Innovative Use of Cellphone Technology for HIV/AIDS Behaviour Change Communications: Three Pilot Projects

Posted by MarkWeingarten on Apr 16, 2011
Innovative Use of Cellphone Technology for HIV/AIDS Behaviour Change Communications: Three Pilot Projects data sheet 1618 Views
de Tolly, Katherine and Helen Alexander
Publication Date: 
Jan 2009
Publication Type: 
Report/White paper

The opportunities in South Africa for using mobile technologies to support initiatives in the HIV/AIDS sector are enormous. A huge number of people have cellphone access, and there are a range of innovative ways in which cellphones can be used to support treatment, disseminate information, provide anonymous counselling, gather data and link patients to services. Cell-Life is an NGO based in Cape Town, South Africa, that seeks to improve the lives of people infected and affected by HIV through the appropriate use of technology. This paper describes three pilot interventions that use cellphones for behaviour change communication, ie that are experimenting with different cellphone technologies to disseminate information, undertaken as part of Cell-Life’s Cellphones4HIV project: ARV adherence SMSs, USSD content delivery and content delivery via MXit. Challenges around measuring impact in behaviour change communications are briefly discussed, and some of Cell-Life’s upcoming initiatives are outlined.

Improving Efficiency of Monitoring Adherence to ARV at PHC Level: Case Study of Introduction of Electronic Technologies in SA

Posted by MohiniBhavsar on Aug 24, 2010
Improving Efficiency of Monitoring Adherence to ARV at PHC Level: Case Study of Introduction of Electronic Technologies in SA data sheet 2166 Views
Xanthe Wessels; Nicoli Nattrass; Ulrike Rivett
Publication Date: 
Oct 2007
Publication Type: 
Journal article

This paper presents a case study of the efficiency gains resulting from the introduction of electronic technologies to monitor and support adherence to highly active antiretroviral therapy (HAART) in Guguletu, South Africa. It suggests that the rollout of HAART to such resource-poor communities can be assisted significantly by the introduction of modified cellphones (to provide home based support to people on HAART and improve the management of adherence data) and simple barcoding and scanning equipment (to manage drug supplies). The cellphones have improved the management of information, and simplified the working lives of therapeutic counsellors, thereby enabling them to spend less time on administration and to devote a constant amount of time per
patient even though their case loads have risen threefold. It has helped integrate the local-level
primary health service provision of HAART with the kind of centralised data capture and analysis
that could potentially support a national HAART rollout.

RedChatZone: HIV Counselling via Mobile Instant Messaging Chat

Posted by kdetolly on Aug 13, 2010
RedChatZone: HIV Counselling via Mobile Instant Messaging Chat data sheet 6924 Views

In South Africa, the number of cellphones greatly outweighs the number of landlines. The National Aids Helpline (NAHL) is free to call from a landline, but regular cellphone rates apply. This makes the NAHL expensive to use from a cellphone, or people have to make use of public phones which are often within earshot of others.

Cell-Life and LifeLine worked together to make HIV counselling more accessible to young South Africans in a medium which is comfortable and familiar to them. Marlon Parker, who started the successful Angel drug counselling service on MXit, was brought in to implement a similar system.

MXit is a very popular downloadable (instant messaging) chat application, where users can add contacts and text/chat to each other at a very low cost. Without getting into a technical description of the system, here is the basic outline of how the service was created:

Basic Information
Organization involved in the project?: 
Project goals: 

The main goal of this project was to create a mobile-based platform for youth and young adults to learn more about HIV and get support by offering them the ability to communicate anonymously and privately with a trained counselor at a very low cost.

Brief description of the project: 

This project has enabled MXit users to have a conversation with a trained counsellor on their cellphone at a very low cost (around $0.01 in data costs). This has made HIV counselling more accessible and private to users, and has made the counselling process more efficient.

Target audience: 

The 18 million MXit users; generally South Africans between the ages of 12 and 35.

