Mobile Health for Improving Type 2 Diabetes (MOBILE-4T2D)

Type 2 Diabetes (T2D) is increasingly contributing to the global burden of disease, especially in Sub-Saharan Africa (SSA) where its management outcomes are still very low. In Uganda, available evidence shows that only 29.5% of patients with diabetes are retained into care, and only 20.8% achieve glyceamic control, putting such patients at high risk of T2D associated morbidity and mortality. Diabetes can be effectively managed and its complications delayed with optimal glyceamic control using a combination of medication and multiple risk factor management. Mobile technology provides an innovative way to improve provider-patient communication and maintain follow-up and support to persons with T2D. This project aims at developing and evaluating the effectiveness of a low–cost mobile health technology intervention with high scale-up potential to improve T2D management outcomes. The project is being conducted in Iganga and Mayuge Districts.

Reporting period:

January 2020 – December  2021

Summary of key activities to be implemented

1. Developing/ compiling standardized messages for patients with T2D that aim at: providing health education on diabetes, supporting compliance to medications and healthy behavior, and supporting compliance to health facility appointments.
2. Conducting Focus Group Discussions (FGDs) with patients with diabetes and Key Informant Interviews (KII) to enrich and improve the compiled messages so as to generate final messages that are contextually relevant to the Ugandan community.
3. Developing a text–messaging mHealth web-based application to deliver the health education messages.
4. Evaluating the effectiveness of the mHealth intervention towards improvement of retention into care and glycemic control.

Practice/policy implications:

The proposed mHealth intervention is a low-cost technology application with substantial public health benefits. In case it is found effective in improving diabetes management outcomes and is cost-effective, we anticipate that policy makers at the Ministry of Health will have research evidence to support their consideration of incorporating such an mHealth intervention to be part of the routine strategies to support management of patients diagnosed with diabetes. Further, the strategy can be used to improve management outcomes in patients with other chronic non-communicable conditions, such as hypertension, etc.

Project Team:

1. David Guwatudde, PhD (Project PI),
   Professor, Department of Epidemiology & Biostatistics,
   School of Public Health
   College of Health Sciences, Makerere University
    
2. Roy William Mayega, PhD (co-I),
   Lecturer, Department of Epidemiology & Biostatistics,
   School of Public Health,
   College of Health Sciences, Makerere University
    
3. Fiona Tulinayo, PhD (co-I),
   Senior Lecturer; Department: Information Technology,
   College of Computing and Information Sciences, Makerere University.
    
4. Silver Bahendeka, PhD (co-I),
   Senior Consultant Physician, Department of Diabetes and Endocrinology
   St. Francis Hospital Nsambya
    
5. Brenda Ayugi Ojara, MPH (Project Coordinator/ Field Supervisor),
   Department of Epidemiology & Biostatistics,
   School of Public Health,
   College of Health Sciences, Makerere University.