Bringing two-way texting (2wT) from research to practice

I am excited to share some results of a CHT-based two-way texting (2wT) app for post male circumcision (MC) follow-up in Zimbabwe, work that could not be successful without the amazing Medic collaborators that partner with me, @beatrice @Femi @mureithi @adnan @Evelyn_Waweru @raymond @kawerewagaba @isaacholeman and others that I am sorry to not tag! As some of you may know, 2wT for MC provides direct provider-to-patient telehealth. In 2020, we completed a randomized control trial (RCT) of 2wT in Zimbabwe, showing the high usability of our 2wT App for male circumcision (MC) follow-up in Zimbabwe to reduce healthcare worker burden while improving the quality of care at lower cost.

Now, we have more to share in how 2wT made the transition from RCT to routine 2wT practice, led by local Zimbabwean partner, Zim-TTECH. Similar to research outcomes, routine 2wT was safe and provided clear efficiency advantages over in-person follow-up in routine settings. 2wT also reduced unnecessary patient-provider contact for COVID-19 infection prevention. Although 2wT is challenged by rural network coverage and cannot, therefore, reach all men in all settings, we believe that 2wT benefits for MC programs and potential benefits of 2wT-based telehealth for other health contexts outweigh the drawbacks. Recent 2wT uptake continues to point towards scale-up success: over 12,000 men have been successfully followed up by 2wT for MC follow-up in the last year in the ZAZIC MC program! Please reach out if you’d like to learn more.