Abstract
AimThis research aims to identify response strategies that non-profit organizations (NPOs) can apply to overcome the barriers that hamper the sustainable use of mobile health (mHealth) interventions in low-resource environments (LREs), such as in Sub-Saharan Africa (SSA).Subject and methodA qualitative study on mHealth initiatives in SSA is conducted through semi-structured interviews with 15 key informants of NPOs that operate and manage mHealth interventions in this region. The interviews focus on identifying existing barriers and response strategies that NPOs apply to enable sustainable and long-term running interventions.ResultsBuilding on grounded theory techniques, the collected data guided us towards a process model that identifies four aggregated categories of challenging areas that require response strategies (economy, environment, technology, and user acceptance).ConclusionThis study provides contributions from and implications for NPOs and researchers. Health practitioners are provided with a knowledge base of what barriers to expect and how to overcome them, to strive for sustainable implementation from the very beginning of an intervention. A process model is identified that structures the response strategies in a time-based agenda of mHealth initiatives and thus makes a theoretical contribution. Overall, this study addresses the need for a theoretical consideration of the “pilotitis” phenomenon, which currently hampers the sustainable implementation and scaling up of mHealth initiatives. While the focus is specifically on mHealth initiatives, the overall findings help prevent discontinuance of projects in the future after the pilot, and help facilitate LREs on their way to sustainable health interventions and universal health coverage.
Highlights
Mobile healthcare enables healthcare service provision via mobile technology, most prominently via smartphone applications (Latif et al 2017; Silva et al 2015)
The related research background reveals a knowledge gap of research focusing on the non-profit organizations (NPOs)’ actions to enable sustainable Mobile healthcare (mHealth) interventions. This study addresses this gap by exploring the phenomenon of “pilotitis” of mHealth interventions in low-resource environments (LREs), as well as deriving the successfully applied strategies of NPOs from sustainable mHealth applications as a response to existing barriers to answer the following research question: How can NPOs overcome the barriers of a sustainable and scaled use of mHealth in LREs?
The data analysis guided towards four aggregated dimensions that depict the thematic areas of the response strategies towards barriers to sustainable mHealth interventions
Summary
Mobile healthcare (mHealth) enables healthcare service provision via mobile technology, most prominently via smartphone applications (Latif et al 2017; Silva et al 2015). MHealth facilitates technological development, improves the country’s overall wealth, and saves lives (Arief et al 2013; Wicklund 2019) These advantages of mHealth can be realized in any context but are valuable in hard-to-reach areas or regions with low resources Such health interventions hold the promise to reach more people faster, improving healthcare provision in low-resource environments (LREs) through mobile technologies (Mechael 2009). This is vital since, for example, a disproportionate number of maternal and neonatal deaths occurs in LREs, in rural areas (WHO 2004b, 2019)
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