| dc.description.abstract | Retention in care and adherence to medication among pregnant and breastfeeding women living
with HIV (PBWLH) are crucial for prevention of mother to child transmission (PMTCT) of HIV.
Wide coverage of mobile phones, digital tools, including the use of internet enabled medication
dispensers and short message service (SMS), have been recommended as potential interventions
to improve adherence to medication by PBWLH. The main objective of the study was to
understand the needs and contents for a customized digital tool for retention in care and medication
adherence among PBWLH. A mixed-methods study was conducted from September 2021 to
March 2022 at five health facilities in Kilimanjaro region. Pregnant and breastfeeding women
receiving PMTCT services were included in a survey using a semi-structured questionnaire.
Among the interviewed, twenty breastfeeding women were purposively selected and enrolled to
use an internet enabled Wisepill medication dispenser for one month. They received different types
of SMS reminders for a period of one month and feedback on their adherence patterns was received
after one month using adherence graph from the Wisepill digital tool. Later, exit interviews, in-
depth interviews were conducted to explore needs and contents for a future customized digital
adherence tool. Descriptive analyses for quantitative data and thematic content analyses for
qualitative data were also done. Among 142 women interviewed, 42(30%) were pregnant and 100
(70%) were breastfeeding. A majority of 136 (95%) had access to mobile phones and used SMS
daily, while 90% were interested in receiving reminder messages. Qualitative findings revealed
more insights on reminders’ content and educational SMS. Most people preferred neutral SMS
which does not contain the word “medication”. Health educational SMS content was preferred to
be on breastfeeding, opportunistic diseases, nutrition and entrepreneurship education. Overall,
SMSs were regarded helpful to remind clients on medication time and the medication dispenser
provided them with privacy and safe storage for their medication. Findings from this study will
help to construct useful content for future digital adherence tools to support the health of pregnant
and breastfeeding women living with HIV. | en_US |
