Challenges for the adoption of ICT for diabetes self‐management in South Africa
Open accessAbstract
The increasing disease burden in developing countries inhibits the provision of quality care to citizens. However, the increased availability of information communication and technology (ICT) tools makes this a viable option for inclusion in primary health care. Even so, barriers are impeding the successful adoption and usage of ICT tools in health care contexts. This research focuses on one such context to identify the challenges and barriers for the adoption of ICT tools for diabetes self‐management in the Western Cape province of South Africa. The extended technology acceptance model (TAM) and four factors (educational, technological, economic, and sociocultural factors) were identified as a basis for investigation. Evidence was gathered from a sample of 131 diabetic patients using semistructured interviews. These factors, together with TAM constructs, explore how patients interact with ICT and their attitudes towards the use of ICT for diabetes self‐management. The results indicate that all four factors form barriers to ICT adoption for diabetes self‐management. These findings provide a basis to inform how future interventions at the primary health care level may be developed to overcome the identified barriers in efforts to integrate ICT tools into diabetic patients' daily self‐management routines.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The theory of planned behavior
Ajzen, I. (1991) · Organizational Behavior and Human Decision Processes · doi:10.1016/0749-5978(91)90020-t · Cited by 90,587 · see citing works
Perceived usefulness, perceived ease of use, and user acceptance of information technology
Davis, F. D. (1989) · MIS Quarterly · doi:10.2307/249008 · Cited by 68,483 · see citing works
User Acceptance of Information Technology: Toward A Unified View1
Venkatesh, V., Morris, M. G., Davis, G. B., & Davis, F. D. (2003) · MIS Quarterly · doi:10.2307/30036540 · Cited by 45,035 · see citing works
(1975) · PhilPapers (PhilPapers Foundation) · Cited by 36,737 · see citing works
A Theoretical Extension of the Technology Acceptance Model: Four Longitudinal Field Studies
Venkatesh, V., & Davis, F. D. (2000) · Management Science · doi:10.1287/mnsc.46.2.186.11926 · Cited by 23,066 · see citing works
Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study
Vaismoradi, M., Turunen, H., & Bondas, T. (2013) · Nursing & Health Sciences · doi:10.1111/nhs.12048 · Cited by 8,327 · see citing works
Sampling for qualitative research
Marshall, M. N. (1996) · Family Practice · doi:10.1093/fampra/13.6.522 · Cited by 4,293 · see citing works
Patient Self-management of Chronic Disease in Primary Care
Bodenheimer, T. (2002) · JAMA · doi:10.1001/jama.288.19.2469 · Cited by 3,598 · see citing works
The Technology Acceptance Model: Past, Present, and Future
Lee, Y., Kozar, K. A., & Larsen, K. R. T. (2003) · Communications of the Association for Information Systems · doi:10.17705/1cais.01250 · Cited by 2,572 · see citing works
Unified Theory of Acceptance and Use of Technology: A Synthesis and the Road Ahead
University of Arkansas, Venkatesh, V., Thong, J., Hong Kong University of Science and Technology, Xu, X., & The Hong Kong Polytechnic University (2016) · Journal of the Association for Information Systems · doi:10.17705/1jais.00428 · Cited by 2,513 · see citing works
Schoeppe, S., Alley, S., Van Lippevelde, W., Bray, N. A., Williams, S. L., Duncan, M. J., & Vandelanotte, C. (2016) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-016-0454-y · Cited by 949 · see citing works
Aranda-Jan, C. B., Mohutsiwa-Dibe, N., & Loukanova, S. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-188 · Cited by 644 · see citing works
Can Mobile Phone Apps Influence People’s Health Behavior Change? An Evidence Review
Zhao, J., Freeman, B., & Li, M. (2016) · Journal of Medical Internet Research · doi:10.2196/jmir.5692 · Cited by 618 · see citing works
The Logic of Qualitative Survey Research and its Position in the Field of Social Research Methods
Jansen, H. A. M. (2010) · Forum qualitative Sozialforschung · doi:10.17169/fqs-11.2.1450 · Cited by 532 · see citing works
Beratarrechea, A., Lee, A. G., Willner, J. M., Jahangir, E., Ciapponi, A., & Rubinstein, A. (2014) · Telemedicine and e-Health · doi:10.1089/tmj.2012.0328 · Cited by 403 · see citing works
Sun, Y., Wang, N., Guo, X., & Peng, Z. C. (2013) · Journal of electronic commerce research · Cited by 360 · see citing works
Where does the black population of South Africa stand on the nutrition transition?
