| TAMA (Treatment Advice by Mobile Alerts) | |
| Supporting Treatment of People Living with HIV / AIDS in Resource Limited Settings with IVRs | |
The National Aids Control Organisation (NACO) introduced antiretroviral therapy (ART) for the treatment of HIV patients for free in government hospitals India in year 2005. Since then, the HIV has been converted from a “virtual death sentence” to a “chronic manageable disease”. And yet, in year 2012 NACO estimated that over 170,000 people die of HIV each year in India. Clearly the problem of treating HIV is far beyond just providing free medication. Supporting Treatment of People Living with HIV / AIDS in Resource Limited Settings with IVRs TAMA Anirudha Joshi + Mandar Rane + Debjani Roy + Shweta Sali + Neha Bharshankar + Prasad Rashinkar + Salil Badodekar + Nagraj Emmadi + Padma Srinivasan FACULTY PROJECT We started our research in 2009 with a qualitative study of 5 HIV clinics in India wherein we observed and interviewed doctors, counsellors and 64 people living with HIV/AIDS (PLHA). We found that despite several efforts, PLHA have limited access to authentic information. Some know facts and procedures, but lack conceptual understanding of HIV. Challenges include low education, no access to technology, lack of socialisation, less time with doctors and counsellors, high power-distance between PLHA and doctors and information overload. We realised that information solutions based on mobile phones can lead to better communication and improve treatment adherence and effectiveness by repetition, visualisation, organisation, localisation, and personalisation of information, improved socialisation, and complementing current efforts in clinics. |
We developed an interactive voice response (IVR) system called TAMA (Treatment Advice by Mobile Alerts) that provides treatment support to PLHA on ART. TAMA provides daily pill-time reminders, lets PLHA look up remedies for common symptoms, and provides authenticated information to PLHA in 30-second audio nuggets. In year 2011, we evaluated early prototypes of TAMA with people in remote villages and improved its design iteratively until it became usable by even the least literate and least exposed users. Based on the feedback, we developed a production version of TAMA in year 2012 in 6 languages (Marathi, Hindi, Telugu, Tamil, Kannada, and English). We worked with doctors, counsellors, and software developers to ensure that the design intent is carried through.
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In year 2012-2013, we deployed TAMA with 54 PLHA in 5 HIV clinics in India for a period of 12 weeks as a pilot study. We gathered feedback about TAMA’s design and usage. We conducted detailed qualitative interviews and analysed usage logs. We found that TAMA was usable and viable in the real life settings of PLHA and had many desirable effects on their treatment adherence. Our insights informed the design of the next version of TAMA, and some of these can be generalised to design of other long-term, frequent-use IVR applications for users in developing countries in the healthcare domain and beyond. Since year 2013, TAMA is undergoing a randomised control trial where about 300 PLHA will use TAMA and their medical outcomes will be compared with a control group of another 300 PLHA. The results of this study are awaited.
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Anirudha Joshi + Mandar Rane + Debjani Roy + Shweta Sali + Neha Bharshankar + Prasad Rashinkar + Salil Badodekar + Nagraj Emmadi + Padma Srinivasan Group page of TAMA Health care via cell phones |