Large numbers of infants in Zambia are infected with HIV in the womb, at delivery, or when breastfeeding. Among the infants who contract the virus, about 30% die before the age of one and 50% before the age of two, if no interventions for paediatric HIV care and support are provided. Survival rates are up to 75% higher for HIV-positive newborns that are diagnosed and begin treatment within their first 12 weeks of life.
Exposed infants need a special type of HIV detection test, which differs from the standard antibody test for adults and older children because infants still have their mother’s antibodies in their bloodstream. Transport of the samples and the test results, especially for rural clinics, is one of the biggest obstacles facing early infant diagnosis and initiation of antiretroviral therapy for HIV-positive infants, significantly reducing their chance of survival.
Project Mwana, a mobile health (mHealth) initiative implemented by the Ministry of Health with support from UNICEF and collaborating partners has reduced delays in transmitting results from the HIV test laboratories to rural health facilities via instant SMS message. SMS delivery of results can increase turnaround times by 50% on average, with a greater positive impact in rural facilities. Mwana cuts the total time from 66 days down to 33 on average. More than that, it cuts the time for the return journey from approximately 30 days down to seconds.
Project Mwana aims to:
- Strengthen early infant diagnosis, aiming both to increase the number of mothers receiving results and to reach mothers in a faster, more efficient manner using the Results160 SMS application.
- Improve the rate of postnatal follow-up, increasing the number of birth registrations for clinic and community births, while also raising the number of clinic visits for mothers through community health worker tracing using the RemindMi application.
The system was designed using the free and open source code-base RapidSMS and developed with its users, the community health workers, to ensure a real life workable system. Zambia is in the process of scaling up the system aiming to achieve national scale with health facilities offering early infant diagnosis services.