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

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dc.contributor.authorLeon, Natalie
dc.contributor.authorSchneider, Helen
dc.contributor.authorDaviaud, Emmanuelle
dc.date.accessioned2013-02-27T18:40:42Z
dc.date.available2013-02-27T18:40:42Z
dc.date.issued2012
dc.description.abstractBackground: Mobile 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. Methods: A 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. Results: Four 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. Conclusion: Against 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.en_US
dc.description.accreditationWeb of Scienceen_US
dc.identifier.citationLeon, N; Schneider, H. & Daviuad, E. (2012). Applying a framework for assessing the health system challenges to scaling up mHealth in South Africa. BMC Medical Informatics and Decision Making, 12:123en_US
dc.identifier.issn1472-6963
dc.identifier.urihttp://hdl.handle.net/10566/552
dc.language.isoenen_US
dc.privacy.showsubmitterfalse
dc.publisherBioMed Centralen_US
dc.rights© 2012 Leon, et al; licensee BioMed Central Ltd.This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
dc.status.ispeerreviewedtrue
dc.subjectmHealthen_US
dc.subjectMobile phone technologyen_US
dc.subjectHealth systems frameworken_US
dc.subjectCommunity-based health servicesen_US
dc.subjectSouth Africaen_US
dc.titleApplying a framework for assessing the health system challenges to scaling up mHealth in South Africaen_US
dc.typeArticleen_US

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