Implications of baseline study findings from rural and deep rural clinics in Ethiopia, Kenya, Malawi and South Africa for the co-design of mHealth4Afrika

mHealth4Afrika is a collaborative research and innovation project, co-funded under Horizon 2020, that is evaluating the potential impact of co-designing an open source, multilingual mHealth platform on the quality of maternal and newborn healthcare delivery in rural and deep rural clinics. This paper presents results from a comprehensive baseline study carried out with 40 informants from the leadership of 19 healthcare clinics in Northern Ethiopia, Western Kenya, Southern Malawi and Eastern Cape, South Africa during November — December 2015, using focus groups and semi-structured interviews. These findings identified human resource capacity, environmental, practical and technical challenges, and equipment and infrastructure deficits. Training requirements of healthcare workers were also identified. Constraints identified include the need for: intuitive, easy-to-use user interfaces to reduce the need for extensive training; use of flexible data protocols to facilitate cost effective bandwidth and effective data exchange; cost effective; low power consumption technologies to reduce cost of replication and scaling; solar charging units to increase availability; support for sensors and telemedicine due to a deficit of healthcare professionals in rural and deep rural clinics; and the need for easy configuration and adaptation to facilitate wider adoption. This insight will be used to inform co-design of the mHealth4Afrika platform during 2016–2018, based on user-centered design principles, leveraging current state-of-the-art in terms of electronic patient record systems and medical sensors. It will also inform the minimum ICT infrastructure required in each clinic. The expected outcome is a multi-region proof of concept that can make a significant contribution in accelerating exploitation of mHealth across Africa.