Contextual Barriers to Mobile Health Technology in African Countries: A Perspective Piece

O’Connor, Yvonne; Donoghue, John O’

doi:10.7309/jmtm.4.1.7

Cited by 26 publications

(31 citation statements)

References 19 publications

(14 reference statements)

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“…The information in this paper echoes implementation challenges from other papers [42][43][44] but they add an NCDs perspective. The two systematic reviews on impact of mHealth on NCDs show modest and variable results 45,46 ; and the scoping review in this paper points to implementation information being a missing link.…”

Section: Discussionsupporting

confidence: 53%

Implementation barriers for mHealth for non-communicable diseases prevention and management in low and middle income countries: a scoping review and field-based views from implementers

et al. 2020

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Background: Mobile health (mHealth) has been hailed as a potential gamechanger for non-communicable disease (NCD) management, especially in low- and middle-income countries (LMICs). Individual studies illustrate barriers to implementation and scale-up, but an overview of implementation issues for NCD mHealth interventions in LMICs is lacking. This paper explores implementation issues from two perspectives: information in published papers and field-based knowledge by people working in this field. Methods: Through a scoping review publications on mHealth interventions for NCDs in LMICs were identified and assessed with the WHO mHealth Evidence Reporting and Assessment (mERA) tool. A two-stage web-based survey on implementation barriers was performed within a NCD research network and through two online platforms on mHealth targeting researchers and implementors. Results: 18 studies were included in the scoping review. Short Message Service (SMS) messaging was the main implementation tool. Most studies focused on patient-centered outcomes. Most studies do not report on process measures and on contextual conditions influencing implementation decisions. Few publications reported on implementation barriers. The websurvey included twelve projects and the responses revealed additional information, especially on practical barriers related to the patients’ characteristics, low demand, technical requirements, integration with health services and with the wider context. Many interventions used low-cost software and devices with limited capacity that not allowing linkage with routine data or patient records, which incurred fragmented delivery and increased workload. Conclusion: Text messaging is a dominant mHealth tool for patient-directed of quality improvement interventions in LMICs. Publications report little on implementation barriers, while a questionnaire among implementors reveals significant barriers and strategies to address them. This information is relevant for decisions on scale-up of mHealth in the domain of NCD. Further knowledge should be gathered on implementation issues, and the conditions that allow universal coverage.

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Section: Discussionsupporting

confidence: 53%

Implementation barriers for mHealth for non-communicable diseases prevention and management in low and middle income countries: a scoping review and field-based views from implementers

et al. 2020

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“…The SL engineering team relied upon Hevner et al's. (2004) guidelines when developing the SL eCCM App, in combination with the knowledge that the technological artefact is required to operate in a complex social, political, economic, and cultural context as advocated by Thapa andSaebø (2014) andO'Connor andO'Donoghue (2015). One central theme to derive from the findings is the concept of integration.…”

Section: Discussionmentioning

confidence: 99%

“…Build refers to the process of constructing a technological artefact for a specific purpose. For a technological artefact, it is imperative that contextual factors (eg, cultural, economic, and social) should be considered when building technological artefacts to be used in a developing world environments (O'Connor & O'Donoghue, ; Thapa & Sæbø, ). Evaluation assesses how well the artefact meets its objectives (Helfert, Donnellan, & Ostrowski, ; Hevner et al, ).…”

Section: Methodsmentioning

confidence: 99%

A mobile health technology intervention for addressing the critical public health issue of child mortality

O’Connor

O’Sullivan

Gallagher

et al. 2017

E J Info Sys Dev Countries

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Evaluations of development initiatives in resource-poor settings dominate Health Information Technology/Systems research. Yet a dearth of research exists, which documents the design and development of these technological artefacts. Through the lens of Transition Management Framework, this research attempts to address this gap in literature, to describe a particular technology (ie, Supporting LIFE-SL eCCM App) and the way in which its hardware, software, and system configurations interact with the sociocultural and economic context in one rural region of the Malawian community. This study uses a design science perspective to ensure the design and development of a health technology intervention that is relevant and has utility in the context for which it has been built, ie, Malawi Africa. This paper addresses the manner in which the configurations of a mobile Health intervention (known as Supporting LIFE eCCM App) interact within a developing world context. Supporting LIFE eCCM aims to leverage the critical societal issue of reducing child mortality in Malawi, Africa. The design science approach supports the design and build of a health intervention that is a good fit for the "real-world" health scenario considered.Coupled with Geel's Transition Management Framework, we emphasise the need for a balanced sociotechnical approach to mHealth, placing individuals at the centre of the IT development project while also considering social, economic, and cultural factors. These are key environmental aspects of a development project such as this one. KEYWORDShealth informatics, IT and the global Community, rural health infrastructure, scalable infrastructures for development

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“…[33] [34][35][36][37] As shifting health challenges combine with maturing eHealth opportunities, consideration of different solutions, in different proportions, in different settings is required. This constantly changes the nature of eHealth investment decisions.…”

Section: Resultsmentioning

confidence: 99%

Increasing Need for an eHealth Impact Framework for Africa (Preprint)

Broomhead¹,

Mars²,

Scott³

et al. 2018

Preprint

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Background: Efforts by African countries to improve healthcare and citizens' health within challenging resource limitations put considerable pressure on investment decisions. eHealth is believed to have potential to strengthen health systems and is now seen by some entities as a determinant of health, yet its impact is not well estimated in advance or measured after implementation. This is an obstacle to the effective allocation of healthcare resources and limits national and regional abilities to develop eHealth and realise its potential in health systems transformation.

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Contextual Barriers to Mobile Health Technology in African Countries: A Perspective Piece

Cited by 26 publications

References 19 publications

Implementation barriers for mHealth for non-communicable diseases prevention and management in low and middle income countries: a scoping review and field-based views from implementers

Implementation barriers for mHealth for non-communicable diseases prevention and management in low and middle income countries: a scoping review and field-based views from implementers

A mobile health technology intervention for addressing the critical public health issue of child mortality

Increasing Need for an eHealth Impact Framework for Africa (Preprint)

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