SMS quiz doubles HIV/AIDS testing

SMS quiz doubles HIV/AIDS testing

Organization type: 
nonprofit/ngo/citizen sector
$500,000 - $1 million
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

Text to Change combines the increasing growth of mobile telephony with the need for better healthcare. TTC works in countries affected by poverty and conflict and contributes to the welfare of individuals by creating a more informed citizenry and by enhancing transparency. Together with its local partners, TTC aims to support change by increasing awareness and enabling citizens to take their health and well-being into their own hands. Our mission is to empower citizens by unleashing the potential of mobile telephony to provide and collect information, increase awareness and knowledge levels, enhance transparency and strengthen advocacy. Our vision is a world with informed citizens who freely choose their path of development and who hold their representatives to account.

About Project

Solution: What is the proposed solution? Please be specific!

• It needs to be stipulated that mobile phones had never been used before on such a large scale for health educational purposes (first of its kind in Africa). TTC has been the pioneer in using mobile phones for health monitoring in Uganda reaching out to the general public at a large scale. • Participants in the survey could win prizes such as airtime, mosquito nets, mobile phones, football jerseys and radios. That's why the response rate was so high (nearly 20%). • The interactive based Text to Change concept, were people receive questions on health and are enabled to send back their answers for free has proven to be very innovative. • Participation in the survey was confidential. Mobile Telephony it is the way to communicate to people on a personal level and because of the anonymity it is perfectly suitable for sending messages regarding stigmatized subjects such as HIV/AIDS. • Text to Change provides open data because it supports transparency in development aid. • TTC links new mobile phone technology with traditional but still powerful media such as radio • The project was definitely demand driven. It was no top-down but a bottom-up awareness campaign. • Participation was free. • Participation was easily accessible for the people. • The way we collect participants’ data for analysis, which then helps us to plan our campaigns more effectively, is very innovative. In this way, we are reaching out to - and improving the lives of - thousands of people.
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

Text to Change (TTC) is a Dutch and Ugandan based organization founded in 2007. It is dedicated to support and improve health education via mobile phones in Africa. TTC works on developing innovative mobile telephony based concepts in developing countries and is specialized in incentive based text message programs addressing health issues. TTC aims at creating awareness, collecting data and generating an uptake in health services by using mobile telephones. It has an experienced track record in developing well-designed flexible mobile platforms that are being used to send question and answers messages via SMS supporting numerous projects in Uganda reaching out to thousands of people. With a four year successful track record, Text to Change brings both passion and senior-level Tech and innovative SMS service delivery experience. TTC combines modern data collection and analysis with advocacy aimed at individuals and institutions at all levels in society. It does so through a wide variety of approaches varying from workplace based SMS programs aimed at changing sexual behavior, to data collection in conflict areas, to campaigning for improved school quality and reduced teacher absenteeism. We are working to make life saving knowledge easily available to the general public and especially to community and family level caregivers. Text to Change is specialized in interactive and incentive based SMS programs addressing a wide range of health issues such as HIV/AIDS, Malaria and Reproductive Health. To increase HIV awareness and to enhance HIV testing in Lira District, Text to Change (TTC) carried out a survey in collaboration with the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ), using SMS messages. Mobile phones are one of the fastest spreading technologies in the world, and they are now being used for more than just their traditional functions. Uganda has over 10 million mobile phone subscribers and throughout Africa as a whole it is estimated that more than a million phone users are being added every week. Phone company research in Uganda estimates that approximately 85% of the population has “access” to a mobile phone through relatives, friends, acquaintances and mobile phone kiosks or itinerant mobile service providers. The objective of the study was to improve HIV/AIDS awareness and to increase the number of people going for testing services in Lira in order to increase the awareness of one’s HIV status and to encourage people to seek early treatment and care in order to decrease further HIV transmission.
About You
Text to Change
About You
First Name


Last Name

de Vroeg

About Your Organization
Organization Name

Text to Change

Organization Phone


Organization Address

's-Gravenhekje 1A

Organization Country

Netherlands, NH

Country where this project is creating social impact

Uganda, JIN

How long has your organization been operating?

