Factors associated with the use of a mobile phone-based health information system among caregivers of children under-five in Rural Ghana
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Date
September, 2019
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Abstract
Introduction
Although childhood mortality and morbidity continues to be one of the leading challenges in
LMICs, the burden can significantly be prevented with simple and affordable interventions. The
phenomenon of using mobile phone technology in healthcare (mHealth) has attracted a global
attention because of increase access and use of mobile phones in both urban and rural areas.
MHealth interventions therefore provide a promising vehicle to improving the health outcomes
in developing countries where access to health continues to be a significant obstacle.
Notwithstanding the potential benefits of mHealth, its adoption and use among the end users in
developing countries, such as Ghana, have not been thoroughly explored.
Objective
This study assessed the factors that influence the use of a mobile phone-based health information
system among caregivers of children under five years in the Asante Akim North District.
Methodology
A community-based cross-sectional study nested in the MOBCHILD project was conducted in
Asante Akim North District, a rural area in Ghana. In all 354 caregivers of children under-five
years were interviewed using a structured questionnaire. Regression analysis was done to
examine the strength of the relationship between the independent and dependent constructs
(variables) within the Unified Theory of Acceptance and Use of Technology (UTAUT) model.
Results
Most caregivers were females (86.44%). Mobile phones ownership was very high (86%). Male
gender, age and socio-economic status were associated with phone ownership (p<0.05). A
significant 92.66% (324) of the all the respondents expressed intention to use to mHealth service
in the future although a third (28.53%) reported actual use.
The results also indicated that the relationship between Performance Expectancy (PE) and
Behavioural Intention (BI) (β-0.278, 95% CI-0.207-0.349 p<0.001), Effort Expectancy (EE) and
BI (β-0.242, 95% CI-0.159-0.326, p<0.001), Social Influence (SI) and BI (β-0.081, 95% CI-
0.044-0.120, p<0.001), Facilitating Condition (FC) and User behaviour (UB) (β-0.609, 95% CI-
0.502-0.715, p<0.001), were significant. Behavioural Intention (BI) had a strong positive impact
on User Behaviour (UB) (β-0.426, 95% CI-0.255-0.597, p<0.001). Mobile phone experience and
socio-economic status significantly moderated the effect of performance expectancy, effort
expectancy, social influence, facilitating condition on behavioural intention and usage of
mHealth service.
Conclusion
The perceived usefulness (PE) of mHealth system, ease associated with its use (EE), social
influences (SI) and existing facilitating condition (FC) are strong determinants of users’ attitude
and actual use (UB) of mHealth services. In order to increase uptake of mHealth, barriers such as
electricity and network challenges must also be considered.
Description
A thesis submitted to the School of Public Health, Kwame Nkrumah University of Science and Technology in partial fulfillment of the requirements for the degree of Master of
Public Health (Population, Family and Reproductive Health).
Keywords
Mobile phone, Health information system, Caregivers, Children, Rural, Ghana