The Communication Initiative
Development action with informed and engaged societies
The Communication Initiative
After nearly 28 years, The Communication Initiative (The CI) Global is entering a new chapter. Following a period of transition, the global website has been transferred to the University of the Witwatersrand (Wits) in South Africa, where it will be administered by the Social and Behaviour Change Communication Division. Wits' commitment to social change and justice makes it a trusted steward for The CI's legacy and future.
 
Co-founder Victoria Martin is pleased to see this work continue under Wits' leadership. Victoria knows that co-founder Warren Feek (1953–2024) would have felt deep pride in The CI Global's Africa-led direction.
 
We honour the team and partners who sustained The CI for decades. Meanwhile, La Iniciativa de Comunicación (CILA) continues independently at cila.comminitcila.com and is linked with The CI Global site.
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SMS to Treat TB

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A doctor in Cape Town, South Africa is using Short Messaging Service (SMS) technology to remind patients to take their medication for the treatment of tuberculosis (TB). SMS is a text message service that enables short messages of up to 160 characters to be transmitted between cell phones. Through his company Compliance Service, Dr. David Green established this service as a result of the high incidence of treatment failure due to non-compliance with the treatment regimen.
Communication Strategies

This initiative is premised on the observation that TB patients often do not take their medication simply because they forget. This initiative, run by Dr. Green, uses SMS to alert patients to take their medication. Dr. Green enters the names of TB patients onto a database. Every half an hour his computer server reads the database and sends personalised messages to the patients, reminding them to take their medication. The idea here is to use technology to address a real need effectively, but in a simple, affordable, and flexible way.

Specifically, Dr. Green uses a server, free software and a bulk SMS provider to send out the SMS messages. The technology he uses to send out the messages is low-cost and durable: an open source software operating system, web server, mail transport agent, applications, and a database. When patients complained that the initial message ("Take your Rifafour now") was too drab, Dr. Green added jokes, pearls of wisdom, and tips about lifestyle management to light up their day - while still reminding them to take their medication.

Development Issues

Health, Technology.

Key Points

Cape Town has one of the world's highest incidences of TB, largely due to socio-economic and climatic factors. TB patients must strictly follow a difficult drug regime- four tablets five times a week for six months - and they often forget to take their medication. Non-compliance with the drug treatment has exacerbated the high occurrence of TB and has created difficulties for the healthcare service. Medicine is wasted and the TB virus is becoming increasingly drug resistant.

Healthcare professionals were reportedly skeptical about whether the uptake of cell phone technology was high enough to justify the project. However, Dr. Green found that over 50% of people in the Cape Peninsula had access to cell phones. At the clinic where the pilot study was conducted, 71% of TB patients had access to a cell phone.

The South African Government is considering the technology for nationwide use. The system is also being investigated for use with HIV treatment.

Sources

Pambazuka News, Issue 97, January 30 2003 and the bridges.org website on October 5 2006.