Barriers to eHealth adoption in routine antenatal care practices: Perspectives of expectant mothers in Uganda – A qualitative study using the unified theory of acceptance and use of technology model

Abstract

Current empirical evidence suggests that successful adoption of eHealth systems improves maternal health outcomes, yet there are still existing gaps in adopting such systems in Uganda. Service delivery in maternal health is operating in a spectrum of inadequacy, hence eHealth adoption cannot ensue. This study set out to explore the challenges that impede eHealth adoption in women's routine antenatal care practices in Uganda. A qualitative approach using semi-structured interviews was employed to document challenges. These challenges were classified based on a unified theory of acceptance and use of technology constructs. One hundred and fifteen expectant mothers, aged between 18 and 49 years, who spoke either English or Luganda were included in the study that took place between January to May 2019. Thematic analysis using template analysis was adopted to analyse qualitative responses. Challenges were categorised based on five principal unified theories of acceptance and use of technology constructs namely: performance expectancy, effort expectancy, social influence, facilitating conditions and behavioural intention. Facilitating conditions had more influence on technology acceptance and adoption than the other four constructs. Specifically, the lack of training prior to using the system, technical support, computers and smart phones had a downhill effect on adoption. Subsequently, the cost of data services, internet intermittency, and the lack of systems that bridge the gap between mothers and health providers further hindered technology uptake. In conclusion, strategies such as co-development, training end-users, garnering support at the national and hospital levels should be advocated to improve user acceptance of technology.

Exploring Challenges in Accessing Primary Healthcare for Pregnant Women in Pakistan: A Qualitative Descriptive Study

“…Partners, mothers-in-law, and senior family members decide to take antenatal treatment rather than the pregnant woman herself. It has been shown in several studies that a husband's positive and friendly behavior towards antenatal care participation signi cantly affected women's decisions to access antenatal care facilities (11). This study also showed community trust in lady health works to facilitate their positive experience throughout the pregnancy.…”

Does the transcultural problem really matter? An integrated approach to analyze barriers to eHealth SMEs’ development

“…Based on empirical research on eHealth SMEs in the wellness and healthcare sector, Jaring et al (2013) propose that the main barriers are lack of capability to deploy new ICT solutions, weak customer awareness of eHealth, healthcare employees' lack of skills to pilot new eHealth technologies, the difficulty and expense of building ICT solutions, and the difficulty of determining which partners and channels to focus on. In Namatovu et al ' (2021) view, the cost of data services, internet intermittency, and lack of training in using eHealth systems are the top three barriers to eHealth technology uptake. Kesse-Tachi et al (2019) analyze factors influencing eHealth technology adoption from the perspective of managerial and institutional characteristics, and performance and effort expectancy.…”

“…(2013) propose that the main barriers are lack of capability to deploy new ICT solutions, weak customer awareness of eHealth, healthcare employees’ lack of skills to pilot new eHealth technologies, the difficulty and expense of building ICT solutions and the difficulty of determining which partners and channels to focus on. In Namatovu et al. ’ (2021) view, the cost of data services, Internet intermittency and lack of training in using eHealth systems are the top three barriers to eHealth technology uptake.…”

Perspectives of Mothers and Providers regarding Virtual Care Approaches during Pregnancy in High and Low-Income Countries: A Meta-Synthesis on Qualitative Studies

“…All included studies were in English and were published from 2015 to 2022, including 2022 (n � 2), 2021 (n � 1), 2020 (n � 3), 2019 (n � 2), 2018 (n � 2), 2017 (n � 4), 2016, and 2015, one article each. Among the 16 included articles, ten (62.5%) were related to high-income countries [2,7,11,[34][35][36][37][38][39][40] and six (37.5%) to low-income countries [20,[41][42][43][44][45]. From highincome countries, three articles were implemented in the USA [2,7,11], followed by one in the UK [35], China [39], South Africa [36], Guatemala [37], Germany [34], the Netherlands [38], and Australia [40].…”

“…Also, in low-income countries, one study was conducted in each country, including Uganda, Madagascar, Bangladesh, India, Pakistan, and Ghana. Te included studies in terms of the type of virtual approach contained mHealth (n � 7) [20,36,37,[40][41][42][43], mHealth or eHealth App (n � 4) [34,38,39,45], Telehealth (n � 2) [7,11], eHealth [44], remote care [35], and virtual visit [2] having one each case (Figure 2). Regarding the type of participant, in six studies (37.5%) [7,34,36,37,39,44], mothers were the only participants in three (18.75%) [11,43,45], providers presented only, and in seven (43.75%) [2,20,35,38,[40][41][42], both were involved.…”