Applying a framework for assessing the health system challenges to scaling up mHealth in South Africa

BMC Medical Informatics and Decision Making

Research Article

Natalie Leon¹  Emmanuelle Daviaud¹  Helen Schneider² 

[1] Health Systems Research Unit, Medical Research Council of South Africa, P.O Box 19070, 7505, Tygerberg, Cape Town, South Africa;School of Public Health, University of the Western Cape, Private Bag X17, 7535, Bellville, Cape Town, South Africa;

关键词: MHealth;    Mobile phone technology;    Health systems framework;    Community-based health services;    South Africa;   

DOI  :  10.1186/1472-6947-12-123

 received in 2012-06-09, accepted in 2012-10-17,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundMobile phone technology has demonstrated the potential to improve health service delivery, but there is little guidance to inform decisions about acquiring and implementing mHealth technology at scale in health systems. Using the case of community-based health services (CBS) in South Africa, we apply a framework to appraise the opportunities and challenges to effective implementation of mHealth at scale in health systems.MethodsA qualitative study reviewed the benefits and challenges of mHealth in community-based services in South Africa, through a combination of key informant interviews, site visits to local projects and document reviews. Using a framework adapted from three approaches to reviewing sustainable information and communication technology (ICT), the lessons from local experience and elsewhere formed the basis of a wider consideration of scale up challenges in South Africa.ResultsFour key system dimensions were identified and assessed: government stewardship and the organisational, technological and financial systems. In South Africa, the opportunities for successful implementation of mHealth include the high prevalence of mobile phones, a supportive policy environment for eHealth, successful use of mHealth for CBS in a number of projects and a well-developed ICT industry. However there are weaknesses in other key health systems areas such as organisational culture and capacity for using health information for management, and the poor availability and use of ICT in primary health care. The technological challenges include the complexity of ensuring interoperability and integration of information systems and securing privacy of information. Finally, there are the challenges of sustainable financing required for large scale use of mobile phone technology in resource limited settings.ConclusionAgainst a background of a health system with a weak ICT environment and limited implementation capacity, it remains uncertain that the potential benefits of mHealth for CBS would be retained with immediate large-scale implementation. Applying a health systems framework facilitated a systematic appraisal of potential challenges to scaling up mHealth for CBS in South Africa and may be useful for policy and practice decision-making in other low- and middle-income settings.

【 授权许可】

CC BY   
© Leon et al.; licensee BioMed Central Ltd. 2012