Qualitative Assessment of the Feasibility, Usability, and Acceptability of a Mobile Client Data App for Community-Based Maternal, Neonatal, and Child Care in Rural Ghana

Abstract

Mobile phone applications may enhance the delivery of critical health services and the accuracy of health service data. Yet, the opinions and experiences of frontline health workers on using mobile apps to track pregnant and recently delivered women are underreported. This evaluation qualitatively assessed the feasibility, usability, and acceptability of a mobile Client Data App for maternal, neonatal, and child client data management by community health nurses (CHNs) in rural Ghana. The mobile app enabled CHNs to enter, summarize, and query client data. It also sent visit reminders for clients and provided a mechanism to report level of care to district officers. Fourteen interviews and two focus groups with CHNs, midwives, and district health officers were conducted, coded, and thematically analyzed. Results indicated that the app was easily integrated into care, improved CHN productivity, and was acceptable due to its capacity to facilitate client follow-up, data reporting, and decision-making. However, the feasibility and usability of the app were hindered by high client volumes, staff shortages, and software and device challenges. Successful integration of mobile client data apps for frontline health workers in rural and resource-poor settings requires real-time monitoring, program investments, and targeted changes in human resources.

Using a mHealth system to recall and refer existing clients and refer community members with health concerns to primary healthcare facilities in South Africa: a feasibility study

“…In some facilities, they had no additional support with these tasks, and allocating such support could be difficult in overburdened and understaffed PHC facilities in resource-constraint settings. As in several other studies [42][43][44], we found that successfully maintaining an mHealth system was a challenge when added to staff's existing job descriptions. In addition, many clerks reported struggling with the technical aspects of the mHealth system.…”

“…Several studies confirm the need for integration, claiming that it may strengthen health system functioning [39] and promote the sustainability of the mHealth system [40]. As was found in our study, poor integration may frustrate users and lead to additional labourintensive tasks for them [41,42]. With this in mind, automated entry, as suggested by the clerks, could help to ensure that staff with many other responsibilities do not have to spend time on manually issuing and closing recalls and referrals.…”

Development and Evaluation of a Perinatal Service Delivery Web Platform for Prenatal Care Coordinators (Preprint)

“…Research shows that adoption of technological tools by MHWs relies heavily on their perceived usability, value, security and social influence, along with the ease of tool's integration into the existing workflow [3,25]. But, steps should be taken to address the literacy levels of the health workers utilizing the equipment [21].…”

Cervical cancer data and data systems in limited‐resource settings: Challenges and opportunities

“…Limited‐scale implementation of applications—for data collection, clinical decision support, and follow‐up visit reminder systems—has provided valuable information regarding feasibility, usability, acceptability, and ability to promote quality data collection. Common lessons learned are the need to understand local conditions in‐depth prior to implementation, continually evaluate systems to ensure they meet user needs, and provide periodic supervision to enhance data quality and use …”

“…Common lessons learned are the need to understandlocalconditionsin-depthpriortoimplementation,continuallyevaluatesystemstoensuretheymeetuserneeds,andprovide periodicsupervisiontoenhancedataqualityanduse. 19,40,41 In Zambia, a system for telemedicine and quality assurance that combinesmobiletelecommunicationsanddigitalcervicographyplayed avitalroleinimprovingandscalingupvisualinspectionwithaceticacid (VIA)-based cervical cancer screening. 42,43 A similar approach using smartphonestocaptureandtransmitdigitalcervicalimageshasbeen successfullytestedinMadagascar, 44 andscaled-upinBotswana.…”