Background: Patients' lack of awareness of available services is a significant barrier to delivering surgical care in resource-limited settings. Short message service (SMS) text messaging is a potential means to disseminate this information in resource-limited settings, where rates of mobile phone usage are high.
Methods: A blast SMS text informing local populations of upcoming cleft lip-palate (CLP) surgical services was distributed to 25% of the subscriber base 1 week prior to arrival of a (CLP) surgical team in Zimbabwe. A retrospective cohort analysis comparing characteristics of patients presenting to the CLP clinic in the year prior to (2016) and 2 years following (2017-2018) the implementation of the blast SMS text messaging system is performed to assess its impact.
Results: Patients presenting to a single Zimbabwean CLP surgical program in the years with SMS messaging notifications were significantly more likely (52 [64%] vs. 5 [17%], P < .001) to have been informed of surgical services through their mobile phones. The average distance traveled per patient was not significantly different prior to implementation of mass text messaging (180.4 km [SD114.8] vs. 167.4 km [SD105.9], P = .580). The average patient age was significantly higher following the implementation of mass text messaging (7.4 [SD8.7] vs. 3.0 [SD2.8] years, P = .010).
Conclusions: SMS messaging is an effective method of informing patients of CLP surgical services in resource-limited settings. After implementation of SMS text notifications, surgical patients were of increased age, but showed no difference in distance traveled.
Level of evidence: IV.
Keywords: Global health; cleft lip and palate; global surgery; mhealth; mobile health; text messaging.