Proposing Parameters for Evaluating Sustainability of mHealth Systems in Developing Countries
DOI:
https://doi.org/10.24297/ijct.v17i1.7140Keywords:
Sustainability, mHealth, EvaluationAbstract
The exponential rise in global healthcare challenges; the rise in morbidity and mortality, especially in developing countries have compelled stakeholders to explore alternative ways of overcoming the crisis. Guided by the recommendation of WHO (2013), efforts have been directed towards prevention, response and strengthening of the existing healthcare systems. There have also been efforts to explore the potential of mobile technology towards healthcare provision, with numerous mHealth projects being reported across the developing world. Reports indicate that a significant number of these solutions have failed before realizing the primary goals, pointing to a possible mHealth sustainability challenge. The study explored literature covering global health challenges, use of mobile technology healthcare solutions in developing countries as well literature covering evaluating technology sustainability. Through the review, key factors that influence sustainability of technology were identified. A cross-sectional survey using questionnaires and a qualitative exploratory study using interviews and Focused Group Discussion, targeting mHealth stakeholders were used to map and contextualize the identified sustainability factors to the developing country context. The identified factors were categorized into three broad categories; Individual factors; User Satisfactions, Access to system, and User Support, Technological Factors; System Quality, System Scalability, Technology Sustainability, Technology Relevance and System Interoperability and Management Factors; mHealth Ownership and Net Benefits (Return on Investment). The paper identifies challenges in the sustainability of mHealth systems in developing countries; using Kenya health sector as a case study and propose sustainability evaluation parameters for mHealth systems in developing countries.
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References
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[2] WHO. World Health Statistics. 2014. Indicator compendium: Health-related Millennium Development Goals. 2014
[3] King, D. A. Peckham, C. Waage, J. K. Brownlie J. Woolhouse, M. 2006. ‘Infectious Diseases – Preparing for the future’, Science 303, 1392–1393. 2006, http://dx.doi.org/10.1126/science.1129134, PMid:16959992
[4] Jones, K. E. Patel, N. G. Levy, M. A. Storeygard, A. Balk, D. Gittleman, J. L. Daszak, P. 2008. Global trends in emerging infectious diseases. Nature. 2008 Feb 21;451(7181):990-3
[5] United Nnations. Resolution adopted by the General Assembly-United Nations Millennium Declaration. 2000. http://www.un.org/millennium/declaration/ares552e.pdf (Accessed 11th July 2015)
[6] United Nations. 2016 The Sustainable Development Goals Report 2016. United Nations
[7] Institute for Health Metrics and Evaluation. 2013. The Global Burden of Disease: Generating Evidence, Guiding Policy. Seattle, WA: IHME, 2013.
[8] Boutayeb A. 2010. The Burden of Communicable and Non-Communicable Diseases in Developing Countries. Handbook of Disease Burdens and Quality of Life Measures. 2010, pp 531-546
[9] Marshall SJ. 2004. Bulletin of the World Health Organization | July 2004, 82 (7)
[10] Tariq, A. Akter, S. 2011. An assessment of m-Health in developing countries using task technology fit model. Research Online; University of Wollongong. 2011.
[11] WHO Global Observatory for eHealth. 2011 New horizons for health through mobile technologies. Geneva: World Health Organization; (2011).
http://www.who.int/healthinfo/global_burden_disease/about/en/ (Accessed 9th August 2015)
[12] WHO. 2011c. mHealth: New horizons for health through mobile technologies, WHO, Geneva. 2011c
[13] Adedejim, A. A. Sanusi, B. Tella, A. Akinsanya, M. Ojo, O. Akinwunmi, M. O. Tikare, O. A. Ogunwande, I. A. Ogundahuns, O. A. Ayilara, O. O. 2011. Exposure to anti-malarial drugs and monitoring of adverse drug reactions using toll-free mobile phone calls in private retail sector in Sagamu, Nigeria: implications for pharmacovigilance. Malar J 2011.
[14] Wakadha, H., Chandir, S., Were, E. V., Rubin, A., Obor, D., Levine, O. S., Gibson, D. G, Odhiambo, F., Laserson, K. F., Feikin, D. R. 2013. The feasibility of using mobile-phone based SMS reminders and conditional cash transfers to improve timely immunization in rural Kenya. Vaccine 2013, 31(6):987–993.
[15] Ngabo F, Nguimfack J, Nwaigwe F, Mugeni C, Muhoza D, Wilson DR, Kalach J, Gakuba R, Karema C, Binagwaho A. 2012. Designing and Implementing an Innovative SMS-based alert system (RapidSMS-MCH) to monitor pregnancy and reduce maternal and child deaths in Rwanda. Pan Afr Med J 2012, 13:31.
[16] Githinji S, Kigen S, Memusi D, Nyandigisi A, Mbithi AM, Wamari A, Muturi AN, Jagoe G, Barrington J, Snow RW, Zurovac D. 2013. Reducing stock-outs of life saving malaria commodities using mobile phone text-messaging: SMS for life study in Kenya. PLoS One. 2013, 8 (1): e54066-10.1371/journal.pone.0054066.
[17] Mechael P. Batavia H. Kaonga N. Searle S. Kwan A. Goldberger A. Fu. L. Ossman J. 2010. ‘Barriers and gaps affecting mHealth in low and middle income countries’, Policy white paper, Columbia University Earth institute and mHealth Alliance. 2010. (Accessed 14 December 2015).
[18] WHO 2011b. mHealth: New horizons for health through mobile technologies, Global Observatory for eHealth series - Volume 3, WHO, Geneva. 2011b. Accessed 16th November
2015.
[19] Vital Wave Consulting. 2009. Health Information Systems in Developing Countries: A
Landscape Analysis. 2009.
