Experience with the mobile health application 'mSaada' to facilitate home-based human papillomavirus testing in...

Cervical cancer screening using human papillomavirus (HPV) DNA testing is an essential component of prevention efforts. Countries with limited health care infrastructure need innovative strategies to make HPV-based screening feasible. Our team developed a mobile phone application, mSaada, to facilitate counseling, data collection, and client follow-up for HPV-based cervical cancer screening in western Kenya.

Community health promoters (CHPs) working in Kisumu County underwent training in mSaada-assisted HPV-based screening before offering testing via self-collection during routinely scheduled home visits. After each visit, CHPs filled out a questionnaire to capture factors interrupting the home visits, including technology challenges. HPV results and follow-up information were provided directly to women by text or home visit and put into their clinic records. Treatment with thermal ablation was offered at their local health facilities, free of charge. All CHPs completed an mSaada usability survey and focus group discussion at completion of the pilot.

Twenty-two CHPs performed screening between October 2023 and June 2024. Of the 1118 women approached, 964 (86%) agreed to screen. Within 3 months after the screening period ended, 116 out of 218 women (53%) who tested positive for HPV completed follow-up treatment. Device or mSaada issues were minimal, with the most common being charging problems, slow mSaada performance, and quick response (QR) code scanner malfunctions. Usability scores indicated high satisfaction with mSaada (mean 4.4/5).

mSaada was a useful tool to facilitate HPV-based screening during home visits. Workflow observations and qualitative data helped identify specific improvements in the workflow, device quality, and app design to improve impact and sustainability.