Design considerations for patient‐centered eHealth interventions in an underserved context: A case of health and wellbeing services within Nairobi's informal settlements in Kenya

Abstract

AbstracteHealth offers the opportunity to transform the health sector. Unfortunately, eHealth interventions in underserved contexts continue to remain deficient due challenges such as the design‐reality gap, fragmentation, and high implementation costs, etc. This situation hampers the delivery of anticipated results from such projects. Furthermore, the voice of patients is hardly heard concerning the design of these interventions. The study sought to establish participants' views on how patient‐centered eHealth interventions may be designed in a resource‐constrained, Sub‐Saharan African context to deliver value. This was a qualitative study conducted across six government health facilities within Nairobi's informal settlements in Kenya. Data collection involved in‐depth interviews (n = 24), focus group discussions (n = 23) and observation. Participants comprised of Facility In‐Charge, clients, community health workers, medical staff, and ICT experts. Interviews and discussions explored participant's perceptions of the quality of health care, challenges faced, and the potential of eHealth in improving health care delivery. Thematic analysis was performed using manual coding whereby eight data themes emerged including: data access, contextualization, health IT utilization, implementation, integration, stakeholders, quality, and user‐centered design (UCD). The themes were then used to derive a theoretical framework to guide the designing and implementation of patient‐centered eHealth interventions in the Kenyan context.