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Sustainability of ‘mHealth’ interventions in sub-Saharan Africa: A stakeholder analysis of an electronic community case management project in Malawi

Dharmayat, Kanika ; Tran, Tammy ; Hardy, Victoria ; Chirambo, Griphin Baxter ; Thompson, Matthew ; Ide, Nicole ; Carlsson, Sven LU ; Andersson, Bo LU ; O’ Donoghue, John and Mastellos, Nikolaos (2019) In Malawi Medical Journal 31(3). p.177-183
Abstract
Background

The global health community and funding agencies are currently engaged in ensuring that worthwhile research-based programmes are sustainable. Despite its importance, few studies have analysed the sustainability of global health interventions. In this paper, we aim to explore barriers and facilitators for the wider implementation and sustainability of a mobile health (mHealth) intervention (Supporting LIFE Community Case Management programme) in Malawi, Africa.

Methods

Between January and March 2017, a qualitative approach was used to carry out and analyse 13 in-depth semi-structured interviews with key stakeholders across all levels of healthcare provision in Malawi to explore their perceptions with... (More)
Background

The global health community and funding agencies are currently engaged in ensuring that worthwhile research-based programmes are sustainable. Despite its importance, few studies have analysed the sustainability of global health interventions. In this paper, we aim to explore barriers and facilitators for the wider implementation and sustainability of a mobile health (mHealth) intervention (Supporting LIFE Community Case Management programme) in Malawi, Africa.

Methods

Between January and March 2017, a qualitative approach was used to carry out and analyse 13 in-depth semi-structured interviews with key stakeholders across all levels of healthcare provision in Malawi to explore their perceptions with regards to the implementation and sustainability of the mHealth programme. Data were analysed thematically by two reviewers.

Results

Overall, our analysis found that the programme was successful in achieving its goals. However, there are many challenges to the wider implementation and sustainability of this programme, including the absence of monetary resources, limited visibility outside the healthcare sector, the lack of integration with community-based and nationwide programmes, services and information and communication technologies, and the limited local capacity in relation to the maintenance, further development, and management.

Conclusions

Future developments should be aligned with the strategic goals and interests of the Ministry of Health and engage with national and international stakeholders to develop shared goals and strategies for nationwide scale-up. These developments should also focus on building local capacity by educating trainers and ensuring that training methods and guidelines are appropriately accredited based on national policies. Our findings provide a framework for a variety of stakeholders who are engaged in sustaining mHealth programmes in resource-poor settings and can be used to develop an evidence-based policy for the utilization of technology for healthcare delivery across developing countries. (Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
mHealth, child health, Malawi, community case management, sustainability, policy impact
in
Malawi Medical Journal
volume
31
issue
3
pages
177 - 183
publisher
Malawi Medical Journal
external identifiers
  • scopus:85075026798
ISSN
1995-7262
language
English
LU publication?
yes
id
e6fe96ff-a842-4145-a2c9-5cc902e852d6
alternative location
http://www.mmj.mw/?p=9848
date added to LUP
2019-10-17 11:55:07
date last changed
2020-10-07 06:44:51
@article{e6fe96ff-a842-4145-a2c9-5cc902e852d6,
  abstract     = {Background<br/><br/>The global health community and funding agencies are currently engaged in ensuring that worthwhile research-based programmes are sustainable. Despite its importance, few studies have analysed the sustainability of global health interventions. In this paper, we aim to explore barriers and facilitators for the wider implementation and sustainability of a mobile health (mHealth) intervention (Supporting LIFE Community Case Management programme) in Malawi, Africa.<br/><br/>Methods<br/><br/>Between January and March 2017, a qualitative approach was used to carry out and analyse 13 in-depth semi-structured interviews with key stakeholders across all levels of healthcare provision in Malawi to explore their perceptions with regards to the implementation and sustainability of the mHealth programme. Data were analysed thematically by two reviewers.<br/><br/>Results<br/><br/>Overall, our analysis found that the programme was successful in achieving its goals. However, there are many challenges to the wider implementation and sustainability of this programme, including the absence of monetary resources, limited visibility outside the healthcare sector, the lack of integration with community-based and nationwide programmes, services and information and communication technologies, and the limited local capacity in relation to the maintenance, further development, and management.<br/><br/>Conclusions<br/><br/>Future developments should be aligned with the strategic goals and interests of the Ministry of Health and engage with national and international stakeholders to develop shared goals and strategies for nationwide scale-up. These developments should also focus on building local capacity by educating trainers and ensuring that training methods and guidelines are appropriately accredited based on national policies. Our findings provide a framework for a variety of stakeholders who are engaged in sustaining mHealth programmes in resource-poor settings and can be used to develop an evidence-based policy for the utilization of technology for healthcare delivery across developing countries.},
  author       = {Dharmayat, Kanika and Tran, Tammy and Hardy, Victoria and Chirambo, Griphin Baxter and Thompson, Matthew and Ide, Nicole and Carlsson, Sven and Andersson, Bo and O’ Donoghue, John and Mastellos, Nikolaos},
  issn         = {1995-7262},
  language     = {eng},
  number       = {3},
  pages        = {177--183},
  publisher    = {Malawi Medical Journal},
  series       = {Malawi Medical Journal},
  title        = {Sustainability of ‘mHealth’ interventions in sub-Saharan Africa: A stakeholder analysis of an electronic community case management project in Malawi},
  url          = {http://www.mmj.mw/?p=9848},
  volume       = {31},
  year         = {2019},
}