One counsellor can counsel many clients at the same time
Detailed Information
Mobile Tools Used: 
Length of Project (in months) : 
What worked well? : 

Mobile text-chat is an ideal way of providing HIV counselling: it's cheap for users; people can get counselling from anywhere (like their bedroom); it's efficient for providers (as counsellors can counsel many people at the same time); and it's an appropriate way of getting youth to talk about HIV.

Research has shown that users sometimes struggle to call the National AIDS Helpline from a landline because it's difficult to talk about certain things for fear of someone overhearing. They felt more comfortable using the service on a cellphone as it would seem like they were just chatting with a friend on MXit.

The MXit "splash screen" advertising used on National AIDS Day (1st December 2009) increased the use of the service by roughly 4000%. There were even more people queuing, though unfortunately there were not enough counsellors to handle the demand.

Training counsellors to understand "chat" language allowed them to communicate on the same level as the users. Once they were used to text-based counselling, they were able to handle up to 10+ conversations at the same time. Also, due to the less personal nature of chat, counsellors found that users would get to the point far quicker.

Hoax calls are a big problem for South African helplines; the National AIDS Helpline find that up to 80% of calls are hoax, which wastes a lot of counsellor time. On MXit, this decreased dramatically, and the few that there are are easy to deal with as the counsellor can ignore them and carry on with their other conversations. A possible reason for the decrease in hoax calls is that this costs the user a small amount of airtime that could rather have been spent on chatting with friends.

Below are some other features of the system:

  • It’s very cheap to use: a counselling session will cost the user about US$0.01 in airtime.
  • Counsellors can view the chat history of clients, removing the need for the client to repeat ground already covered in previous counselling sessions.
  • Usage statistics can be obtained as and when needed, making staff and service management easier.
  • The conversation text can be made available for analysis (though privacy also needs to be taken into consideration).
  • Counselling can be provided from any computer connected to the internet, saving on call-centre infrastructure costs.
What did not work? What were the challenges?: 

Currently there are only 1-5 counsellors available between 1pm and 3pm. Whilst for most days this is fine (the average number of conversations in a 2-hour session is 46), on days where there have been large numbers of conversation requests (due to advertising the service), the counsellors have not been able to meet the demand. This could easily be fixed by employing a more counsellors, however there are budget constraints preventing this.

EMIT: Mobile Monitoring and Evaluation

Posted by kdetolly on Apr 28, 2010
EMIT: Mobile Monitoring and Evaluation data sheet 4476 Views

System Description

EMIT is an application that allows facilitators to capture field data on cellphones and submit it via GPRS to a centralised database. Surveys are customised and data is monitored, verified and prepared for analysis in real time. Read more here.

From Pilot to National

The pilot was performed with the Community Media Trust (CMT), who used EMIT as a monitoring and evaluation (M&E) tool to capture information on their HIV prevention and treatment literacy sessions in clinics, their training programme and open day events held in public spaces in communities where they work. CMT had been struggling with long turnaround times:

Basic Information
Organization involved in the project?: 
Project goals: 

EMIT is an application that allows facilitators to capture field data on cellphones and submit it via GPRS to a centralised database. Surveys are customised and data is monitored, verified and prepared for analysis in real time.

Brief description of the project: 

A national roll-out of EMIT as a mobile-based data monitoring and evaluation (M&E) system revealed a clear trend of lower costs, greater accuracy and a faster turnaround time on reporting. With proper training and widespread buy-in, fieldworkers used EMIT with successfully and managers found it an efficient and effective monitoring tool.


Target audience: 

Field workers in mobile health. 

How EMIT works - flowchart
Detailed Information
Mobile Tools Used: 
Length of Project (in months) : 
What worked well? : 

Training was easier than expected as the fieldworkers were already competent cell-phone users.

The data capturing system allowed for real-time access where CMT management could see submissions in real time and make follow up calls to the clinics to ensure their fieldworkers were in fact on duty.

