Lamanna Camillo, Byrne Lauren
Division of Emergency Medicine, University of Cape Town, Cape Town, South Africa.
Department of Emergency Medicine, University of Sydney, Sydney, Australia.
Pan Afr Med J. 2019 May 22;33:50. doi: 10.11604/pamj.2019.33.50.16318. eCollection 2019.
The World Health Organization estimates that up to half of vaccines are wasted, however only a minority of mHealth programs in Africa have been directed at vaccine supply chain optimisation. We piloted a novel mHealth solution dependent only on short message services (SMS) technology that allowed workers in rural health centres in Zambia to report vaccine stock levels directly to an online platform. Small airtime incentives were offered to encourage users to engage with the system, as well as weekly reminder messages asking for stock updates.
The primary outcome measured was the percentage-of-doses-tracked, calculated over the study period. Each vaccine box was randomly allocated to offer either a standard or double airtime incentive and either weekly or daily reminders, in a 2 x 2 design; ANOVA was used to calculate if any of these factors affected time-to-reply.
Over the study period, the total percentage-of-doses-tracked was 39.9%. Within the subset of users who sent at least one message to the platform, the percentage-of-doses-tracked was 93.8%. There was no significant difference in average time-to-reply between the standard airtime incentive and double airtime incentive groups, nor was there a significant difference between the standard reminder and daily follow-up reminder groups.
This pilot study found that in an active subgroup of health workers, an incentivised mHealth solution was able to collect tracking data for 93.8% of doses. More research is needed to identify methods to encourage healthcare workers to engage in timely stock reporting practices.
世界卫生组织估计，高达一半的疫苗被浪费，然而在非洲，只有少数移动健康项目旨在优化疫苗供应链。我们试点了一种仅依赖短信技术的新型移动健康解决方案，该方案使赞比亚农村卫生中心的工作人员能够直接向在线平台报告疫苗库存水平。提供少量通话时长激励措施以鼓励用户使用该系统，同时每周发送提醒消息要求更新库存。
测量的主要结果是在研究期间计算出的追踪剂量百分比。每个疫苗盒被随机分配，采用2×2设计，提供标准或双倍通话时长激励以及每周或每日提醒；使用方差分析来计算这些因素是否影响回复时间。
在研究期间，追踪剂量的总百分比为39.9%。在至少向平台发送一条消息的用户子集中，追踪剂量的百分比为93.8%。标准通话时长激励组和双倍通话时长激励组之间的平均回复时间没有显著差异，标准提醒组和每日跟进提醒组之间也没有显著差异。
这项试点研究发现，在积极参与的卫生工作者子群体中，一种有激励措施的移动健康解决方案能够收集93.8%剂量的追踪数据。需要更多研究来确定鼓励医护人员及时进行库存报告的方法。
