The MomConnect Nurses and Midwives Support Platform (NurseConnect): A Qualitative Process Evaluation

Abstract

Background Over the past decade, mobile health has steadily increased in low-income and middle-income countries. However, few platforms have been able to sustainably scale up like the MomConnect program in South Africa. NurseConnect was created as a capacity building component of MomConnect, aimed at supporting nurses and midwives in maternal and child health. The National Department of Health has committed to expanding NurseConnect to all nurses across the country, and an evaluation of the current user experience was conducted to inform a successful scale up. Objective This study aims to evaluate the perception and use of NurseConnect by nurses and midwives to produce feedback that can be used to optimize the user experience as the platform continues to scale up. Methods We conducted focus group discussions and in-depth interviews with 110 nurses and midwives from 18 randomly selected health care facilities across South Africa. Questions focused on mobile phone use, access to medical information and their experience with NurseConnect registration, as well as the content and different platforms. Results All participants had mobile phones and communication through calls and messaging was the main use in both personal and work settings. Of 110 participants, 108 (98.2%) had data-enabled phones, and the internet, Google, and apps (South African National Department of Health Guidelines, iTriage, Drugs.com) were commonly used, especially to find information in the work setting. Of 110 participants, 62 (56.4%) were registered NurseConnect users and liked the message content, especially listeriosis and motivational messages, which created behavioral change in some instances. The mobisite and helpdesk, however, were underutilized because of a lack of information surrounding these platforms. Some participants did not trust medical information from websites and had more confidence in apps, while others associated a “helpdesk” with a call-in service, not a messaging one. Many of the unregistered participants had not heard of NurseConnect, and some cited data and time constraints as barriers to both registration and uptake. Conclusions Mobile and smartphone penetration was very high, and participants often used their phone to find medical information. The NurseConnect messages were well-liked by all registered participants; however, the mobisite and helpdesk were underutilized owing to a lack of information and training around these platforms. Enhanced marketing and training initiatives that optimize existing social networks, as well as the provision of data and Wi-Fi, should be explored to ensure that registration improves, and that users are active across all platforms.

Uptake of the Ithaka mobile application in Johannesburg, South Africa, for human immunodeficiency virus self-testing result reporting

“…Similar to reports of other South African digital health interventions, for users to completely embrace Ithaka and realise its full use, marketing campaigns can be used to create awareness, followed by a more comprehensive onboarding to motivate users. 22 Although practical reasons for stopping the use of the app, such as forgetting to log back in or not using the test yet, should be mitigated with text message reminders, which have been shown to improve the user responsiveness of other mHealth apps, 23,24,25 we did not find this in our study in which registered participants received reminder messages on day 1 and day 7. Some participants cited data costs and network issues as challenges to the app, and these are well-documented barriers for any mHealth app to enter into the South African market; 6,22 however, Ithaka was a reverse-billed online platform that removed the barrier of data costs.…”

Evaluation of a mobile application to support HIV self-testing in Johannesburg, South Africa

“…Data concerns are also an important issue in South Africa, with previous mHealth studies highlighting data costs and phone memory as a barrier to entry. 26 , 44 Future app development should focus on keeping storage requirements minimal to ensure that the app is available for as many individuals as possible. Furthermore, the necessity to upload images may also incur additional data charges and may not be affordable for all users.…”

Health care providers’ perceptions of barriers to perinatal mental healthcare in South Africa

“…• Expand MOMConnect mobile app mental health messaging supported by the National Department of Health [ 48 ]. • Continue expansion of psychosocial support via NurseConnect mobile health application supported by National Department of Health [ 49 ]. • Identify lessons learned from the CLEVER Maternity Care intervention, which aims to increase respectful, quality obstetric care [ 50 ].…”