m-Health adoption and sustainability prognosis from a care givers' and patients' perspective

Abstract

The penetration of mobile phones and mobile technologies in developing countries has led to innovative developments of various m-Health applications. These applications have proven the potential of mobile technologies for improving the quality of health care service in general and the fight against HIV/AIDS in particular. However, to achieve greater impact on the ground level (e.g. in an antiretroviral (ARV) treatment clinic) in a developing country's context, these applications have to be adopted and their utilization sustained. A study was undertaken to investigate sustainability and scalability challenges of mobile phone-based applications/projects for HIV/AIDS care in developing countries and the adoption and sustainability prospects of such m-Health applications in an ARV clinic in Pretoria. The findings presented here, are that from a care givers' and patients' perspective, adoption and sustainability of these applications is not merely dependent on the proposed technology's capabilities to enhance service delivery. Adoption and sustainability is however, mostly dependant on: (1) the care givers and patients' willingness and capability to incur any technological adoption and continuous use costs and, (2) their pre-conceived notions of government or sponsor-supported service provision.These technologies have the potential to improve access to health care services [43] particularly in developing countries where mobile phones are more prevalent than ICTs such as landlines, telephones and the internet [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39]. In these regions the healthcare system constantly faces challenges such as infrastructural deficit, resources shortages, tropical diseases and the burden of widespread diseases such as the HIV/AIDS epidemic [43]. The magnitude of the HIV/AIDS pandemic in developing countries combined with the contextual healthcare provision factors in many ARV clinics has raised the need to develop innovative ways to tackle the complexity that involves the provision of adequate health care in such circumstances.The exploration of the potential of mobile phones in the fight against HIV/AIDS has led to the establishment of mobile phone-based projects for HIV/AIDS care and the development of mobile phone-based applications for health care in developing countries such as South Africa, India, Rwanda, Peru, Uganda, etc [39]. These applications fall in the following utilisation areas: Education and Awareness, Remote Data Collection, Remote Monitoring, Communication and Training for healthcare workers, Disease and Epidemic Outbreak Tracking, and Diagnostic and treatment support [39]. White [42] and Fynn et al [11] note that these applications take advantage of the mobility and flexibility that mobile phones provide, in combination with other ICT technologies such as the internet and database technologies, the potential to overcome many of the barriers of distance and cost facing developing countries.Although these applications have proven the potential ...

Nonlinearities in personalization-privacy paradox in mHealth adoption: The mediating role of perceived usefulness and attitude

“…As a type of eHealth service, mHealth mainly delivers health services through mobile devices [19]. There are many definitions of mHealth.…”

Review of patients perspective’s of m-health adoption factors in the developing world. Development of a framework

“…Research methods used in the 54 reviewed resources were: 25 qualitative papers , 9 surveys [42][43][44][45][46][47][48][49][50], 7 mixed methods [51][52][53][54][55][56][57], 4 experimental [52,[58][59][60], 3 usability assessments [8,61,62], 2 cohort studies [63,64], and 4 cross sectional studies [65][66][67][68]. Collectively they reported the spectrum of factors that affect patient adoption.…”

“…Some issues were related to cost, affordability, and incentives. When the operating costs are not affordable [17,18,43,44,51,60,61], and patients must buy airtime (i.e., where the patient pays for the calls or messages he/she receives or makes in accessing mhealthcare from the service provider [63]), m-health is likely to fail, unless the patient is able or willing to pay [19,45]. Patients may accept the technology if the cost of owning and operating it is considered acceptable [29,45].…”

“…Other issues related to actual cell phone ownership, which was identi ed as a critical determinant in the adoption and uptake of m-health services [44,46,63], included owning the appropriate mobile phone with the required technology [47,58,65]. One study noted that globally, women are 21% less likely to own a mobile phone than men [25].…”

“…Information and communications technology use in low-income countries is lower among females [44,78,79] and a 'gatekeeper effect' was noted in several studies with women requiring permission from their parents, husband or partner to use a cellphone [25,30,42]. This was exacerbated by being ashamed to raise issues about women's diseases with their gatekeeper [42] or fear of punishment if they accessed a phone without permission [37].…”