Experiences and factors associated with the use of mHealth among health care workers to provide health services in Kampala, Uganda

Abstract

Introduction: Despite the potential benefits of mHealth, its adoption remains a big challenge in developing countries such as Uganda. Additionally, limited data exist on the utilization of mHealth among health workers to provide services and associated factors in Kampala. This study sought to fill this gap in knowledge by providing more information on the status of the adoption of mHealth by documenting health worker experiences and assessing the facilitators and barriers to the use of mHealth among health workers in health facilities in Kampala. Methods: We conducted a cross-sectional study among 424 health workers randomly selected from 10 health facilities in Kampala in January 2023. Data was collected using both quantitative and qualitative methods through a structured questionnaire administered using the open data kit (ODK) and in-depth interview guides respectively. Binary logistic regression models at the bivariate level to estimate Crude Odds Ratios (COR) and multivariate levels to estimate Adjusted Odds Ratios (AOR) of utilizing m-Health. Qualitative data were analyzed using thematic content analysis. Results: More than half of the study participants, 242 (57.1%) were females, 196 (45.75%) were aged between 18-29 years, and 183(43.2%) had attained degree/ postgraduate training. Almost all 414 (97.6%) owned a mobile device and 306 (72.2%), 53. 8% (n=424) of the respondents were currently using mHealth devices to offer medical services. The findings show that private facility ownership AOR: 1.84 (95%CI:1.19-2.86 p<0.006), access to mHealth tools at work AOR: 3.6 (95%CI:2.3-5.53 p<0.001, training in m-health AOR: 1.64(0.07-4.40, p-value < 0.024), perceived usefulness of m-health technology (AOR; 2.24(1.31-3.79 p-value 0.030), male sex (AOR: 1.67(95%CI; 1.09-2.56), and age between 18-29 (AOR= 2.44 (95%CI: 1.23-4.85 p<0.011) were factors associated with increased utilization of mobile health device. Poor mobile network and internet connectivity, and privacy and safety of patient information were reported as constraints while efficient means of communication with clients and fellow health workers was reported as perceived benefit. Conclusion: The proportion of use of mHealth among health workers to provide health care was moderate (53.8%). This utilization rate is still low compared to the overall mobile phone penetration of over 71%. There is a need to address the constraints to the adoption and use of mobile health devices among health care workers to provide care such as improving internet connectivity and addressing privacy and security issues, to encourage wider adoption and utilization this can be done by subsidizing operational costs for the internet, purchasing mobile devices, scaling up internet connectivity, and regulating the use of the internet.