Acceptability, feasibility and implementation challenges of phone-based reminder system for patient-centered TB treatment in Northwest Ethiopia
Kassahun Dessie Gashu1*, Kassahun Alemu Gelaye2, Richard Lester3, Binyam Tilahun1

1Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 3University of British Columbia, Research Pavilion, Rm 566, 828 W 10th, Vancouver, BC, V5Z 1 M9, Canada

*Corresponding author
Postal address: 196, Gondar; Email: kassahundessie@gmail.com; Telephone: +251912071344

ABSTRACT
Background: mHealth technologies showed a promising effect on improving adherence to Tuberculosis (TB) treatment. However, its usability was limited due to various factors. This study aimed to explore acceptability, feasibility and implementation challenges of phone-based medication and refilling reminder systems for home-based TB treatment.
Methods: We implemented a web-based system to remind TB patients for their daily medication plus weekly refilling of their pills for a-four months continuation phase from July 2019 to December 2019 . We explored participants’ lived experiences while receiving reminder messages during our interventional study. In-depth interviews with 15 patients from different health facilities of eight districts in Central Gondar Zone and Gondar town, northwest Ethiopia. Additionally, we obtained a message delivery report from Ethio telecom and captured observational data during the implementation of the new system. Interpretation and analysis were conducted using framework analysis. We triangulated with quantitative data generated from Ethio telecom.

Result: Many participants reported that they were happy with the reminder system. All participants who received the messages replied as the system was useful. Overall, 84.6% of daily and weekly reminder messages were delivered to the patients. Four patients did not receive any message at all. The majority mentioned that they often notice the daily notification and many of them open and see the messages. Participants reported poor telecommunication network, fluctuating electric power, and variation in patient’s preference on time of message delivery as major challenges of implementation.
Conclusion: Mobile phone-based reminder system was found to have promising acceptability and feasibility for supporting home-based TB treatment during the continuation phase. However, unreliable access to power and network and variation in patient’s preferences on delivery time were still challenges in the implementation of the system.

Kassahun Dessie Gashu MSc

University of Gondar

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