RoadMApp: A feasibility study for a smart travel application to improve maternal health delivery in a low resource setting in Zimbabwe

Abstract

Background: Travel time and health care financing are key determinants to the provision of quality maternal health care in low resource settings. Despite the availability of pregnancy-related mHealth and smart travel applications, there is a lack of evidence on their usage to travel to health facilities for routine antenatal care and emergencies in low resource settings like Zimbabwe. Little is known about the feasibility of the usage of custom-made mobile technologies that integrate smart travel and mHealth. This paper explores the feasibility of implementing a custom-made geographically enabled mobile technology-based tool (RoadMApp) to counter the negative effects of long travel times and poor financing strategies for maternal care in Kwekwe District, Zimbabwe. Methods: Focus group discussions were conducted with pregnant women, women of childbearing age, men (household heads) and elderly women. Participatory learning approaches with stakeholders (community members) and in-depth interviews with key informants (health care service providers, transport operators) were utilised. In total 193 people took part in the study. The discussion questions centred on travel time, availability of transport, cellular network coverage and perceptions of the RoadMApp application. Data was analysed thematically using Nvivo Pro 12.Results: Most parts of rural Kwekwe have long distances to health facilities and an inefficient road and telecommunications network. Hence, it is hard to predict if RoadMApp will integrate into the lives of the community - especially those in rural areas. Since these issues are pillars of the design of the RoadMApp application, the implementation is likely to be challenging.Conclusion: Communities are keen to embrace the RoadMApp application. However, the feasibility of implementing RoadMApp in Kwekwe District will be challenging due to maternal health care barriers such as poor road network, poor phone network and the high cost of transport. There is, therefore, a need to investigate the social determinants of access to maternity services in order to inform the RoadMApp implementation.

The Potentials of a Maternal Mobile Wallet: a Qualitative Case Study on Opportunities and Challenges From Zimbabwe

“…The data on Table 3 was obtained in IDIIs as some of the details could not be collected using FGDs. The interview guide with questions on nancial strategies is available (18). At the time the data was collected the rate between the USD and the Zimbabwe dollar was USD 1: Z$10.…”

“…RoadMApp is being implemented in Kwekwe District, Zimbabwe, in 2020. The RoadMApp MHMW is expected to utilise culturally established micro-savings to nance this process (18). It is anticipated that this MHMW will also work as medical savings that will be targeted at persons residing in Kwekwe District (18).…”

“…The research team further used quota sampling on participants drawn from the clinics/hospitals. A standardised interview guide was used in both the FGDs and the IDIIs (18).…”

“…RoadMApp is a new maternal healthcare mobile wallet (MHMW) facility fused into a geographically enabled transport (geo-mHealth) technology for accessing care. Figure 1 showing an infographic of the proposed RoadMApp, with the MHMW circled (17,18). The arrows on Figure 1 show the direction of service within the RoadMApp intervention.…”