Bourne, L. T., Lambert, E. V., & Steyn, K. (2002) · Public Health Nutrition · doi:10.1079/phn2001288 · Cited by 299 · see citing works
Faruque, L. I., Wiebe, N., Ehteshami-Afshar, A., Liu, Y., Dianati-Maleki, N., Hemmelgarn, B. R., Manns, B. J., & Tonelli, M. (2017) · Canadian Medical Association Journal · doi:10.1503/cmaj.150885 · Cited by 281 · see citing works
The importance of health belief models in determining self‐care behaviour in diabetes
Harvey, J. N., & Lawson, V. L. (2008) · Diabetic Medicine · doi:10.1111/j.1464-5491.2008.02628.x · Cited by 270 · see citing works
Cotter, A. P., Durant, N., Agne, A. A., & Cherrington, A. L. (2014) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2013.07.003 · Cited by 239 · see citing works
Akhlaq, A., McKinstry, B., Muhammad, K. B., & Sheikh, A. (2016) · Health Policy and Planning · doi:10.1093/heapol/czw056 · Cited by 225 · see citing works
Müller, A. M., Alley, S., Schoeppe, S., & Vandelanotte, C. (2016) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-016-0434-2 · Cited by 213 · see citing works
Anstey Watkins, J. O. T., Goudge, J., Gómez-Olivé, F. X., & Griffiths, F. (2018) · Social Science & Medicine · doi:10.1016/j.socscimed.2018.01.011 · Cited by 196 · cited 2× · see citing works
“…is supported by a study of m ‐ health usage among patients and health workers in rural South Africa that found that the “ use of the websites and social media was intermittent due to lack of financial ability to afford airtime ” (Anstey Watkins, Goudge, Gómez ‐ Olivé, & Griffiths, 2018, p. 139).”
BackgroundTan, X. W., Chapman, C. D., Cedernaes, J., & Benedict, C. (2017) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2017.11.001 · Cited by 194 · see citing works
Hoque, M. R. (2016) · BMC Medical Informatics and Decision Making · doi:10.1186/s12911-016-0289-0 · Cited by 181 · see citing works
Kan, M. P. H., & Fabrigar, L. R. (2017) · Springer eBooks · doi:10.1007/978-3-319-28099-8_1191-1 · Cited by 180 · see citing works
Bawack, R. E., & Kamdjoug, J. R. K. (2017) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2017.10.016 · Cited by 178 · see citing works
A systematic review of IT for diabetes self-management: Are we there yet?
