There is a growing interest in the effect of mobile phones in health care 
(mHealth) service delivery, but more research is needed to determine whether 
short message service (SMS)-based campaigns are appropriate for developing 
countries. This pilot study explored the efficacy of an mHealth campaign using 
SMS as a platform to disseminate and measure HIV/AIDS knowledge, and to promote 
HIV/AIDS testing at clinics in rural Uganda. Over a 1-month period, 13 HIV/AIDS 
quiz questions were sent to 10,000 mobile subscribers. Despite participation 
incentives, only one-fifth of the mobile subscribers responded to any of the 
questions. The campaign had proportionately limited success in increasing 
knowledge levels on a mass scale. Furthermore, the program design may be 
reinforcing entrenched knowledge gaps. The results suggest that it is important 
to be conservative when considering the potential overall effect of SMS-based 
programs. However, the authors recognize the potential of mHealth tools when 
extended to millions of mobile phone users as part of an integrated health 
campaign approach. The authors propose several steps to improve the program 
design to reach a larger portion of the intended audience and increase campaign 
effectiveness.