The Effect of SMS Reminders on Health Screening Uptake

with Maja-Emilia Marcus, Lisa Rogge, and Sebastian Vollmer
working paper | RCT | primary data | Indonesia

As cardiovascular diseases (CVD) become the leading cause of death in low- and middle-income countries (LMICs), this raises new challenges for health systems. Regular screening is a key measure against CVD risk factors, but the uptake of such services remains low despite free provision. We conducted a randomized controlled trial in Indonesia to assess whether personalized and targeted text messages increase the usage of public screening services for diabetes and hypertension in the at-risk population. Our intervention increased screening uptake by 6.6 percentage points. Among those who received and read the messages, the effect size was 17 percentage points. We show that text messages can be effective in a context of a relatively new disease burden in LMICs, where population responses may still be shaped by low salience and missing screening routines.

Funding: This work was supported by the German Research Foundation’s Research and Training Group 1723 “Globalization and Development” (DFG: RTG1723).

Parental health, children’s education and the role of state support

with Till Bärnighausen and Sebastian Vollmer
working paper | RDD | secondary data | South Africa

This study investigates whether eligibility for antiretroviral therapy (ART) of HIV positive parents improved their children’s educational attainment in KwaZulu-Natal, South Africa, employing a regression discontinuity design. We find that there is a positive impact of ART eligibility on paternal health, but this does not translate into general improvements of children’s education. Instead, impacts differ by the previous reception of state support. Previous recipients of health-contingent state support can lose the state support after initiation of ART, as their health improves after ART is initiated. For these parents, we see a negative impact of ART eligibility on children’s education, potentially driven by the negative impact on the household’s wealth. In contrast, there is a positive impact of ART eligibility on children’s education for fathers who previously received non-health-contingent state support.

Predicting control of cardiovascular disease risk factors in South Asia

with Mohammed K. Ali, Viswanathan Mohan, Lydia Chwastiak, Kavita Singh, KM Venkat Narayan, Dorairaj Prabhakaran, Nikhil Tandon, and Nikkil Sudharsanan
ongoing | machine learning | secondary data | India, Pakistan

This study aims at providing risk scores for 12-month risk of not meeting CVD care goals among patients with diabetes in South Asia. We apply machine learning methods on data from two harmonized, randomized controlled trials in India and Pakistan. We focus on predictors regularly collected or easily added in routine care settings to enable a wide application of the resulting risk score calculators.

Health care visits among the population aged 50 or older in Europe

with Nguyen Van Kinh, Mirna Abd El Aziz, and Till Bärnighausen
ongoing | descriptive | secondary data | Europe

Regular access to health care is crucial to ensure prevention and adequate care for chronic diseases. This is particularly important as people age, as the probability to have a chronic condition increases. We use data from the Survey on Health. Ageing and Retirement in Europe to analyze patterns of health care visits among the population aged 50+ in Europe.

Funding: This research is a part of the European Union’s H2020 SHARE-COVID19 project (Grant Agreement No. 101015924).

Barriers to hypertension and diabetes screening uptake in Aceh, Indonesia

with Farah Diba, Marthoenis, Maja Marcus, Lisa Rogge, and Sebastian Vollmer
ongoing | descriptive | primary data | Indonesia

The burden of cardiovascular diseases is rising in Indonesia. Despite free and local screening services, screening for hypertension and diabetes remains low. To investigate potential barriers to uptake, we conducted a study on knowledge, attitudes and practices of diabetes and hypertension among the population at risk in Aceh, Indonesia. We find a high awareness of severe complications as well as the benefits of early screening. Women were more likely to ever be screened, and hypertension screenings were more common than blood glucose screenings. The asymptomatic nature of hypertension and diabetes at early stages seems to be a major barrier to screening uptake.

Funding: This work was supported by the German Research Foundation’s Research and Training Group 1723 “Globalization and Development” (DFG: RTG1723).