1‐5 years

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What stage is your project in?

Operating for 1‐5 years

Tell us about the community that you engage? eg. economic conditions, political structures, norms and values, demographic trends, history, and experience with engagement efforts.

It is important to increase awareness of HIV/AIDS. Only 28% of Ugandan women and 36% of men aged 15-49 years have comprehensive knowledge about HIV & AIDS according to the results of the Uganda Demographic and Health Survey. The current HIV prevalence in Uganda is estimated at 5.4% amongst adults.
The study population consisted of people living in the Lira and its surrounding communities who use a mobile phone on one of the 4 major networks in Uganda (MTN, UTL, AIRTEL, and WARID). The program also targeted family and friends of the mobile phone users. Lira-town has an estimated 80,000 inhabitants and approximately 145,000 people live in Lira-district. To initialize the survey, we utilized radio and flyers to boost participation.

Share the story of the founder and what inspired the founder to start this project

Text to Change was launched in 2007, after Bas Hoefman was inspired by a documentary on the growth of mobile telephony in Africa. Bas Hoefman was a Marketing Manager, his sister was a Tropical Doctor and Hajo van Beijma was an IT-specialist. Bas and Hajo are friends since kindergarten. Mobile phones are now readily available at relatively low cost throughout the poorest countries. Networks cover the majority of the world’s population. Bas Hoefman, Hajo van Beijma and Marieke Hoefman combined their expertise and developed this brilliant idea of using short message service (SMS) communication in order to reach wide audiences on health related issues.

TTC was the first of its kind in Africa, mobile phones had never been used before on such a large scale for health educational purposes. The success of Text to Change’s initial programmes in Uganda – covering HIV prevention and the uptake of HIV Voluntary Counseling & Testing (HCT), malaria, family planning, reproductive health and child abuse – paved the way for Text Change’s emerging presence across Africa and other developing regions.

Social Impact
Please describe how your project has been successful and how that success is measured

• A high response rate. The DED-TTC survey reached over 7000 people in the Lira district for health education by SMS.
• An uptake in HIV testing of 200%!
The survey documents that after sending SMS questions and reminders in the second week of February, 398 HIV tests were carried out at the Lira AIDS Information Centre, twice the number compared with 185 in the first week of February
• 96% of the participants stated that the survey helped them to gain knowledge on HIV. Knowledge of one's HIV status is important to reduce the transmission of HIV since persons living with undiagnosed HIV infection unknowingly transmit the infection to their sexual partners
• TTC has proven that SMS is a simple and very successful way to transfer health information to the interest and needs of different target populations;
• Text to Change was one of the first in Uganda to have acquired a zero rated Short code; 8181 over 4 major networks in Uganda: MTN, Airtel, UTL and Warid.

• TTC has proven that SMS is a simple and very successful way to transfer health information to the interest and needs of different target populations.
• TTC provides open data so the content and the outcome of the SMS quiz is available.
• The investments costs are low since the survey is based on an existing mobile network, and SMS is cost-effective.
• Offering free HIV testing during the survey.
• Radio appeared to be a good medium to inform a large audience of people about the survey. Eighty percent of participants had first heard about the survey by radio. Consistent with much of Africa, radio ownership in Uganda is high: 78% nationwide, 84% in the Western and Northern regions.

How many people have been impacted by your project?

More than 10,000

How many people could be impacted by your project in the next three years?

More than 10,000

Winning entries present a strong plan for how they will achieve growth. Identify your six-month milestone for growing your impact

We will focus on better partnerships and positioning Text to Change more. Partnerships with the private and public sector with a global view.

Task 1

In the coming 6 months we will work outside of Africa for the first time and we'll work on our global footprint.

Task 2

We want to focus more on the private sector besides our normal public sector contracts

Task 3

We'll improve our mobile technologies. We already combine them with radio. Now we work on campaigns with games, images and mobile internet.

Identify your 12-month impact milestone

In 12 months we'll work in 3 continents for 5 governments, 10 companies, 8 UN-organizations and 20 NGO's.

