Do mobile SMS reminders affect medical treatment?

Evidence from an impact evaluation on malaria medication in Ghana

Speaker: Heather Lanthorn, Evaluation Specialist, 3ie
Date: 14 November, 3.30-5 p.m.
Venue: ISID Complex, 4, Vasant Kunj Institutional Area, New Delhi
Discussant: Simon Brooker, London School of Hygiene and Tropical Medicine
Chair: Beryl Leach, deputy director -- policy advocacy and communication

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Globally, malaria kills between 600,000 and 1.2 million people each year and is a leading cause of sickness and death across much of sub-Saharan Africa. Most killed are young children and pregnant women.

Only one class of antimalarial medication remains fully effective in Africa as a means of curbing this mortality -- artemisinin-based combination therapies (ACTs). Therefore, the appropriate use and completion of ACTs by infected individuals is a critical global health concern.

This randomised-controlled trial (RCT) tests the effectiveness of SMS reminders on increasing patient completion of ACTs in Ghana’s northern region. The data, collected in 2011, coincided with a rapid increases in ACT accessibility (availability and affordability) to patients. This access, however, can only translate into improved health outcomes and a delay in the development of parasite resistance if patients use ACTs -- and use them correctly.

This talk will cover three main aspects of this randomised-controlled evaluation:
• The main result that SMS reminders improved ACT completion by 5 percentage-points, from 61.5 to 66.4 percent, which is significant statistically and as a proof-of-concept for direct-to-patient SMSs in a high-poverty, limited-literacy setting.
• Lessons from implementing this intervention with a variety of ACT providers.
• Lessons for research design from the logistical complexities of this test of a ‘simple’ intervention.

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