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A Framework for the Design of a Mobile-Based Alert System for Outpatient Adherence in Nigeria

Nigeria ranks among the countries with the highest child and maternal mortality rate. Chronic diseases are the most common contributors to the diseases burden in Nigeria most especially Malaria, Tuberculosis (TB) and HIV/AIDS. Adherence to long-term therapy in out-patient condition is required to reduce and curb the prevalence of these diseases. Poor adherence to long-term therapies severely compromises the effectiveness of treatment; making this a critical issue in population health both from the perspective of quality of life and of health economics. This work introduces a m-technology based system that will provide an easy way of complying with drug regimen. It will make use of the Short Messaging Service (SMS) of mobile phones to provide reminders at dosing times. It will design architecture for mobile health interventions and develop a prototype SMS-based system to improve out-patient adherence. This system will be deployed over a period of time at selected hospitals and chronic disease management centers in selected states in Nigeria, and the adherence rates measured via health outcomes and evaluated. This would provide a significant positive return on investment through primary prevention (of risk factors) and secondary prevention of adverse health outcomes. It will also inform predictions of future population health outcomes predicted by treatment efficacy data. 
Keywords: out-patient, m-technology, adherence, chronic diseases, Nigeria, SMS