Udenigwe Ogochukwu, Okonofua Friday E, Ntoimo Lorretta F C, Yaya Sanni
School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, Ottawa, Canada.
Women's Health and Action Research Centre, KM 11 Lagos-Benin Expressway, Igue-Iyeha, Benin City, Edo State, Nigeria.
Dialogues Health. 2022 Oct 30;1:100067. doi: 10.1016/j.dialog.2022.100067. eCollection 2022 Dec.
Acceptability has become a key consideration in designing, implementing and evaluating digital health interventions. Current evidence points to acceptability as a crucial factor in sustaining mobile health programs for maternal health across sub-Saharan Africa particularly in Nigeria where the burden of maternal mortality is high. This paper describes the enablers and barriers to the acceptance of Text4Life, a mobile phone-based health intervention that extends maternal healthcare services to rural areas of Edo State Nigeria.
This is a cross-sectional qualitative study of women who used Text4Life, their spouses who were all men and Ward Development Committee chairpersons who oversaw the implementation of Text4Life. This study was set in Etsako East and Esan Central Local Government Areas of Edo State, Nigeria. Between September 2021 and January 2022, eight focus groups were conducted with 64 participants: 39 women and 25 men. Two in-depth interviews were conducted with Ward Development Committee chairpersons. Data collection was conducted in English and Pidgin English. Discussions and interviews were digitally recorded and translated to English from Pidgin English where necessary. Data analysis followed a mainly deductive approach to thematic analysis, however, emergent information from the data was also considered and reported.
The results show that participants' positive attitudes towards the intervention, the involvement of the community, participants' understanding of the intervention, and perceived effectiveness of the Text4Life program were enablers to women's acceptance of Text4Life and enablers to Ward Development Committee chairpersons' assistance with the program. On the other hand, limited resources and a clash with the community's value system presented barriers to the acceptability of the Text4Life program.
Our findings demonstrate the importance of alleviating the burdens associated with participating in mobile health interventions while noting that the risk of obstructing the gains from mobile health interventions is high if plans for sustaining it are not incorporated early enough in the design phase.
可接受性已成为设计、实施和评估数字健康干预措施的关键考量因素。现有证据表明，可接受性是在撒哈拉以南非洲地区，尤其是在孕产妇死亡率负担较高的尼日利亚，维持孕产妇健康移动健康项目的关键因素。本文描述了Text4Life（一项将孕产妇医疗服务扩展到尼日利亚江户州农村地区的基于手机的健康干预措施）被接受的促进因素和障碍。
这是一项对使用Text4Life的女性、她们均为男性的配偶以及监督Text4Life实施的 Ward 发展委员会主席进行的横断面定性研究。该研究在尼日利亚江户州的埃萨科东部和埃桑中部地方政府辖区进行。在2021年9月至2022年1月期间，对64名参与者进行了8个焦点小组访谈：39名女性和25名男性。对 Ward 发展委员会主席进行了两次深入访谈。数据收集使用英语和洋泾浜英语。讨论和访谈进行了数字录音，并在必要时从洋泾浜英语翻译成英语。数据分析主要采用演绎法进行主题分析，不过，也考虑并报告了数据中出现的新信息。
结果表明，参与者对该干预措施的积极态度、社区的参与、参与者对干预措施的理解以及Text4Life项目的感知效果是女性接受Text4Life的促进因素，也是Ward发展委员会主席协助该项目的促进因素。另一方面，资源有限以及与社区价值体系的冲突对Text4Life项目的可接受性构成了障碍。
我们的研究结果表明减轻参与移动健康干预措施相关负担的重要性，同时指出，如果在设计阶段没有尽早纳入维持移动健康干预措施的计划，那么阻碍从移动健康干预措施中获益的风险就很高。
