Maintenance Notice

Due to necessary scheduled maintenance, the JMIR Publications website will be unavailable from Wednesday, July 01, 2020 at 8:00 PM to 10:00 PM EST. We apologize in advance for any inconvenience this may cause you.

Who will be affected?

Accepted for/Published in: Journal of Medical Internet Research

Date Submitted: Feb 25, 2020
Date Accepted: Jun 11, 2020

The final, peer-reviewed published version of this preprint can be found here:

Operability, Usefulness, and Task-Technology Fit of an mHealth App for Delivering Primary Health Care Services by Community Health Workers in Underserved Areas of Pakistan and Afghanistan: Qualitative Study

Zaidi S, Kazi M, Riaz A, Ali A, Najmi R, Jabeen R, Khudadad U, Sayani S

Operability, Usefulness, and Task-Technology Fit of an mHealth App for Delivering Primary Health Care Services by Community Health Workers in Underserved Areas of Pakistan and Afghanistan: Qualitative Study

J Med Internet Res 2020;22(9):e18414

DOI: 10.2196/18414

PMID: 32940612

PMCID: 7530697

Operability, usefulness, and task technology fit for mHealth application to deliver primary healthcare services by community health workers in underserved areas of Pakistan & Afghanistan

  • Shehla Zaidi; 
  • Momim Kazi; 
  • Atif Riaz; 
  • Ammarah Ali; 
  • Rabia Najmi; 
  • Rawshan Jabeen; 
  • Umerdad Khudadad; 
  • Saleem Sayani

ABSTRACT

Background:

The recent proliferation of digital technology in health in LMICs has made it possible for the community health workers (CHWs) to use m-health for performing tasks such as data recording and training. Though majority of studies focus on the prospect of digital applications to motivate and connect CHW, only a few have captured end-user experiences of the utilization of mobile-based applications. We examined front line health workers’ experience of moving towards digitalized real-time data for recording maternal and childcare services in remote areas of Afghanistan and Pakistan.

Objective:

Our study aimed to explore perceptions of CHWs on i) Operability of the m-health application in a community setting ii) Usefulness of the app in delivery of assigned maternal and childcare functions; iii) Task-technology fit with monitoring information systems.

Methods:

The Hayat application designed to digitalize and facilitate electronic record-keeping was evaluated for embedding into mainstream health systems. The application had two components i.e. application for data entry in smartphones; and a dashboard (web portal) for visualization of the MNCH reports. Using qualitative exploratory study design, we conducted a total of eight focus group discussions (FGDs) with purposively selected LHWs and CHWs in 3 districts of Pakistan and 3 hamlets of Afghanistan respectively. FGDs were conducted in the local language, were audio-recorded and converted into expanded notes for thematic analysis.

Results:

Though a majority of LHWs used the app with ease, some initially faced difficulties in operating it and requested a longer duration of training. Contrary to LHWs, the CHWs were able to use the app without difficulty as they were using it to only register the clients. Overall using the m-Health application in both countries resulted in a positive impact on health education sessions, easier communication with parents/clients, tracking of RI defaulters and follow-ups, superior validity of app data, easily accessible vaccination schedule and faster registration. In addition to building up their image in the community and personal development, the improved reporting and monitoring mechanisms have also set the stage for the LHWs to get recognized for their hard work. CHWs in Afghanistan also reported that the app provided immediate access to information when requested by their supervisor. Though the Hayat app eliminates the need for carrying multiple registers and helps in recall client information at the touch of a button, technical issues around connectivity and data inputting tabs were highlighted by the participants.

Conclusions:

The digitization of CHWs records not only provided them support in their daily routine but also strengthened monitoring mechanisms and improved motivation. We recommend conducting end-user experience studies before embedding applications into mainstream health systems as high acceptability does not always result in high uptake of digital technology.


 Citation

Please cite as:

Zaidi S, Kazi M, Riaz A, Ali A, Najmi R, Jabeen R, Khudadad U, Sayani S

Operability, Usefulness, and Task-Technology Fit of an mHealth App for Delivering Primary Health Care Services by Community Health Workers in Underserved Areas of Pakistan and Afghanistan: Qualitative Study

J Med Internet Res 2020;22(9):e18414

DOI: 10.2196/18414

PMID: 32940612

PMCID: 7530697

Download PDF


Request queued. Please wait while the file is being generated. It may take some time.

© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.