Innovative demand creation for HIV testing and counseling using mobile phone SMS among young people in Lusaka and Chongwe districts through “Zambia UReport”
Apparently, trying to convince a young person in Zambia to voluntarily go and get tested for HIV can sometimes be a mathematical and/or scientific endeavor. That is why when we received a request to conduct an SMS campaign to try and influence young people in Lusaka and Chongwe to do just that in June of 2013, we figured it would be a nice challenge and it would be interesting to see the results.
HIV Testing and Counseling (HTC) is ultimately the entry to HIV prevention, treatment and care. Uptake of HTC remains low among adolescents and youths in Zambia. We modeled the use of a free, confidential and interactive mobile phone SMS campaign to generate demand for HTC among young people (UReporters) in Zambia.
Yes, I just made it all sound like it was a straight-forward and easy process. It was anything but. For starters, how do you effectively fit a campaign message into the 160 characters that are required for SMS? Some slightly smarter phones now accept more than that but UReport is built to work on even the simplest of phones so this was a consideration. We spent hours editing and re-editing all the original messages to meet this requirement. By the time we were done I’m pretty sure I could recite all the messages backwards!
Secondly, we needed to make the language correct but at the same time interesting enough to get a young person to respond and not hit the delete button as soon as they received it. For this, we created a closed user group on Facebook with about 30 young UReporters who vetted each message and changed some, threw out others and finally came up with the final messages. It worked. We got a really good response rate to the polls we conducted.
There was also the aspect of figuring out how to get the system to be clever enough to group people into groups based on their responses so that the messaging could be targeted to an individual UReporter. We were not going to send 10 messages encouraging a person who tested last week to go and get tested! But that is a story for another day.
Long story short (well, somewhat short), we sent out a poll asking if a UReporter had been for testing in the last twelve months, had the system group people based on the answer to that question, then send targeted messages every two days for two weeks to the ones who had not been, giving them information on why it was important to get tested and encouraging them to go and get tested. Counselors were on hand to respond to all the questions that came in from UReporters and also recommended places where young people could get tested that were nearby to where they lived.
Two weeks after the campaign, we asked UReporters who had initially said they had not been for testing if they had gone to test for HIV during the campaign period. Among the age group 15 – 19 years, over 42% reported having gone for testing. As someone I know put it, online businesses would be envious of such a high click-through rate to our ‘ads’ for HIV testing and counseling!
We also asked the UReporters who went for testing whether they liked the services and the ones who did not go why they didn’t. Of those that didn’t go, 58% said they had been busy with school and work, 17% because they were scared and 18% because they thought were sure they were not HIV-positive. Of the ones who went, 93% liked the services so that was good to hear.
If you live in Zambia and wish to join the Zambia UReport community, text the word “JOIN” to 878 on all three networks. All SMS’ are FREE and the counsellors are on hand 24/7 to respond to your questions.
By Priscilla Chomba-Kinywa
Innovation / T4D Officer, UNICEF Zambia
For more details on this campaign, click here.