Accepted for/Published in: JMIR Formative Research
Date Submitted: May 12, 2025
Date Accepted: Feb 23, 2026
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Frugal-oriented ICT for Development Framework Towards Low-cost Digital Maternal Health in LMICs: a Quantitative Descriptive study
ABSTRACT
Background:
Sustainable Development Goals (SDGs) seek to end poverty and inequality, and above all ensure that all people enjoy good health. Unfortunately, little has been achieved, particularly on target 3.1, which seeks "to reduce the global maternal mortality ratio to less than 70 per 100,000 live births". Despite increased adoption of digital innovations to improve healthcare delivery, a significant population in low- and middle-income countries (LMICs) still lacks access to primary healthcare due to predominant resource constraints.
Objective:
This paper aims to leverage the principles of frugal innovation (FI) and ICT for development (ICT4D) to propose a frugal-oriented ICT4D framework, and deliver low-cost digital maternal health solutions for underserved communities in LMIC settings, thereby achieving SDG 3.
Methods:
The study was conducted in both rural and urban-poor settings in Kenya in two phases. A quantitative approach was adopted whereby the first phase entailed an exploration of eight theoretical themes to guide the study. The themes were represented on sorting cards bearing different colours, which the participants then ranked to determine the significance of each theme in the uptake of maternal health. The second phase involved administering survey questionnaires to collect empirical data. A sample size of 32 participants (n=32) participated in the study.
Results:
Four of the predetermined theoretical themes, that is, information services, resources, technical competency, and social support programs emerged as the most important contextual factors influencing maternal health promotion. The results, therefore, provide a comprehensive understanding of the complexities of maternal health, which informs the proposed research framework.
Conclusions:
Despite efforts to leverage digital innovations as an enabler for healthcare transformation in LMICs, little has been achieved in the delivery of maternal health. There is low adoption of existing capital-intensive digital solutions due to resource constraints, hence the need for low-cost innovative approaches to foster equitable health access. The study observed the need to adopt principles of FI and ICT4D to create low-cost digital health interventions to increase access to maternal health towards achieving target 3.1 of SDG 3. Clinical Trial: n/a
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