Acceptability and usability of a digital tool to support long-lasting insecticide-treated net distribution in Northern Bahr el Ghazal State, South Sudan

Abstract

Background: Long-lasting insecticide-treated nets (LLINs) have been the backbone of malaria prevention for decades. In South Sudan, LLINs are typically distributed by volunteers who use paper-based systems to collect distribution data. Paper-based systems are simple to use but have a higher occurrence of data inaccuracies and can hinder the timely use of data for decision making. In 2022, a digital tool was introduced to collect data during the LLIN campaign in Northern Bahr el Ghazal (NBeG). The tool aimed to improve the accuracy of data entry and enable data to be use in real-time for decision making during the campaign. This study assessed the acceptability and usability of the digital tool. Methods: A questionnaire containing open and closed questions was conducted with users of the digital tool, supervisors and other key stakeholders in five counties of NBeG. The questionnaire was administered using Malaria Consortium’s Projects Results System Android mobile application. Usability was determined through a modified and validated System Usability Scale (SUS) approach and acceptability was assessed by responses to open questions. Results: A total of 93 participants responded to the usability and acceptability questionnaire. The mean (±standard deviation) usability score across 10 SUS-scoring items was 60.91 (12.87), indicating a moderate level of usability. The majority of users reported the tool was useful for managing the LLIN distribution workflow, was easy to use, reduced workload, and supported stock management and real-time campaign monitoring. There was no significant difference in the usability scores across genders, roles, and counties. The digital tool was perceived to be acceptable, and the majority of respondents with experience of both paper-based and the digital tool reported a preference for the digital tool over paper-based systems. The majority of respondents also said they would recommend the digital tool to colleagues. Conclusion: Digital tools are perceived to be beneficial for collecting data during LLIN campaigns, even in remote areas where network coverage is challenging. Additional improvements can be implemented to overcome operational challenges and improve usability of the tool. Further study is needed to determine the impact of the digital tool on data quality and real-time data use.