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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September, 2019
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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.
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).
Mobile phone, Health information system, Caregivers, Children, Rural, Ghana