El-Gayar, O., Timsina, P., Nawar, N., & Eid, W. (2013) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2013.05.006 · Cited by 148 · see citing works
Nelson, L. A., Mulvaney, S. A., Gebretsadik, T. S., Ho, Y.-X., Johnson, K. B., & Osborn, C. Y. (2015) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocv082 · Cited by 103 · see citing works
Peng, W., Yuan, S., & Holtz, B. E. (2016) · Telemedicine and e-Health · doi:10.1089/tmj.2015.0180 · Cited by 94 · see citing works
Shiferaw, S., Spigt, M., Tekie, M., Abdullah, M., Fantahun, M., & Dinant, G.-J. (2016) · PLOS ONE · doi:10.1371/journal.pone.0158600 · Cited by 90 · see citing works
Mutyambizi, C., Booysen, F., Stokes, A. C., Pavlova, M., & Groot, W. N. J. (2019) · PLoS ONE · doi:10.1371/journal.pone.0211208 · Cited by 85 · see citing works
Pullar, J., Allen, L. N., Townsend, N. P., Williams, J., Foster, C. E., Roberts, N. W., Rayner, M., Mikkelsen, B., Branca, F., & Wickramasinghe, K. K. (2018) · PLoS ONE · doi:10.1371/journal.pone.0193378 · Cited by 75 · see citing works
Self, self-care and self-management concepts: implications for self-management education
Omisakin, F. D., & Ncama, B. P. (2011) · Cited by 58 · see citing works
The Chronic Care Model and Technological Research and Innovation: A Scoping Review at the Crossroads
Gammon, D., Berntsen, G., Koricho, A. T., Sygna, K., & Ruland, C. M. (2015) · Journal of Medical Internet Research · doi:10.2196/jmir.3547 · Cited by 55 · see citing works
Didarloo, A., Shojaeizadeh, D., Asl, R. G., Habibzadeh, H., Niknami, S., & Pourali, R. (2012) · Europe PMC (PubMed Central) · Cited by 51 · see citing works
Using Mobile Health to Support the Chronic Care Model: Developing an Institutional Initiative
Nundy, S., Dick, J. J., Goddu, A. P., Hogan, P. C., Lu, C.-Y. E., Solomon, M. C., Bussie, A., Chin, M. H., & Peek, M. E. (2012) · International Journal of Telemedicine and Applications · doi:10.1155/2012/871925 · Cited by 49 · see citing works
Diabetes Mellitus m-Health Applications: A Systematic Review of Features and Fundamentals
Bellei, E. A., Biduski, D., Cechetti, N. P., & Marchi, A. C. B. D. (2018) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2017.0230 · Cited by 49 · see citing works
McMillan, K. A., Kirk, A. F., Hewitt, A., & MacRury, S. M. (2016) · Journal of Diabetes Science and Technology · doi:10.1177/1932296816656018 · Cited by 48 · see citing works
Brinkel, J., Dako‐Gyeke, P., Krämer, A., May, J., & Fobil, J. N. (2017) · Public Health · doi:10.1016/j.puhe.2016.11.017 · Cited by 47 · see citing works
Rehman, H., Kamal, A. K., Sayani, S., Morris, P. B., Merchant, A. T., & Virani, S. S. (2017) · Current Atherosclerosis Reports · doi:10.1007/s11883-017-0650-5 · Cited by 46 · see citing works
Adopting health apps, what's hindering doctors and patients?
Dehzad, F., Hilhorst, C., de Bie, C., & Claassen, E. (2014) · Health · doi:10.4236/health.2014.616256 · Cited by 46 · see citing works
Safonova, T., & Sántha, I. (2009) · Forum qualitative Sozialforschung · doi:10.17169/fqs-11.1.1430 · Cited by 41 · see citing works
van Heerden, A., Harris, D. M., van Rooyen, H., Barnabas, R. V., Ramanathan, N., Ngcobo, N., Mpiyakhe, Z., & Comulada, W. S. (2017) · Social Science & Medicine · doi:10.1016/j.socscimed.2017.04.046 · Cited by 41 · see citing works
mHealth Interventions to Counter Noncommunicable Diseases in Developing Countries
Beratarrechea, A., Moyano, D., Irazola, V., & Rubinstein, A. (2017) · Cardiology Clinics · doi:10.1016/j.ccl.2016.08.009 · Cited by 40 · see citing works
Alshehri, M. A. (2013) · Griffith Research Online · doi:10.25904/1912/1770 · Cited by 37 · see citing works
