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Shortages of health workers, infrastructural deficiencies, limited access to medical care are just a few of the many barriers to care in developing countries. The integration of smartphones and mobile devices into healthcare systems has been proposed to address some of the physical barriers to care and service delivery. These mHealth solutions extend the reach of medical care into rural areas of developing countries. However, it is not clear how mHealth solutions designed and tested in one developing region can be positively appraised for use in others. This study frames this problem using a coping theory approach based on an exploratory case-study to understand the factors that influence primary appraisal of smartphone-enabled clinical guidelines (mHealth tool) for accessing, classifying and eliciting treatment recommendation for sick children under the age of five by rural healthcare workers (RHCWs). Findings identified a set of factors which are bound as an emerging explanatory positivity model that influence primary appraisal of an mHealth tool in a new context. These factors are the set of individual and social factors that governments, funding bodies and non-governmental organisations should consider before embarking on the introduction of an mHealth tool in rural communities of developing countries. It is envisaged that by understanding the factors that influence primary appraisal, that is, either as an opportunity or a threat, practitioners and organisations will support positive appraisal and minimise the occurrence of negative ones when introducing mHealth tools. These findings have implications for theory, practice, and future research as explained in the concluding section of this paper.

Despite the benefits promised by mobile health, the introduction of these solutions is often met with resistance from various stakeholders. This article adopts a shared mental model approach to unearth the current perceptions, concerns, and mentalities of key stakeholders engaged in the provision of healthcare in Nigeria. These include policy makers, academics, healthcare professionals, and health information systems developers. Interviews and focus groups were used to examine stakeholders’ views across three mental models: (1) the technology, (2) processes, and (3) the team. Our investigations reveal disparities in stakeholders’ existing mental models and their perceptions of the proposed mobile health solution. We argue that fostering a common understanding of mobile health, as well as elucidating an improved understanding of processes and team behaviours, will mitigate the risk of resistance among stakeholders involved in the design and delivery of community healthcare services and culminate in a positive attitude towards new mobile health solutions among these stakeholders. We highlight the need to enhance communication and training from national to rural levels to promote complementary mental models and positively influence team performance.