Midwives in rural Ghana work at the frontline of the healthcare system, where they have access to essential data about the patient population. However, current methods of data capture, primarily pen and paper, make the data neither accessible nor usable for monitoring patient care or program evaluation. Electronic health (eHealth) systems present a potential mechanism for enhancing the roles of midwives by providing tools for collecting, exchanging, and viewing patient data as well as offering midwives the possibility for receiving information and decision support. Introducing such technology in low-resource settings has been challenging due to low levels of user acceptance, software design that does not match the end-user environment, and/or unforeseen challenges, such as irregular power availability. These challenges are often attributable to a lack of understanding by the software developers of the end-users’ needs and work environment. A mobile health (mHealth) application, known as mClinic was designed to support midwife access to the Millennium Village-Global Network (MVG-Net), an eHealth delivery platform that captures data for managing patient care as well as program evaluation and monitoring, decision-making and management. We conducted a descriptive usability study comprised of three phases to evaluate an mClinic prototype: 1) hybrid lab-live software evaluation of mClinic to identify usability issues; 2) completion of a usability questionnaire; and 3) interviews that included low-fidelity prototyping of new functionality proposed by midwives. The heuristic evaluation identified usability problems related to four of eight usability categories. Analysis of usability questionnaire data indicated that the midwives perceived mClinic as useful but were more neutral about the ease-of-use. Analysis of midwives’ reactions to low-fidelity prototypes during the interview process supported the applicability of mClinic to midwives’ work and identified the need for additional functionality. User acceptance is essential for the success of any mHealth implementation. Usability testing identified mClinic development flaws and needed software enhancements.

By documenting widespread use of mobile phones and health worker perceptions of their most useful applications, this paper provides a framework for their integration into the community case management of malaria programme in Saraya, Senegal.

The purpose of this paper is to illustrate the importance of using open source technologies and common standards for interoperability when implementing eHealth systems and illustrate this through case studies, where possible. The sources used to inform this paper draw from the implementation and evaluation of the eHealth Program in the context of the Millennium Villages Project (MVP). As the eHealth Team was tasked to deploy an eHealth architecture, the Millennium Villages Global-Network (MVG-Net), across all fourteen of the MVP sites in Sub-Saharan Africa, the team recognized the need for standards and uniformity but also realized that context would be an important factor. Therefore, the team decided to utilize open source solutions. The MVP implementation of MVG-Net provides a model for those looking to implement informatics solutions across disciplines and countries. Furthermore, there are valuable lessons learned that the eHealth community can benefit from. By sharing lessons learned and developing an accessible, open-source eHealth platform, we believe that we can more efficiently and rapidly achieve the health-related and collaborative Millennium Development Goals (MDGs).

The purpose of this study was to explore the feasibility of using a Web-based tool to provide tailored symptom management strategies for persons living with HIV (PLWH) and to estimate the effect size of the tool for future studies. Testing the components of the Web-based system was done by incorporating a repeated measures design measuring the outcomes of symptom frequency and intensity, use of symptom management strategies, and engagement with health care providers. We recruited 42 PLWH; participants were enrolled in the study for 12 weeks and were asked to use the system and complete the questionnaires every 2 weeks. Our results showed that participants who used the strategies were more likely to have a decrease in symptom frequency and intensity. Findings from this feasibility study provide preliminary evidence for the use of a Web-based HIV symptom management tool with self-management strategies for individuals living with HIV infection.