We are developing a clinical trial aiming at assessing a mobile app for diabetic patients in Rwanda (for more information on the D²Rwanda study: https://clinicaltrials.gov/ct2/show/NCT03376607). To enable access to the app, we would like to provide all patients with a smartphone and a SIM card with a monthly mobile data bundle for the 12 months of the study's run. The SIM card would allow exclusive access to our app (through VPN / static IP) so that the patients wouldn’t spend the pack on voice calls, text messages or browsing the Internet (the supplied phones are dual-SIM, and therefore patients can continue using their own SIM cards as well).

We are currently facing a major challenge regarding obtaining the SIM cards: we would like to refrain from registering the SIM cards to each patient individually so that we avoid the selection bias (we hypothesise that some patients would not participate in the study if they are asked to provide their IDs for the SIM card registration —not to mention that some patients in rural areas may not even have IDs). For that, we would like to register the approximately 150 SIM cards under one of the institutions which co-develop the project. However, in Rwanda, there is a strict legislation, which requires individual registration of each card.

We have also looked for companies providing SIM cards with international roaming –but so far the bundles we have found are prohibitively expensive. Does anyone have any experience with such issues? We would be grateful for any insights, ideas or experience!