JMIR Publications

ABSTRACT

Background:

Malaria infection is associated with many adverse outcomes for pregnant women and neonates. The HASA study was a cluster-randomized controlled trial that provided pregnant women in Tanzania with e-vouchers to redeem for LLINs for malaria prevention.

Objective:

This study was an evaluation of the HASA study to determine challenges, unintended findings, and lessons learned.

Methods:

Following the e-voucher expiration, voluntary phone follow-up surveys were conducted for nurses that supported the trial, as well as participants in both intervention and control groups of the trial who did not redeem their e-vouchers. Both surveys provided lists of pre-set answers to questions as well as the option to provide open-ended responses.

Results:

While nurses had a positive perception of the HASA study, some barriers identified by nurses included network connectivity, workload increase, and difficulty with workflow. Several barriers identified by participants included personal obligations preventing them from redeeming the e-voucher on time, losing the e-voucher number, or not receiving an SMS with the e-voucher number promptly or at all.

Conclusions:

Large-scale e-voucher platforms for health-related commodity interventions such as LLIN distribution in sub-Saharan Africa are feasible, but challenges including network connectivity must be addressed. In a future scale-up, the number of nurses trained should be increased, e-voucher issuance workflow should be simplified, the network of retailers should be expanded, and e-voucher expiration period should be extended.