Text scheme helps Papua New Guinea health workers

Transcript

Health workers in Papua New Guinea have been trialing a new text message scheme to ensure they're adhering to new malaria treatment protocols.

The protocols -- in line with the World Health Organisation's -- were put in place in 2011 to adopt a more rigorous process when diagnosing and treating malaria patients.

Researchers from the University of Auckland looked into the feasibility of using text messages to reach health workers in more isolated areas of the country.

A population health expert and Associate Professor, Dr Chris Bullen, told Sophie Leggett about the impact of the service.

Chris Bullen: There's a real problem when you're trying to train remote, rural health workers in countries like Papua New Guinea. You tend to have to bring them back into the centre somewhere, at enormous cost and disruption, for often a minimum of a week, because of the infrequency of flights, or the difficulties of weather. The other factor is the availability, now, of mobile phones - everyone seems to have one - and the coverage of the service is very, very good.

Sophie Leggett: What kind of text messages are being sent?

CB: Well, there's only ten messages, and though we piloted this over only a couple of weeks, and we sent messages twice a day, so as not to be too irritating, and they were based on the new treatment regime that's been instituted in Papua New Guinea for diagnosis and management of malaria. The new regime has these, what is called, rapid diagnostic tests - point of care testing kits - where you can actually, with the patient in front of you, do a little blood test and identify whether they might have malaria or not, or if you're in a bigger hospital or health centre, you may be able to do a microscopic examination of a blood drop and look for malaria and only treat if the test is positive, rather than just treating anybody with a fever. So, it's much more specific treatment. So, this is quite a big change for health workers who may have been working for five, ten, twenty years out in the field, often poorly supported, and so, what we wanted to see was, could this text messaging be a way of introducing a change in their treatment regime that would be acceptable and lead to, you know, new compliance or adherence to the new protocol.

SL: What has the response been from health workers receiving the messages?

CB: Actually, remarkably positive. We were quite surprised. So, again, this was a pilot study. We tried both remote, rural, and some peri-urban health centres, and we found universally it was very welcomed. So, it seemed a natural way to make contact with them. There's a big future in this. It's been tried with women in labour who might need emergency help. But this is the first time, to my knowledge, that it's been used to train health workers in a new malaria management protocol.

SL: Obviously the change of guidelines happened in 2011, what have been the differences since then, in terms of how it's been treated?

CB: The change in practice, in relation to the change in protocol hasn't been as rapid as was hoped, because the implementation of the new protocol has not been supported perhaps as well as it might have been through training. So this was one attempt to try and do it a little differently. My understanding is there's been a sort of disappointing level of uptake of adherence to the new malaria treatment protocols, so, I think, you know, we need to be more creative about the way we do this.