With the remote delivery of health care is quintessential

With their ubiquitous presence and ever
decreasing costs of owning a mobile phone and network services in resource
limited settings, the usage of devices for the remote delivery of health care is
quintessential in the modern day context. Tuberculosis, a chronic disease can
be significantly associated with barriers like stigma, lower rates of long term
medication compliance, privacy concerns and transport limitations for in-person
DOT regimens and device based programs can help overcome these barriers, while
also serving as a financially effective solution. Motivational health messages
and language customized medication reminders can be made available to a larger
and a more diverse population. Several studies have consistently shown the
benefits of phone based interventions and illustrate the growing popularity of digitalizing
health care, particularly in resource limited settings.


Medication reminders:

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These reminders can be sent through mobile
phones either as a voice call or SMS message, and would help increase
medication compliance in chronic communicable and non communicable diseases. A
majority of our respondents agreed to receiving reminders for their illness,
without such an intervention being considered an intrusion into their privacy.


Preferred type of communication: SMS vs
Voice calls

A study conducted at Lesotho, Africa
reported high uptake of SMS interventions with 92.1% of HIV/TB patients choosing
to receive SMS messages as an acceptable form of health care delivery system 18. Contrary
to studies like this, a majority of our study participants preferred voice
calls in comparison to SMS. Young, employed and educated respondents were more
likely to use SMS as a preferred mode of communication. The employed participants
preferred reading an SMS as opposed to answering a phone call most probably due
to lesser availability of time, higher literacy rates, privacy concerns and
ease of use. Another possible reason for the low uptake of SMS based reminders
could be the usual language of communication they have been accustomed to
receiving such messages, which is English. Text reminders could be made
available in regional languages which would target the audience with higher

It has been found that SMS messages are an
acceptable form of health care delivery elsewhere, but nonetheless, in the
Indian context we recommend voice calls as the preferred mode of communication.

An alternate to this would be the usage of pictorial text messages that could
help overcome the language barrier.