A few organisations had ill-defined organisational processes, making it hard to implement a solution that had little existing foundation. In specific cases it was important to analyse existing processes and re-engineer processes that were redundant. This was done by having workshops and interviews with relevant parties to try and come up with a better defined process that could not only be auditable by funders but logical to the M&E manager. This was very successful as it allowed Cell-Life to analyse organisations and customize the technology accordingly.

What did not work? What were the challenges?: 

In terms of the sector, there is a great need for broad-based IT skills as training is still required at most of the partner NGOs. For this reason, training has become a core part of the EMIT product offering.

The lack of network coverage in certain rural areas meant that data capturers had to go to areas with network coverage in order to send their collected forms.

There are challenges involved in the provision of cellphones. Clear policies for cellphone usage are necessary to try and reduce loss. In the near future, the EMIT application will be compatible with all Java enabled cell-phones, meaning that most facilitators will be able to use their personal cellphones, minimizing the cost of providing handsets and the management thereof.


Posted by PrabhasPokharel on Sep 15, 2009
Mobilisr data sheet 3986 Views
Organization that developed the Tool: 
Main Contact: 
Peter Benjamin
Problem or Need: 

Currently NGOs have to rely on sometimes-expensive private-sector suppliers of mobile services such as bulk SMS, USSD, etc. Mobilisr allows organisations to manage their own multi-channel mobile communications.

Main Contact Email : 
Brief Description: 

Mobilisr is an open source mobile messaging platform. It is a Web-based system that allows you to manage communications via mobile phone using a range of mobile technologies: broadcast SMS, interactive keyword SMS, SMS subscribe and unsubscribe, static USSD, and interactive USSD. Future releases will include interactive voice recording (IVR), location-based services, WAP and voicemail push (where a recorded voicemail is sent to people's phones).

Examples of how these can be used include: bulk SMSs sent to patients at an ARV clinic reminding them to take their medication; and interactive USSD used to gather patient feedback on service quality.

Mobilisr allows for tracking of 'campaigns', so you can monitor how many messages have been sent and to whom, which facilitates easier reporting.

Demo URL: http://www.cell-life.org.za/Mob2
username: demo
password: demo

Tool Category: 
App resides and runs on a server
Is a web-based application/web service
Key Features : 

Mobilisr contains functionality to:

  • Build Campaigns (Campaigns are collections of content and services)
  • Design and Manage Content intended for different mobile channels
    • Bulk SMS, SMS Keyword Response, Keyword-based (Un)Subscription
    • Building of and deploying of USSD services
    • Deploying of IVR / VoiceMail based technology (to be developed)
    • Location-based services (to be developed)
  • Capture data through these various channels
  • Manage database of users, messages, and create reports

More details here

Main Services: 
Bulk SMS
Premium SMS and Billing
USSD Services
Display tool in profile: 
mobilisr screenshot of home page
Tool Maturity: 
Currently deployed
All phones -- SMS
All phones -- Voice
All phones -- USSD
All phones/Mobile Browser
Program/Code Language: 
Organizations Using the Tool: 

Treatment Action Campaign, Soul City, Positive Muslims, HIVAN, Caris

Number of Current End Users: 
Under 100
Number of current beneficiaries: 
Support Forums: 
Languages supported: 
Handsets/devices supported: 
Server can be deployed on a java-enabled system. Or web app can be used with Cell-Life support.
Is the Tool's Code Available?: 
Is an API available to interface with your tool?: 

Say No to Xenophobia: Cell Phones Against the South Africa Violence

Posted by KatrinVerclas on May 26, 2008

I am in South Africa this week as violence against immigrants broke out in townships all over the country. There are several initiatives that have now been launched to combat the violence -- using mobile phones.

In response to the violence against foreigners, the Western Cape Emergency Task Team with the leadership of Peter Benjamin of Cell-Life, has activated a national SMS emergency system for citizens to respond to the violence. The Task Team, a coalition of South Africa's Treatment Action Campaign (TAC) and over 20 NGOs, has activated “NO TO XENOPHOBIA” SMS lines across South Africa.

Refugee camp in Capetown, South Africa