Text Messaging Improves Attendance at Post-Operative Clinic Visits after Adult Male Circumcision for HIV Prevention in Kenya {a call for votes}

It’s really cool to see chaps I went to school with blaze the trial in their chosen filed. Thomas A. Odeny, M.B.Ch.B., M.P.H, was selected as one of the top 30 finalists in the “Top 11 Mobile Health Innovators in 2011” by Health Unbound. To make it to the next round is by way of public voting before a final round done by judges. In order to vote, you will need to register online. It will take you no more than 3 minutes to register and vote – please take the time.

A summary of what got him to the top 30 is below.

The WHO recommends that male circumcision services should include routine follow-up visits within seven days of the procedure. A high proportion of men fail to return for scheduled post-operative visits, missing oppportunities for detection of adverse events, additional counseling, and monitoring of wound healing. In sub-Saharan Africa, SMS has been shown to be efficacious in improving various health outcomes. As programs for male circumcision for HIV prevention are rapidly growing in sub-Saharan Africa, and hundreds of thousands of men undergo the procedure, we designed and successfully evaluated a low-cost SMS system to improve health outcomes after male circumcision.

Scalability and Sustainability

Our SMS system was inexpensive. The system sent out thousands of intervention text messages at an average total cost of US$25 per month. Because it is automated and software-based, neither additional human resources nor new physical infrastructure are needed. It also works with different African languages. Our low-cost intervention can be easily integrated into male circumcision programs in sub-Saharan African. To our knowledge, ours is the first study to demonstrate an improvement at such a low monthly cost, with no potential additional cost even if it were to be scaled-up to the millions of men undergoing circumcision for HIV prevention.

Health Systems

With on-going efforts to provide adult male circumcision to millions of men across sub-Saharan Africa, post-operative follow-up will likely be a key element of such large programs. Our SMS system may lead to substantial benefits if applied to the millions of men willing to undergo circumcision for HIV prevention .


We conducted a randomized controlled trial to determine the effect of text messages sent to men after undergoing circumcision on attendance of the scheduled seven-day post-operative clinic visit. In this randomized trial, SMS text messaging significantly increased attendance at the seven-day post-operative clinic visit compared to a control condition with standard care. In the intent-to-treat analysis, we found that 65% of men returned in the intervention arm compared to 60% in the control arm.

Geographic Region

Programs are being scaled up to provide voluntary medical male circumcision for HIV prevention in several countries in sub-Saharan Africa. These programs, targeting millions of uncircumcised men, are rapidly growing in sub-Saharan Africa, and hundreds of thousands of men are undergoing the procedure. It will be important to introduce low-cost, evidence-based strategies to improve health outcomes after male circumcision, such as the one rigorously and successfully evaluated by our study.

Click here to vote for Thomas Odeny

An Africa based entrepreneur in the pursuit of opportunities without regard to resources currently controlled striving to build services that have real-world value for my beloved continent and beyond while having fun along the way.

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