South Africa: Mhealth pilot study surprises with low healthcare worker uptake


An article published in PLoS Medicine has revealed that a new mhealth app designed for healthcare workers who work in a rural South African treatment program for multidrug-resistant tuberculosis (MDR-TB) has failed to generate uptake by those employees. The Mobilize mhealth app provided standardization for the tracking and recording of MDR-TB patients through the use of functional, low cost phones. The study revealed a great deal about how scaling can be conducted in terms of new initiatives of this nature in other environments that are similarly constrained in resources.


The authors of the article looked into seven months of data regarding feasibility and acceptability of the use of the Mobilize mhealth app for recording and submitting weekly adverse event forms throughout the most intensive phase of the therapy for the MDR-TB patients, and to evaluate the perceptions of the healthcare workers.

What was determined was that the tracking and reporting of the adverse clinical events proved to be quite challenging for the workers, who head to the homes of the patients each day in order to administer the treatments for the illness, and monitor the therapies. The mhealth pilot study ran over a period of seven months in South Africa, at which point many of its aspects were measured.

According to the article “This pilot experience demonstrated poor uptake by [healthcare workers] despite positive responses to using mHealth.” It went on to point out that while it is important to take care when interpreting these results due to the limited number of MDR-TB patients and healthcare workers involved in the study, “we recommend carefully exploring the motivations of [healthcare workers] and technologic enhancements prior to scaling new mHealth initiatives in resource poor settings.”

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Among the 33 expected adverse event forms, only nine (27 percent) were actually submitted by the healthcare workers, which spoke against the qualitative results that suggested that the mhealth app would improve the communication of adverse events, assist in daily workflow and could be applied successfully to a broader range of health interventions.