Improving quality of care using mobile technology: experiences from the Urban Leprosy Project in Kolkata, India

Objectives: Urban leprosy control has been a challenging area for the programme. Effective counselling is often compromised due to lack of time and space, despite the availability of trained and well-meaning healthcare personnel. We therefore sought to use mobile technology to improve communication. Methods: We piloted a strategy in Kolkata called ‘aami achhi’ (meaning ‘I am there’ in Bengali) whereby mobile numbers were shared between the leprosy trained supervisor and patients registered for MDT. A total of 105 patients who had accessed the helpline service were interviewed over the telephone. Results: The most common reasons for accessing service over mobile telephony included ‘redness and swelling’, enquiry about availability of the supervisor during a visit to hospital, ‘forgotten the way to take MDT’, stress due to discoloration and other side-effects, and to allay anxiety about the disease. Patients reported improved knowledge of disease and expressed satisfaction with the personalised care provided. The supervisors considered mobile counselling to be effective as it had led to the early detection of reactions, enabled effective referrals, helped patients to manage periods of anxiety and stress, and led to a reduction in the number of interrupters and defaulters. Conclusion: Mobile telephony allows ongoing communications and engagement with patients, leading to improved adherence and patient empowerment through information in a simple, cost-effective way.