Medecins Sans Frontieres/Doctors Without Borders (MSF) has completed a pilot project to send appointment reminders by text message to tuberculosis (TB) patients at its Epworth polyclinic in Harare, Zimbabwe.
The pilot project proved a real success, with missed appointments dropping from 15 to just five percent. The system is now being rolled out to patients across the clinic.
Epworth is home to a poor and marginalised community where households of up to 12 people live in tiny, cramped makeshift houses. MSF has worked in the area since 2005, tackling the high prevalence of HIV and TB alongside Zimbabwe’s Ministry of Health and Child Care.
Working with a mobile community
People who live in Epworth usually have no official address and many travel great distances to find work. This becomes a real challenge with HIV and TB patients, who can become sick very quickly if they do not make their regular appointments and pick up their medication.
When MSF UK was approached by a group of software engineers from Random Hacks of Kindness this issue seemed like a great challenge for them to explore. Over a weekend ‘hackathon’ they created a basic version of the text message appointment reminder systems used in the UK. The system was then tested and refined before it was rolled out to a group of patients at the Epworth clinic.
Unexpected benefits
After the system launched some unexpected benefits for patients emerged.
Many patients mentioned that getting time off work to come to their appointments had been difficult in the past. But the text message meant that they could prove to their employer that they had to visit the clinic, without needing to disclose their medical condition.
Robert Makuyana, an MSF nurse at Epworth, highlighted other benefits of the system: “I’ve had quite a few patients tell me that they work far away sometimes and getting a reminder three days before their appointment means they can start making their way back to Epworth in time for their appointment.”
Setting up the pilot project in an area that had intermittent electricity was challenging, but it demonstrated that a system like this can work in a low resource setting and has a real impact on patients.
The team at Epworth are now looking to roll out the system to all TB and HIV patients across the project. -MSF
