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Study Overview

Short-text (SMS) platform ‘Zambia U-Report’ to increase demand for voluntary medicalized male circumcision among adolescents and young adults
Study is 3ie funded:
Study ID:
Initial Registration Date:
Last Update Date:
Study Status:
Change History for Status
Changed On Previous Value
04/22/2015 In Development
The study takes advantage of the UNICEF-developed SMS platform, Zambia U-Report, to measure the impact of an SMS campaign (BCC messaging + counselling) promoting voluntary medical male circumcision (VMMC) uptake. 2,550 existing and newly recruited uncircumcised male participants above the age of 15 will be randomly assigned to three arms: Routine (control), Conventional, and Tailored. An equal number of participants will be assigned to each arm. In the ‘conventional’ SMS intervention, promotional and educational messages will be sent to participants encouraging enrollees (called Ureporters) to undergo VMMC. In the ‘tailored’ SMS intervention, VMMC messages will be tailored to individual participant needs based on information received via SMS polls. All Ureporters will be able to ask questions to trained HIV counsellors over SMS at any time. The study participants will be recruited in Lusaka and Chongwe districts. The primary outcome measured is VMMC uptake (self-reported and verified), with secondary outcomes including self-reported intention to receive VMMC and U-Report platform un-enrollment.
Registration Citation:
Health, Nutrition, and Population
Additional Keywords:
Secondary ID Number(s):

Principal Investigator(s)

Name of First PI:
Paul Wang
Name of Second PI:
Dr. Landry Tsague

Study Sponsor

International Initiative for Impact Evaluation (3ie)
Study Sponsor Location:
United States

Research Partner

Name of Partner Institution:
Type of Organization:

Intervention Overview

"Conventional" Treatment: Standard package of promotional and informational SMS messages encouraging VMMC uptake. Access to SMS counsellors trained on MC-specific counselling. "Tailored" Treatment: Tailored packages of relevant promotional and informational SMS messages directed to participants depending on their self-reported level of intention to receive VMMC. Access to SMS counsellors trained on MC-specific counselling.
Private Intervention Details:
Theory of Change:
Multiple Treatment Arms Evaluated?

Implementing Agency

Name of Organization:
CHAMP with support from UNICEF-Zambia
Type of Organization:
NGO (local)/Community Based Organization/Other civil society organization

Program Funder

Name of Organization:
International Initiative for Impact Evaluation (3ie)
Type of Organization:

Intervention Timing

Intervention or Program Started at time of Registration?
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Evaluation Method

Evaluation Method Overview

Primary (or First) Evaluation Method:
Randomized control trial
Other (not Listed) Method:
Additional Evaluation Method (If Any):
Other (not Listed) Method:

Method Details

Details of Evaluation Approach:
RCT with three arms (one control and two treatment). Eligible sample frame individuals will be assigned to arms via random assignment, stratified by district, age, and self-reported intention to receive MC. Treatment impact will be measured using multiple logit regression analysis, controlling for select covariates collected at baseline and throughout the evaluation.
Private Details of Evaluation Approach:
Outcomes (Endpoints):
Primary: - VMMC uptake Secondary: - Intention to receive VMMC in the next two months - Intention to receive VMMX at some point - U-Report platform un-subscription
Unit of Analysis:
The following null hypotheses will be tested: 1. The "Conventional" treatment will not increase VMMC uptake versus the control, at the 95% confidence level. 2. The "Tailored" treatment will not increase VMMC uptake versus the control, at the 95% confidence level.
Unit of Intervention or Assignment:
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Number of Individuals in Sample:
Size of Treatment, Control, or Comparison Subsamples:
850 observations per arm (x3)

Supplementary Files

Analysis Plan:
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Outcomes Data

A short SMS survey will be delivered to participants three times (every two months) after a baseline survey and random assignment. The survey re-evaluates participants' self-reported circumcision status as well as intention to receive MC (for uncircumcised individuals). Self-reported VMMC uptake data will be supplemented by data verification at provider partner and clinic sites, via matching of key identifiers including truncated phone numbers, age, and location.
Data Already Collected?
Data Previously Used?
Data Access:
Data Obtained by the Study Researchers?
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Treatment Assignment Data

Participation or Assignment Information:
Data Obtained by the Study Researchers?
Data Previously Used?
Data Access:
Data Obtained by the Study Researchers?
Data Approval Process:
Approval Status:

Data Analysis

Data Analysis Status:

Study Materials

Upload Study Materials:

Registration Category

Registration Category:
Prospective, Category 1: Data for measuring impacts have not been collected

Completion Overview

Intervention Completion Date:
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Unit of Analysis:
Clusters in Final Sample:
Total Observations in Final Sample:
Size of Treatment, Control, or Comparison Subsamples:
Control Arm: N=550; "Conventional" Treatment Arm: N=569; "Tailored" Treatment Arm: N=533


Preliminary Report:
Preliminary Report URL:
Forthcoming at, pending on results being published in JAIDS
Summary of Findings:
A three-arm RCT measured the impact of two 5-month short message service campaigns—each consisting of 21 messages—on self-reported and verified VMMC uptake in urban and peri-urban Lusaka Province, Zambia. The interventions and impact evaluation utilized U-Report, a free and confidential SMS platform for subscribers to access information and counseling on sexual health issues. In the “Conventional” campaign, all participants received the same comprehensive package of messages. In the “Tailored” campaign, participants received messages targeted to their level of VMMC intention. This study enrolled 2,312 U-Report subscribers (males, aged 15-30, in study area who reported being uncircumcised). Data were collected using SMS surveys, and verification of outcomes relied on client data from health facilities. The primary analyses of self-reported and verified outcomes failed to detect a statistically significant impact of either the Conventional or the Tailored SMS-based campaign on VMMC uptake. However, the campaigns had large impact on counselor engagement, revealing demand for information and counselor support.
Paper Summary:
Paper Citation:

Data Availability

Data Availability (Primary Data):
Yes--Available now
Date of Data Availability:
Data URL or Contact:
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Other Materials

Survey Instrument Links or Contact:
Alison Connor at
Program Files:
Program Files Links or Contact:
Alison Connor at
External Link:
External Link Description:
Description of Changes:

Study Stopped