Mhealth as a Viable Solution for the Prevention and Management of Cholera in the Greater Accra Region of Ghana - Perspectives of Provider-Side Stakeholders

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Date

2020-07

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University of Ghana

Abstract

This study explored public health services delivered through the mobile phone (mHealth), the challenges faced and enablers and facilitators leading to the overall impact on the viability for the prevention and management of cholera in the Greater Accra Region of Ghana. The World Health Organization (WHO) identifies technological applications as one of the health system pillars to ensure access and quality of health services for which the universal mobile telephony is identified as a potential healthcare tool due to its high adoption and use by people, including health providers. Despite the foregoing, its use in healthcare has been described as slow due to safety, medico-legal, and cost concerns by healthcare providers. The Ghanaian public healthcare system has been challenged with access and quality of health services and cholera has been one of its major public health challenges, particularly for the GAR. The mobile phone as a technological tool could help in its prevention and management for which the study explored. The study was situated in an Intepretivist-Social Constructionist paradigm, with a qualitative research approach; and a phenomenological design that utilized purposive sampling techniques with sub-techniques such as maximum variation and snowball sampling. In-depth interviews and focus group discussions were used to collect data from participants and discussants of diverse backgrounds. Three study sites (Accra Metro, Ga West, Ada East) with varied characteristics were selected for the research. Qualitative data collected were transcribed and inductively coded using NVIVO (version 11) software package. The data analysis was based on the thematic content (network) technique. The major findings of the research showed a high technological capacity and digital literacy among healthcare providers who use the mobile phone to deliver aspects of healthcare for the management of cholera. The practice of mHealth by healthcare providers was found to be largely informal with some of the mHealth services comprising data collection, digital learning, health emergencies, management and logistics, disease surveillance, and telehealth. Overarching challenges encountered with the use of the mobile phones were Management and leadership, Finance, Access, Infrastructure, Technical and Human resources (MFAITH challenges). The study also showed that there were key enablers and facilitators which enhanced viability of using mobile phones for effective management of cholera such as financial and infrastructure provision, policy framework, human resource development, and task-technology fit. The study concluded that there was high mobile phone adoption and use among healthcare providers for public health services; and that tasks of providers fit in well with the mobile phone. However, the practice was largely informal, without any overarching policy direction, and not aligned with organizational objectives. The health sector must engage the telecommunication companies (Telcos) to play a more active role in mHealth provision by presenting a viable business model for them. A policy framework should be developed to guide and give direction for mHealth design and implementation. Healthcare providers should be trained and motivated to effectively deliver mHealth services for a viable mHealth for the prevention and management of cholera.

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PhD. Health Policy and Management

Keywords

Mhealth, Prevention, Management, Cholera, Ghana

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