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.