Assessing the Usefulness and Challenges of a Mobile Health Intervention among Caregivers of Children Under-5years in Rural Communities in the Asante Akim North District.

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November, 2019.
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The rapid growth in the use of mobile devices has influenced the creation of mobile Health (mhealth) interventions to contribute to healthcare development and childhood survival in underserved communities. MHealth interventions have been found to help widen healthcare coverage, and also improve on the quality of healthcare. Despite these numerous prospects of mHealth interventions in promoting health, its scale-up and sustenance, have been challenging. Many of such interventions are not able to advance beyond the pilot stage of implementation and often cover a small-targeted scope. The full benefits of mHealth therefore, have not been fully realized and utilized. The main objective of this study was to qualitatively explore the usefulness and challenges of a mHealth (IVR/toll-free call) system among caregivers of children under-5years in rural communities in the Asante Akim North District of Ghana. The study adopted an exploratory design and a qualitative approach. A simple random sampling technique was used to select 27 participants for the study. 11 In-depth interviews and 2 Focus group discussions (8 participants in a group) were conducted among participants using an interview guide and a focus group discussion guide respectively. Thematic content analysis strategy was adopted for the analysis of data in this study. The study discovered that the mHealth (IVR) system was useful in improving access to healthcare, improving communication between caregivers and health professionals, served as a decision and emotional support system to caregivers, and improved the knowledge of caregivers on selfmanagement of childhood diseases. The mHealth (IVR) system was found to be feasible and highly acceptable, and the attitude of caregivers towards the system was also found to be positive. Poor network quality and unstable electricity power supply, missed calls, dropped/cut calls, and toll-free number busy, and problems with the pressing of keys to feed information into a mHealth (IVR) system served as challenges towards the acceptance and use of the mHealth system. Among others, improved infrastructure, partnerships with community institutions and community stakeholders, and assignment of healthcare professionals to mHealth care delivery in health facilities were recommended strategies by caregivers to contribute to mHealth system sustenance, scale-up, and integration. The mHealth system implemented in the MOBCHILD project was found to be feasible and acceptable to contribute to healthcare delivery in this study. Therefore, investment in this system by Government and other funding agencies is required to sustain and scale-up, and also, integrate the mHealth (IVR) system into the broader healthcare delivery system.
A Thesis submitted to the School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi In partial fulfillment of the requirements for the Award of Master of Science Degree in Public Health (Msc. Health Education and Promotion).
Mobile health intervention, Children under-5years