2. 7th EAHSC Learnings from a Mobile Phone based Stepping Stones approach in Uganda
Dr. Davis Rusoke

3. The problem of HIV
Sub-Saharan Africa hosts 66% of global HIV burden, with the East and Southern Africa accounting for more than half of people living with HIV. (UNAIDS 2017) Uganda HIV prevalence at 6.2% among adults, hence 1.2 million people are affected. [Uganda Population–Based HIV Impact assessment (UPHIA) report 2017]

4. Social behaviors
High-risk social behaviors, the main drivers of new HIV infections in Sub-Saharan Africa.
Social behavioral change and social behavioral change communication are thus key in the fight against HIV.
Behavior change as a gradual process that requires correct, consistent, timely and age-appropriate information to influence positive behaviors among adults.

5. Social Behavioral Change measures
The physical stepping stones approach is an identified highly effective methodology to promoting social behavioral change.
Barriers to this include limited human & financial resources, time, remote geographical locations etc.

6. The Opportunity

7. Baseline Survey Highlights in 50 Districts

8. Methods used
The Medical Concierge Group (TMCG), run the program over 34 months from December 2016 to October 2018
Consented participants recruited through field activities
SBCC messages in a hierarchical stepping stones approach sent via SMS platform called Rapidpro.
Over a six week period, weekly messages on different HIV/AIDS related topics were shared along with quizzes at the end of each weekly topic.

9. Results 5,743 clients participated Median age of 23 years
3,518 (61.3%) were males and 2,225 (38.7%) were females.
The weekly quizzes on STD, family planning and HIV prevention had the highest response rates  of 34%, 40% and 51% respectively.
On average, 72% of the responses to weekly quizzes were correct.

10. Conclusion
Mobile phone usage an opportunity and a platform for contemporary dissemination of knowledge
overcomes geographical, time, and limited resources as barriers to the traditional physical stepping stones methodology.
Such digital stepping stones content can be standardized, translated into different languages,  approved and availed for open sourcing at a national level.
This mobile phone based approach be into integrated into different public health programs.

11. END