Dobson, R., Whittaker, R., Murphy, R., Khanolkar, M., Miller, S., Naylor, J., & Maddison, R. (2017) · JMIR Diabetes · doi:10.2196/diabetes.7221 · Cited by 32 · see citing works
E-health in low to middle income countries
Clifford, G. D. (2016) · Journal of Medical Engineering & Technology · doi:10.1080/03091902.2016.1256081 · Cited by 31 · see citing works
Beratarrechea, A. G., Diez‐Canseco, F., Irazola, V. E., Miranda, J. J., Ramírez‐Zea, M., & Rubinstein, A. (2016) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2016.03.003 · Cited by 30 · see citing works
Innovative Healthcare Applications of ICT for Developing Countries
Ariani, A., Koesoema, A. P., & Soegijoko, S. (2017) · Understanding complex systems · doi:10.1007/978-3-319-55774-8_2 · Cited by 28 · see citing works
Innovative strategies to improve diabetes outcomes in disadvantaged populations
Ruddock, J. S., Poindexter, M., Gary‐Webb, T. L., Walker, E. A., & Davis, N. J. (2016) · Diabetic Medicine · doi:10.1111/dme.13088 · Cited by 24 · see citing works
Cunningham, P. M., Cunningham, M., van Greunen, D., Veldsman, A., Kanjo, C., Kweyu, E., & Worku, A. G. (2016) · IEEE Global Humanitarian Technology Conference (GHTC) · doi:10.1109/ghtc.2016.7857350 · Cited by 23 · see citing works
David, S. K., & Rafiullah, M. (2016) · International Journal of Clinical Practice · doi:10.1111/ijcp.12816 · Cited by 22 · see citing works
Using critical realism and reflexivity to explain broadband non-adoption in rural Australia
Dobson, P., & Jackson, P. (2017) · AJIS. Australasian journal of information systems/AJIS. Australian journal of information systems/Australian journal of information systems · doi:10.3127/ajis.v21i0.1695 · Cited by 5 · see citing works
Hart, H. E., Geilen, I. E., de Leeuw, E., Rutten, G., & Vos, R. (2017) · JMIR Research Protocols · doi:10.2196/resprot.6910 · Cited by 4 · see citing works
Kusnanto, K., Kurnia, I. D., & Rama, J. J. A. (2017) · International Nursing Conference (INC) · doi:10.2991/inc-17.2017.56 · Cited by 3 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
An extension of technology acceptance model for mHealth user adoption
Rajak, M., & Shaw, K. (2021) · Technology in Society · doi:10.1016/j.techsoc.2021.101800 · Cited by 152 · see citing works
Telemedicine use in Sub-Saharan Africa: Barriers and policy recommendations for Covid-19 and beyond
Dodoo, J. E., Al-Samarraie, H., & Alzahrani, A. I. (2021) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2021.104467 · Cited by 125 · see citing works
“The limited electronic skills and insufficient knowledge to navigate the health technology were major barriers to both clinicians and patients alike [35], especially in countries such as South Africa and Angola.”
BackgroundAn adoption model of mHealth applications that promote physical activity
Ndayizigamiye, P., Kante, M., & Shingwenyana, S. (2020) · Cogent Psychology · doi:10.1080/23311908.2020.1764703 · Cited by 63 · see citing works
Higa, C., Davidson, E., & Loos, J. R. (2020) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocaa223 · Cited by 46 · see citing works
Petersen, F., Jacobs, M., & Pather, S. (2020) · Lecture Notes in Computer Science · doi:10.1007/978-3-030-45002-1_6 · Cited by 43 · see citing works
Self-citationKnowledge and attitude of Saudi Arabian citizens towards telemedicine during the COVID-19 pandemic
Alajwari, H. A., Alfayez, A., Alsalman, D., Alanezi, F., Alhodaib, H. I., Al-Rayes, S., Aljaffary, A. A., AlThani, B., AlNujaidi, H. Y., AlSaif, A. K., et al. (2021) · International Health · doi:10.1093/inthealth/ihab082 · Cited by 37 · see citing works
