Reviewing mHealth in Developing Countries: A Stakeholder Perspective

Eze, Emmanuel; Gleasure, Robert; Heavin, Ciara

doi:10.1016/j.procs.2016.09.276

Cited by 29 publications

(17 citation statements)

References 47 publications

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“…Mobile health (mHealth) project growth has been concomitant to increased cell phone ownership. The evidence base for mHealth initiatives is still solidifying [8] , [9] , but practitioners hope that mHealth can help ameliorate infrastructural deficiencies, shortage of health care workers and problems in reaching remote populations [10] .…”

Section: Introductionmentioning

confidence: 99%

Cell phone ownership and modern contraceptive use in Burkina Faso: implications for research and interventions using mobile technology

et al. 2019

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Objectives With over 420 million unique cell phone subscribers in sub-Saharan Africa, the opportunities to use personal cell phones for public health research and interventions are increasing. We assess the association between cell phone ownership and modern contraceptive use among women in Burkina Faso to understand the opportunity to track family planning indicators using cell phone surveys or provide family planning interventions remotely. Study design We analyzed data from a cross-sectional, nationally representative population-based survey of women of reproductive age in Burkina Faso, the Performance Monitoring and Accountability 2020 Round 4, which was conducted between November 2016 and January 2017. Results Among the 3215 female respondents aged 15 to 49 years, 47% reported cell phone ownership. Overall, 22% of women reported current modern contraceptive use. Women who owned a cell phone were more likely to report modern contraceptive use than those who did not (29% versus 15%). Adjusted for covariates (age, wealth, education, area of residence and marital status), the odds of reporting modern contraceptive use were 68% higher among cell phone owners compared to nonowners (odds ratio=1.68, 95% confidence interval 1.3–2.1). Method mix was substantially more diverse among those who owned cell phones compared to their counterparts. Conclusions The study shows that cell phone ownership is significantly associated with modern contraceptive use in Burkina Faso, even after adjusting for women's sociodemographic characteristics. These results suggest that cell phone ownership selectivity and associated biases need to be addressed when planning family planning programs or conducting surveys using cell phones. Implications Cell phones can be used for myriad family planning purposes, from confidential data collection to contraceptive promotion and knowledge dissemination, but ownership bias is significant. A cell-phone-based intervention or population-based survey is unlikely to reach a critical mass of the population at highest risk for unintended pregnancy.

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Section: Introductionmentioning

confidence: 99%

Cell phone ownership and modern contraceptive use in Burkina Faso: implications for research and interventions using mobile technology

et al. 2019

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“…These interviewees/stakeholders occupy key roles, participate in key binding policy decisions, have the actual power to make changes, and have the important political relational power with other systems (Knoke, 1994) in the Enugu State healthcare delivery system (see Appendix A). The researchers engaged with four key groups of stakeholders in the rural healthcare delivery system (Eze et al, 2016b), specifically, Parents/Guardians, Rural HealthCare Workers (RHCWs), Developers, and Facilitators. According to this classification, the Parents/Guardians (PGs) are individuals that help their children to receive preventative or curative care from the healthcare system; the RHCWs were those directly involved in healthcare processes, they are the direct users of the mHealth tool; the Facilitators were those individuals or bodies that expedite or enable the development, implementation and delivery of mHealth processes, and the Developers were those responsible for building and maintaining the mHealth system.…”

Section: Data Collection and Samplingmentioning

confidence: 99%

“…The use of mHealth tools can vary in focus (Eze, Gleasure, & Heavin, 2016b, 2018. First, mPrevention/Education tools provide preventive, advisory, counselling, and educational services (e.g.…”

Section: Introductionmentioning

confidence: 99%

Understanding the Factors that Influence the Primary Appraisal of mHealth Tools in Developing Countries: An Exploratory Case-Study in Nigeria

Eze

Gleasure

Heavin

2019

AJIS

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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.

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“…In the meantime, it is estimated by the World Health Organisation (WHO) that over 50% of childhood mortality could be prevented with affordable and simple interventions [ 1 ]. The use of mobile devices and technology to support medical practice or public health (mHealth) is one of such potential interventions in health care delivery that has attracted global attention because of the rapid rise in access to mobile phones [ 4 ]. Although there is an increase in the usage of mobile phone-based health information systems, its adoption rate is low [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Determinants of a mobile phone-based Interactive Voice Response (mIVR) system for monitoring childhood illnesses in a rural district of Ghana: Empirical evidence from the UTAUT model

et al. 2021

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Background The use of a mobile phone-based Interactive Voice Response (mIVR) System for real time monitoring of childhood illnesses provides an opportunity to improve childhood survival and health systems. However, little is known about the factors that facilitate its use. This study sought to identify key determinants and moderators of mIVR system use among caregivers in a rural district of Ghana using the Unified Theory of Acceptance and Use of Technology (UTAUT) model. Methods The mIVR system was designed to provide real-time data on common symptoms of childhood illnesses after answering several questions by caregivers with sick children. A structured questionnaire with closed questions was used to collect data from 354 caregivers of children under-five living in rural communities, four (4) months after introducing the system. Regression analysis was used to identify key determinants and moderating factors that facilitate the use of the system based on the UTAUT model. Results A total of 101 (28.5%) caregivers had used the system and 328 (92.7%) had intention to use the mIVR system. Caregivers’ level of education and household wealth were associated with use of the mIVR systems (p<0.001). Behavioural intention (BI) to use mIVR system was positively influenced by performance expectancy (PE) (β = 0.278, 95% CI: 0.207, 0.349), effort expectancy (EE) (β = 0.242, 95% CI: 0.159, 0.326) and social influence (SI) (β = 0.081, 95% CI: 0.044, 0.120). Facilitating conditions (FC) (β = 0.609, 95% CI: 0.502, 0.715) and behavioural intention (β = 0.426, 95% CI: 0.255, 0.597) had a positive influence on user behaviour (UB). Mobile phone experience and household wealth significantly moderated the effect of PE, EE, SI, and FC on behavioural intention and usage of mIVR systems. Conclusion The perceived usefulness of the mIVR system, ease of use, social influences, and facilitating conditions are key determinants of users’ attitude and use of mIVR system. These relationships are significantly moderated by users’ phone experience and wealth status.

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Reviewing mHealth in Developing Countries: A Stakeholder Perspective

Cited by 29 publications

References 47 publications

Cell phone ownership and modern contraceptive use in Burkina Faso: implications for research and interventions using mobile technology

Cell phone ownership and modern contraceptive use in Burkina Faso: implications for research and interventions using mobile technology

Understanding the Factors that Influence the Primary Appraisal of mHealth Tools in Developing Countries: An Exploratory Case-Study in Nigeria

Determinants of a mobile phone-based Interactive Voice Response (mIVR) system for monitoring childhood illnesses in a rural district of Ghana: Empirical evidence from the UTAUT model

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