A mobile health model supporting Ethiopia’s eHealth strategy

Mobile health applications for disease screening and treatment support in low-and middle-income countries: A narrative review

“…mHealth interventions may be one of the tools to help people in hard-to-reach communities access healthcare. Due to unreliable mobile network coverage or insufficient cellular signal, unstable internet services, and a lack of continuous power supply, they are unable to access healthcare via mHealth [ 144 , 148 , 149 ]. In many LMICs, bandwidth for internet connectivity is minimal, and the cost involved in internet connectivity remains expensive since the majority of people cannot afford [ 149 ].…”

Barriers to Sustainable Telemedicine Implementation in Ethiopia: A Systematic Review

“…According to this review, the most frequently reported barriers to the implementation of telemedicine services are cost 17,18,20,21,16,22,[23][24][25] and infrastructure. 13,17,18,21,22,24,26 The initial cost of establishing telemedicine services is very high, and to function telemedicine services in rural or remote areas for underserved communities needs telecommunication expenses, training (health personnel and 20 2013 Cross-sectional Cost, technical support, internet connection Mengesha et al 27 2013 Case study An internet connection and technical support system Abera et al 21 2014 Mixed method Cost, availability of technical support, Internet connection, ICT infrastructure, technological infrastructure, readiness, staff turnover Medhanyie et al 13 2015 Cross-sectional Health system, resistance to change, ICT infrastructure, awareness, language, poor application design, and technically challenged staff.…”

“…13,17,18,21,22,24,26 The initial cost of establishing telemedicine services is very high, and to function telemedicine services in rural or remote areas for underserved communities needs telecommunication expenses, training (health personnel and 20 2013 Cross-sectional Cost, technical support, internet connection Mengesha et al 27 2013 Case study An internet connection and technical support system Abera et al 21 2014 Mixed method Cost, availability of technical support, Internet connection, ICT infrastructure, technological infrastructure, readiness, staff turnover Medhanyie et al 13 2015 Cross-sectional Health system, resistance to change, ICT infrastructure, awareness, language, poor application design, and technically challenged staff. Xue et al 16 2015 Cross-sectional The technical support system, resistance to change, anxiety, costs Dusabe-Richards et al 19 2016 Mixed-method Network coverage, technical support system, language, phone (mobile), socioeconomic status Barkman and Weinehall 22 2017 Descriptive case report Reimbursement, infrastructures, cost Biruk and Abetu 32 2018 Cross-sectional awareness Steege et al 23 2018 Costs, level of education, culture, phone (mobile), awareness Shiferaw et al 24 2018 Cross-sectional Cost, health system, culture, staff turnover, ICT infrastructure, electricity, phone (mobile), service integration, internet, awareness Harding et al 25 2019 Descriptive case report Electricity, e-health literacy, health system, telecommunication service, cost, internet connection, phone (mobile), human resources Dessie Gashu et al 26 2020 RCT ICT infrastructure, e-health literacy, phone (smart mobile)…”

“…Fifteen years ago, in Ethiopia, all concerned bodies such as universities, telecommunication authority, the ministry of health, policy makers, and other responsible institutions agreed to support telemedicine implementation. 21 However, some services such as access to electricity power (only 8% of rural household have access in 2016), 12 e-health literacy, access to health information technologies (IT) to address gaps in IT literacy for health extension workers, 25 network coverage, and internet connectivity, 18,20,21,24,25,27 and HITs were still the main bottlenecks for the implementation of telemedicine services in Ethiopia. We recommend that the Ethiopian government focus on organizational barriers, especially infrastructure challenges such as unstable power supplies, poor communication networks, inadequate internet connectivity with limited bandwidth, lack of human resources with necessary technical expertise to successfully implement telemedicine, and ensure its sustainability.…”

“…A technical solution should be considered related to language issues at the programmer level. Sometimes users and providers encounter the technology itself to be a challenge, 13,25 because some users or providers may not be as familiar with the functionality of their mobile devices, internet connection, or telemedicine applications. It would be crucial that technical supporters offer guidance for successful implementation and ensure users' confidence at the local level.…”