M3-BIORES (Measure, Model & Manage Bioreponses), Division of Animal and Human Health Engineering, Department of Biosystems, KU Leuven, Leuven, Belgium.
School of Biomedical Engineering, Jimma Institute of Technology, Jimma University, Jimma, Ethiopia.
J Med Internet Res. 2024 Mar 27;26:e50337. doi: 10.2196/50337.
Digital technologies are increasingly being used to deliver health care services and promote public health. Mobile wireless technologies or mobile health (mHealth) technologies are particularly relevant owing to their ease of use, broad reach, and wide acceptance. Unlike developed countries, Sub-Saharan Africa experiences more challenges and obstacles when it comes to deploying, using, and expanding mHealth systems. In addition to barriers, there are enabling factors that could be exploited for the design, implementation, and scaling up of mHealth systems. Sub-Saharan Africa may require tailored solutions that address the specific challenges facing the region.
The overall aim of this study was to identify the barriers and enablers for using mHealth systems in Sub-Saharan Africa from the perspectives of patients, physicians, and health care executives.
Multi-level and multi-actor in-depth semistructured interviews were employed to qualitatively explore the barriers and enablers of the use of mHealth systems. Data were collected from patients, physicians, and health care executives. The interviews were audio recorded, transcribed verbatim, translated, and coded. Thematic analysis methodology was adopted, and NVivo software was used for the data analysis.
Through this rigorous study, a total of 137 determinants were identified. Of these determinants, 68 were identified as barriers and 69 were identified as enablers. Perceived barriers in patients included lack of awareness about mHealth systems and language barriers. Perceived enablers in patients included need for automated tools for health monitoring and an increasing literacy level of the society. According to physicians, barriers included lack of available digital health systems in the local context and concern about patients' mHealth capabilities, while enablers included the perceived usefulness in reducing workload and improving health care service quality, as well as the availability of mobile devices and the internet. As perceived by health care executives, barriers included competing priorities alongside digitalization in the health sector and lack of interoperability and complete digitalization of implemented digital health systems, while enablers included the perceived usefulness of digitalization for the survival of the highly overloaded health care system and the abundance of educated manpower specializing in technology.
mHealth systems in Sub-Saharan Africa are hindered and facilitated by various factors. Common barriers and enablers were identified by patients, physicians, and health care executives. To promote uptake, all relevant stakeholders must actively mitigate the barriers. This study identified a promising outlook for mHealth in Sub-Saharan Africa, despite the present barriers. Opportunities exist for successful integration into health care systems, and a user-centered design is crucial for maximum uptake.
数字技术越来越多地被用于提供医疗服务和促进公共卫生。移动无线技术或移动健康（mHealth）技术由于其易用性、广泛的覆盖范围和广泛的接受度而尤为相关。与发达国家不同，撒哈拉以南非洲在部署、使用和扩展 mHealth 系统方面面临更多的挑战和障碍。除了障碍外，还有一些有利因素可以被利用来设计、实施和扩大 mHealth 系统。撒哈拉以南非洲可能需要针对该地区面临的具体挑战的定制解决方案。
本研究的总体目标是从患者、医生和医疗保健管理人员的角度确定撒哈拉以南非洲使用 mHealth 系统的障碍和促进因素。
采用多层次、多主体深入半结构式访谈，从定性角度探讨 mHealth 系统使用的障碍和促进因素。数据来自患者、医生和医疗保健管理人员。访谈进行了录音，逐字记录，翻译，并进行了编码。采用主题分析方法，使用 NVivo 软件进行数据分析。
通过这项严格的研究，共确定了 137 个决定因素。其中，68 个被确定为障碍，69 个被确定为促进因素。患者感知到的障碍包括对 mHealth 系统缺乏认识和语言障碍。患者感知到的促进因素包括对健康监测自动化工具的需求以及社会文化水平的提高。医生认为，障碍包括当地缺乏可用的数字健康系统以及对患者 mHealth 能力的担忧，而促进因素包括减少工作量和提高医疗服务质量的感知有用性，以及移动设备和互联网的可用性。医疗保健管理人员认为，障碍包括数字化与医疗保健部门的其他优先事项竞争以及数字化健康系统的互操作性和完全数字化缺乏，而促进因素包括数字化对高度超负荷医疗保健系统生存的有用性以及专门从事技术的受过教育的人力的丰富性。
撒哈拉以南非洲的 mHealth 系统受到各种因素的阻碍和促进。患者、医生和医疗保健管理人员都确定了共同的障碍和促进因素。为了促进采用，所有相关利益攸关方都必须积极缓解障碍。尽管存在当前的障碍，但本研究为撒哈拉以南非洲的 mHealth 前景带来了希望。成功整合到医疗保健系统中存在机会，以用户为中心的设计对于最大限度地采用至关重要。
