In Kenya, mHealth is improving access to information and health service delivery. access.mobile International along with PharmAccess Foundation seeks to understand how to best engage patients and improve health outcomes through mHealth interventions. Together, we conducted a study of SMS-based bulk messaging and vouchers for health care to identify the impact on health-seeking behaviour in Kenya. As presented by at the Global Digital Health Forum, we found a small increase in health visits when sent free consultation vouchers, nearly 90% of those who redeemed vouchers were symptomatic and over 90% sought care in addition to the free consultation.

SMS health tips and vouchers for health care

To better understand what motivates patients to visit a health facility, we worked with six clinics in Kenya to test bulk SMS messages and vouchers. Patients from three facilities received health tips only while the second group of patients from the other three facilities received the same health tips along with a voucher for a free consultation at week two. To ensure access, at week five, the first group was also sent the free consultation vouchers. The clinics used access.mobile’s practice management and patient engagement technology amHealth to track which patients visited the clinic to redeem vouchers.

Small increase in visits due to vouchers

The results are quite positive considering the short time period of the study and the limited number of people that received vouchers who were likely feeling sick at that time. At any given clinic, between 1% and 5% of vouchers were redeemed.

While the use of vouchers was not high, it was noticeable. Vouchers disproportionately motivated people who were symptomatic. As seen in the chart below, 87% of people that redeemed the voucher were symptomatic, the majority of which were very symptomatic.

Surveys afterward found that patients who did not redeem their vouchers simply did not need health services. There was a noticeable increase in patient visits to clinics after voucher messages were sent showing that while sending health information is important, it may not be enough to attract patients to a clinic. Instead, messages should be sent that offer promotional rates.

What it means for business and public health

Ninety-one percent of patients who redeemed vouchers sought care in addition to their free consultation. Patients often ended up spending more than double what the voucher offered. This is important from both a business and a public health perspective. It suggests that sending vouchers benefits the patient and the clinic, improving patient health and health-seeking behaviour but could result in an unintended financial burden.
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