Task 1

TTC's systems will be available in all (local) languages, next to English and Spanish

Task 2

We'll be executing active sales activities in big countries like Brazil, China, India and Russia.

Task 3

We'll expand from 2 to 4 offices; we'll hire more local people and focus on training our local staff

How will your project evolve over the next three years?

• This project is completely applicable to other sectors and is scalable as well as replicable. This makes the project all the more valuable.
• Mobile phones are everywhere so these kind of projects can be done worldwide
• Text to Change has deals with mobile providers on a large scale
• A response rate can be high everywhere if you offer the right incentives
• Participation is easily accessible if the network is working
• Free HIV testing-facilities should be available

What barriers might hinder the success of your project and how do you plan to overcome them?

Some key challenges faced during this project:
• Results of this survey show that more needs to be done to get people tested regularly. You can encourage HIV testing by offering it free of charge. During the survey, free testing was offered at the AIDS Information Centre in Lira. This way of testing reached many people; test uptake almost doubled after the SMS reminder. This is an important way to enhance (timely) HIV testing by reducing (financial) barriers.
• 31% of all respondents reported a place of residence outside Lira district. Although information on health will also benefit this population, this area was not initially targeted for this project.
• The radio shows reached mainly men. Women were more likely to subscribe to the survey when they were informed by family or other relatives. This demonstrates that radio needs to be complemented with other media to reach both men and women.
• Women had better knowledge than men on several issues. These interesting outcomes can be taken along in new surveys.
• The number of questions in our survey was limited if you compare it to other surveys.

Tell us about your partnerships

With a four year successful track record, TTC has experience in working with both the public and the private sector. Among Text to Change's partners and clients are the UN (Unicef, ECOSOC and GIVAS), governments (USAID, German, Dutch and English Ministries), NGO’s (Family Health International, Cordaid, IICD, Warchild, HIVOS, Twaweza), universities (Johns Hopkins (USA), Makerere (Uganda), University Utrecht (The Netherlands)), companies (Kakira Sugar, IBM, Microsoft, PWC, Clifford & Chance, Merck) and major mobile providers (Orange, Airtel, MTN, Vodacom).

Explain your selections

TTC carried out this survey in collaboration with the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) and the Aids Information Centre in Uganda. The Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) is a German Company for International Cooperation and the Aids Information Centre is a NGO in Uganda.

How do you plan to strengthen your project in the next three years?

We will stay focused on the evaluation and improvement of this project. We're already very much experienced with SMS projects like these but focusing on improvement stays important! We will also focus on better partnerships and positioning Text to Change more. Our project could be strengthened by the right partnerships (with both the private and public sector).

Which barriers to health and well-being does your innovation address?
Please select up to three in order of relevancy to your project.


Other (Specify Below)


Health behavior change


Lack of insurance/financing options for healthcare

Please describe how your innovation specifically tackles the barriers listed above.

Results of this survey show that more needs to be done to get people tested regularly. You can encourage HIV testing by offering it free of charge. During the survey, free testing was offered at the AIDS Information Centre in Lira. This way of testing reached many people; test uptake almost doubled after the SMS reminder. This is an important way to enhance (timely) HIV testing by reducing (financial) barriers.

How are you growing the impact of your organization or initiative?
Please select up to three potential pathways in order of relevancy to you.


Grown geographic reach: Global


Enhanced existing impact through addition of complementary services


Repurposed your model for other sectors/development needs

Please describe which of your growth activities are current or planned for the immediate future.
Do you collaborate with any of the following: (Check all that apply)

Technology providers, NGOs/Nonprofits, For profit companies, Academia/universities.

If yes, how have these collaborations helped your innovation to succeed?

Government and NGOs often are our local partners for setting up TTC projects. They hire TTC and function as our content and financial partners. For profit companies hire us as well, as we do lots of workplace based programs. That way we make sure that employees get tested for HIV/AIDS for example. With technology providers we collaborate on developing software for our technical platform and with universities we work together on research projects, for example to measure our results and how to improve our projects.