders [ 33 ]. While 2 messages per day were found to be acceptable, providers did not like their repetitiveness over time [ 33 ].…”

Health systems readiness and management of febrile outpatients under low malaria transmission in Vanuatu

“…The effective supportive supervision requires adequate human and financial resources, and in a country such as Vanuatu, with shortage of clinical personnel, difficult and expensive physical access to peripheral facilities, significant further investments are required to implement cost-effective supervision. Vanuatu has, however, resolved communication problems through optimum mobile phone network and ownership of phones, and in such settings interventions using, e.g., regular text-message information sent to health workers [ 30 , 31 ], may complement existing interventions and present another strategy to provide ongoing support to health workers to re-inforce malaria testing and a minimum set of clinical standards. Yet, whichever interventions are implemented, appropriate management of non-malaria febrile illnesses and rational use of antibiotics should be an integral part of the quality improvement.…”

Evaluation of a mHealth Data Quality Intervention to Improve Documentation of Pregnancy Outcomes by Health Surveillance Assistants in Malawi: A Cluster Randomized Trial

“…We pre-tested the SMS and made deliberate changes to the initial design of the SMS intervention based on HSA feedback for more variety of SMS content and increased frequency. Robust formative research elaborating recipient perceptions of SMS intervention design and feedback mechanisms may facilitate the design and implementation of an effective mHealth intervention specific to the needs of the SMS recipients [ 45 , 46 ].…”