Lessening barriers to healthcare in rural Ghana: providers and users’ perspectives on the role of mHealth technology. A qualitative exploration

Abstract

Background: Key barriers to healthcare use in rural Ghana include those of economic, social, cultural and institutional. Amid this, though rarely recognised in Ghanaian healthcare settings, mHealth technology has emerged as a viable tool for lessening most healthcare barriers in rural areas due to the high mobile phone penetration and possession rate. This qualitative study provides an exploratory assessment of the role of mHealth in reducing healthcare barriers in rural areas from the perspective of healthcare users and providers.Method: Semi-structured interviews were conducted with 30 conveniently selected healthcare users and 15 purposively selected healthcare providers within the Birim South District in the Eastern Region of Ghana between June 2017 and April 2018. Data were thematically analysed and normative standpoints of participants were presented as quotations.Results: The main findings were that all the healthcare users had functioning mobile phones, however, their knowledge and awareness about mHealth was low. Meanwhile, rural health care users and providers were willing to use mHealth services involving phone call in the future as they perceived the technology to play an important role in lessening healthcare barriers. Nevertheless, factors such as illiteracy, language barrier, trust, quality of care, and mobile network connectivity were perceived as barriers associated with using mHealth in rural Ghana. Conclusion:The support for mHealth service is an opportunity for the development of synergistic relationship between health policy planners and mobile network companies in Ghana to design efficient communication and connectivity networks, accessible, localised, user-friendly and cost-effective mobile phone-based health programmes to assist in reducing healthcare barriers in rural Ghana.

Introduction of digital reporting platform to integrate community-level data into health information systems is feasible and acceptable among various community health stakeholders: A mixed-methods pilot study in Mopti, Mali

“…Future research should consider digital options if they are able to develop strategies to adapt and integrate digital strategies into existing health systems processes and to overcome technological challenges. Such strategies may have more success in urban areas as network connectivity is a common barrier to digital mobile-phone-based interventions in LMICs [ 31 , 32 ].…”

Formalising ‘informal’ mHealth in Ghana: Opportunities and challenges for Universal Health Coverage (UHC)

“…Although much has been written about challenges faced by community health-workers in the line of their duties, the following challenges as summarised by Bogan et al (2009;as cited in Agarwal et al, 2015as cited in Agarwal et al, , p. 1004) are instructive: 'lack of appropriate means to collect data, inadequate access to training and reference materials, poor communication with peers or supervisors to handle situations that are beyond their skills, and difficulty in scheduling household visits and follow-up appointments with patients'. Notably, most of these challenges are applicable to the CHNs in Ghana, but could potentially be addressed, wholly or partially, through the use of mobile phones (Laar et al, 2019Peprah et al, 2019Peprah et al, 2020;). As we discuss below, it is precisely to overcome these kinds of challenges that CHNs in Ghana use their own mobile phones to deliver healthcare in the country.…”

“…Therefore, this current paper examines the practices of informal mhealth, and asks whether and how these practices might productively be integrated into the healthcare delivery of Ghana, with the aim of promoting Universal Health Coverage (UHC), which is a guiding principle within the United Nation's Sustainable Development Goals (SDGs) to ensure that all individuals 'receive the health services they need, of sufficient quality to be effective while at the same time ensuring that the use of these services does not expose the user to financial hardship' (United Nations, 2015). Thus, where people cannot assess health facilities due to transport and other challenges (Peprah et al, 2020;2019), mhealth may help bridge the gap by enabling CHNs to extend healthcare to those areas, thereby contributing to the achievement of universal health coverage (Mehl & Labrique, 2014).…”

Increasing Nursing Student Interest in Rural Healthcare: Lessons From a Rural Rotation Program in Democratic Republic of the Congo

“…Other obvious negative effects from failing to adequately address rural healthcare sta ng and care provision include underreporting of diseases, such as Buruli Ulcer in DRC [23], lack of appropriate and basic diagnostic services such as radiology in across Sub-Saharan Africa [24], and inadequate communication networks and sharing of best practices from urban to rural settings-from healthcare providers and thought-leaders in DRC [11]. While several interventions have been proposed-including ehealth information sharing and application deployment through smartphones in Ghana [25], e-health solutions for rural clinics in South Africa [26], Ghana, Tanzania, and Burkina Faso [27], and improved clinic leadership training for rural healthcare clinic leaders in South Africa [28], none appear to have been more effective than recruiting both rural and urban practitioners, nurses, and CHWs to serve these rural health centers even if only on a rotational basis [7].…”