[20] Chigona W. Mphatso NM. Metfula AS. A. 2013. review on mHealth research in developing countries. The Journal of Community Informatics Vol 9, No 2 (2013)
[21] Kahn J, G. Yang J, S. Kahn J, S. 2010. ‘â€Mobile†health needs and opportunities in developing countries’, Health Affairs. 2010. Vol. 29, pp. 252–58.
[22] Blaya, J, A. Fraser, H, S, F. Holt, B. 2010. E-Health Technologies Show Promise In Developing Countries. Health affairs (Millwood, Va.). 2010.. 29(2), 244-251.
[23] Brundtland, G, H. 1987. Report of the World Commission on Environment and Development: Our Common Future. Oslo, 20 March 1987
[24] Tomlinson, M. Solomon, W. Singh, Y. Doherty, T. Chopra, M. Ijumba, P. Tsai, A, C. Jackson, D. 2009 The use of mobile phones as a data collection tool: a report from a household survey in South Africa. BMC Med Inform Decis Mak. 2009, 9: 51-10.1186/1472-6947-9-51.
[25] Abimbola, S. 2011. "Health systems in an interconnected world: A view from Nigeria." 2011. Medic Review, 13(3), 43-45.
[26] Chan, C. V. Kaufman, D. R. 2010. A technology selection framework for supporting delivery of patient-oriented health interventions in developing countries." Journal of Biomedical Informatics, 2010. 43(2), 300-306.
[27] ITU–T. 2016. Mobile-Cellular Telephone Subscription. 2016 http://www.itu.int/en/ITU-D/Statistics/Pages/stat/default.aspx (Accessed June 2016)
[28] Cargo M. Landscaping of mHealth in South Africa. GSMA June 2013
[29] Siedner, M. J. Haberer, J. E. Bwana, M. B. Ware, N. C. Bangsberg, D. R. 2012. High acceptability for cell phone text messages to improve communication of laboratory results with HIV-infected patients in rural Uganda: a cross-sectional survey study. BMC Med Inform Decis Mak 2012, 12:56.
[30] Haberer, J. E. Kiwanuka, J. Nansera, D. Wilson, I. B. Bangsberg, D. R. 2010. Challenges in using mobile phones for collection of antiretroviral therapy adherence data in a resource-limited setting. AIDS Behav 2010, 14(6):1294–1301.
[31] Smith, C. Vannak, U. Sokhey, L. Cockroft, M. 2013. Overcoming mHealth Operational Challenges in Cambodia (RE: JMTM 2013, 2: 20_23)
[32] Foh, K. 2014. mHealth in Malawi: Challenges and Opportunities. GSMA. 2014
[33] Clara, B. Aranda-Jan, N. M. Svetla, L. 2014. Systematic review on what works, what does not work and why of implementation of mobile health (mHealth) projects in Africa. BMC Public Health 2014 Feb 21;14:188. Epub 2014 Dec 21.
[34] Leon N. Helen S. Emmanuelle D. Applying a framework for assessing the health system challenges to scaling up mHealth in South Africa. BMC Medical Informatics and Decision Making201212:123.
[35] Asiimwe, C. Gelvin, D. Lee, E. Amor, Y. B. Quinto, E. Katureebe, C. Sundaram, L. Bell, D. Berg, M. 2011. Use of an innovative, affordable, and open-source short message service-based tool to monitor malaria in remote areas of Uganda. Am J Trop Med Hyg 2011, 85(1):26–33.
[36] Chang, L. W. Kagaayi, J. Arem, H. Nakigozi, G. Ssempijja, V. Serwadda, D. Quinn, T. C. Gray, R. H. Bollinger, R. C. Reynolds, S. J. 2011. ‘Impact of a mHealth intervention for peer health workers on AIDS care in rural Uganda: A mixed methods evaluation of a cluster-randomized trial’, AIDS and Behavior. 2011, vol. 15. no. 8, pp. 1776–84.
[37] Goodhue, D. L. Thompson, R. L. 1995. Task-technology and individual performance, MIS Quarterly 19(2), 1995, pp. 213-236.
[38] DeLone, W. H. McLean, E. R. 2004. Measuring e-commerce success: applying the DeLone & McLean Information Systems Success Model, Int. J. Electron. Commerce 9 (1) (2004) 31–47.
[39] Scott-Morton, M.S. 1991. The Corporation of the 1990s, Oxford University Press, New York, 1991.
[40] Maryati, M. Yusof, J. Kuljis, A, P. Lampors, K, S. 2008. An evaluation framework for Health Information Systems: human, organization and technology-fit factors (HOT-fit). International journal of medical informatics. 2008. Volume 77(6) 386-398. Elsevier
[41] Aizstrautaa, D. Gintersa, E. Eroles, M, P. 2014. Applying Theory of Diffusion of Innovations to Evaluate Technology Acceptance and Sustainability. ICTE in Regional Development, December 2014, Valmiera, Latvia. Procedia Computer Science 43 ( 2015 ) 69 – 77. www.sciencedirect.com
[42] Quintana, Y. 2015. m-Health Design and Evaluation. Mobile World Congress. 2015.
[43] Lemaire J. 2011. Scaling up Mobile Health: Elements Necessary for the Successful Scale up of mHealth in Developing Countries. Advanced Development for Africa - White paper. Actevis Consulting Group. 2011
http://www.adaorganization.org/documents/ADA_mHealth%20White%20Paper.pdf>.( accessed 9th August 2014)
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Published
2018-01-16
How to Cite
Muhambe, T. (2018). Proposing Parameters for Evaluating Sustainability of mHealth Systems in Developing Countries. INTERNATIONAL JOURNAL OF COMPUTERS &Amp; TECHNOLOGY, 17(1), 7153–7162. https://doi.org/10.24297/ijct.v17i1.7140
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