Zimbabwe – Improving adherence to antiretroviral therapy through SMS in Kadoma.

Date: August 3, 2018
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The good practice involves administering of cell phone supported SMS messaging to standard care on adherence of women receiving antiretroviral therapy ART in Rimuka Kadoma. According to the patient status register at Rimuka Integrated TB and HIV/AIDS clinic as at 04 November 2016, 3644 people are living with HIV/AIDS of which 64% are women. The women are receiving weekly standardized motivational text message as well as normal care.

The method of measuring adherence is a combination of self-report, visual analogue scale (VAS), pill identification tests and pill counts. The good practice is sought to delay disabilities and death helping infected persons to remain productive for longer periods. In addition to that the good practice will reduce the number of orphans who will lose their mothers due to HIV/AIDS. The innovation in the good practice is the use of mobile technology to improve adherence to ART.

This projects sets out to improve adherence to antiretroviral therapy amongst women seeking care at Rimuka Integrated TB/HIV care Clinic (Kadoma) through the use of cell phone short message reminders. It aims to compare the effectiveness of cell phone-supported SMS messaging plus HIV standard care and HIV standard care alone on adherence among women seeking HIV care at Rimuka Integrated TB/ HIV care Clinic. It also opts to investigate the impact of SMS on immunological outcomes among clients seeking HIV care at the Clinic.

Of the direct beneficiaries, 3644 participants were reached. The government, then, allocated $25000 to support this project. People are able to receive sufficient medical supplies.

Challenges faced were that some of the clients do not have cell phones hence other methods of improving adherence are being used which include the adherence counselling, improving health professional relationship with clients as well as knowledge on the importance of adherence. Some of the women were not willing to be reminded hence it was solved by raising awareness.

Women have been empowered through receiving mobile health technology in the form of motivational Short Message Service reminder in order to improve adherence. Women have been empowered because improvement in the adherence to ART will assist in preventing OI infections and cancers.

Moffat Matambo, says, “My wife had no phone so I bought her one so that she could be able to receive a short message service reminder on her mobile phone. I strongly support the initiative, well done health department.”

Men supported the initiative by allowing their women to receive short message service reminders on their mobile phones. Some of the men actually bought cell phones for their wives so that they could receive SMS. Men explained that it was important because at times they would forget to take their medication if they are tired coming from work hence their wives would remind them. Spouses are now accompanying each other to collect medication; previously most men would send their wives to collect medication for them.

Women found out that receiving SMS in order to improve adherence to antiretroviral therapy motivated them and they felt encouraged. They explained that improvement in adherence would help them to look after their families, delaying disabilities and deaths helping them to remain productive for longer periods.

Women can actually perform better than men especially when they are empowered and given the platform. Involvement of women through receiving short message service reminders motivates them at the same time improving adherence.

Through providing a platform for others to come and learn what we have achieved .There are plans to implement the project in all the other clinics of Kadoma. Besides that the project can easily be replicated anywhere else.

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