Utilizing mhealth (mobile health) messaging to increase uptake of cervical cancer screening services: impact, perceptions, and experiences from lusaka province, zambia

Background: Cervical cancer screening rates in Zambia have remained low for women 25 - 59 years old despite efforts to raise awareness among women using different communication platforms. The mHealth for cervical cancer used mass messaging and was implemented to complement already existing interventions aimed at increasing knowledge levels and the number of women accessing screening services. Methods: A concurrent mixed methods design was used. Quantitative data was collected using telephone interviews with both women and men to whom text messages on cervical cancer screening had been sent. The qualitative data was collected using focus group discussions and key informant interviews, and focused on the implementation process as well as the perceptions and experiences of the users. Qualitative data was analyzed using thematic analysis while quantitative data was analyzed using descriptive statistics (proportions). Results: From the 990 (473 men and 517 women) participants sampled in the survey, only 46% of the women and 34% of men had received the short message services (SMSs). The SMSs resulted into 14% (72) of women going for screening for the first time, and 4% (22) for follow-up screening, totaling 18% (94). The intervention was described as appropriate because it resulted in more awareness about cervical cancer; and the frequency, time of day of transmission, the language and content of the SMSs were perceived good. The challenges experienced include low number of SMSs successfully delivered to the target population (50%), and the high cost of transmission. Conclusion: Despite the challenges experienced, the mCervical cancer intervention showed moderate effectiveness in reaching women and encouraging them to go for first time and follow-up screening.