title: Ownership and use of mobile phones among health workers, caregivers of sick children and adult patients in Kenya: cross-sectional national survey.
abstract: BACKGROUND
  The rapid growth in mobile phone penetration and use of Short Message Service (SMS) has been seen as a potential solution to improve medical and public health practice in Africa. Several studies have shown effectiveness of SMS interventions to improve health workers' practices, patients' adherence to medications and availability of health facility commodities. To inform policy makers about the feasibility of facility-based SMS interventions, the coverage data on mobile phone ownership and SMS use among health workers and patients are needed.
  
  
  METHODS
  In 2012, a national, cross-sectional, cluster sample survey was undertaken at 172 public health facilities in Kenya. Outpatient health workers and caregivers of sick children and adult patients were interviewed. The main outcomes were personal ownership of mobile phones and use of SMS among phone owners. The predictors analysis examined factors influencing phone ownership and SMS use.
  
  
  RESULTS
  The analysis included 219 health workers and 1,177 patients' respondents (767 caregivers and 410 adult patients). All health workers possessed personal mobile phones and 98.6% used SMS. Among patients' respondents, 61.2% owned phones and 71.4% of phone owners used SMS. The phone ownership and SMS use was similar between caregivers of sick children and adult patients. The respondents who were male, more educated, literate and living in urban area were significantly more likely to own the phone and use SMS. The youngest respondents were less likely to own phones, however when the phones were owned, younger age groups were more likely to use SMS. Respondents living in wealthier areas were more likely to own phones; however when phones are owned no significant association between the poverty and SMS use was observed.
  
  
  CONCLUSIONS
  Mobile phone ownership and SMS use is ubiquitous among Kenyan health workers in the public sector. Among patients they serve the coverage in phone ownership and SMS use is lower and disparities exist with respect to gender, age, education, literacy, urbanization and poverty. Some of the disparities on SMS use can be addressed through the modalities of mHealth interventions and enhanced implementation processes while further growth in mobile phone penetration is needed to reduce the ownership gap.
authors.affiliation: Malaria Public Health Cluster, KEMRI-Wellcome Trust-University of Oxford Collaborative Programme, Nairobi, Kenya. dzurovac@kemri-wellcome.org
authors.forename: Dejan
authors.initials: D
authors.lastname: Zurovac
authors.forename: Gabriel
authors.initials: G
authors.lastname: Otieno
authors.forename: Samuel
authors.initials: S
authors.lastname: Kigen
authors.forename: Agneta M
authors.initials: AM
authors.lastname: Mbithi
authors.forename: Alex
authors.initials: A
authors.lastname: Muturi
authors.forename: Robert W
authors.initials: RW
authors.lastname: Snow
authors.forename: Andrew
authors.initials: A
authors.lastname: Nyandigisi
mesh_terms: D000328:Adult; D017028:Caregivers / Q000706:statistics & numerical data; D040421:Cell Phone / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006282:Health Personnel / Q000706:statistics & numerical data; D006801:Humans; D007630:Kenya; D008297:Male; D008875:Middle Aged; D010067:Ownership / Q000706:statistics & numerical data*; D010361:Patients / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D060145:Text Messaging / Q000706:statistics & numerical data; D055815:Young Adult