Sze, W. T., & Kow, S. G. (2023) · JMIR Diabetes · doi:10.2196/40968 · Cited by 17 · see citing works
Digital health and self-management of chronic diseases in sub-Saharan Africa: A scoping review
Achieng, M. S., & Ogundaini, O. O. (2022) · South African journal of information management · doi:10.4102/sajim.v24i1.1550 · Cited by 14 · see citing works
An analysis of the current status of Internet of Medical Things policies in developing countries
Kante, M., & Ndayizigamiye, P. (2020) · NPG. Neurologie, psychiatrie, gériatrie/NPG · doi:10.1016/j.npg.2020.03.002 · Cited by 14 · see citing works
Dahiya, H., & Saini, A. K. (2024) · Journal of Indian Business Research · doi:10.1108/jibr-12-2022-0302 · Cited by 11 · see citing works
Bahendeka, S. (2023) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(23)00117-1 · Cited by 8 · see citing works
Achieng, M. S. (2026) · International Journal of Information Management Data Insights · doi:10.1016/j.jjimei.2026.100391 · Cited by 5 · see citing works
Teknologi Kesehatan Digital Dalam Penanganan Masalah Diabetes Melitus Literature Review
Safaruddin, S., & Permatasari, H. (2022) · Malahayati Nursing Journal · doi:10.33024/mnj.v4i4.6201 · Cited by 4 · see citing works
A resistance to change perspective on nonusers of telecenters
Gollakota, K., & Pick, J. B. (2019) · The Electronic Journal of Information Systems in Developing Countries · doi:10.1002/isd2.12127 · Cited by 4 · see citing works
Patients' Experiences in Using Diabetes Self-Management Application: A Scoping Review
Kamillah, S. K. S., Panduragan, S. L., Poddar, S., & Abdullah, B. F. (2022) · Kesmas National Public Health Journal · doi:10.21109/kesmas.v17isp1.5936 · Cited by 4 · see citing works
Bridging Context and Culture: Designing Cross-Cultural Solutions for Type 2 Diabetes Care in Nigeria
Arueyingho, O., O’Kane, A. A., Marshall, P., Aprioku, J. S., Webb, H., & Shivam, R. (2025) · Designing Interactive Systems Conference · doi:10.1145/3715336.3735710 · Cited by 3 · see citing works
An investigation of factors impacting the acceptance of telehealth in rural India
Moray, R. (2025) · Discover Social Science and Health · doi:10.1007/s44155-025-00250-0 · Cited by 3 · see citing works
South African diabetic patients’ use of mobile applications for physical activity: An age comparison
Petersen, F. (2024) · Information Development · doi:10.1177/02666669231222927 · Cited by 3 · see citing works
Self-citationBarriers to Technology Adoption in Developing Countries
Oyenuga, M. O., Singh, R., Apata, S. B., Khan, S., & Kumar, V. (2025) · Climate change management · doi:10.1007/978-3-031-92221-3_17 · Cited by 3 · see citing works
Roozbehani, R., Fatemi, A. A., Zamani, Z., Khedri, B., Arefkia, K., Kabusi, M., Shafiei, Z., Razavinasab, S. A., Bardsiri, T. I., Eshaghzadeh, M., et al. (2023) · Iranian Rehabilitation Journal · doi:10.32598/irj.20.4.1631.2 · Cited by 3 · see citing works
Kante, M. (2020) · NPG. Neurologie, psychiatrie, gériatrie/NPG · doi:10.1016/j.npg.2020.04.004 · Cited by 3 · see citing works
Digital development for a progressive networked society
Takavarasha, S. (2020) · The Electronic Journal of Information Systems in Developing Countries · doi:10.1002/isd2.12141 · Cited by 3 · see citing works
Detection of Thyroid Nodules Through Neural Networks and Processing of Echographic Images
Haro, A. R., Toalombo, J. C., Galarza, E. E., & Guerrón, N. (2020) · Lecture notes in computer science · doi:10.1007/978-3-030-58811-3_12 · Cited by 2 · see citing works
Awareness, Attitude, and Perception of Telemedicine Among Trinidad and Tobago PopulationPreprint
Ezinne, N. E., Bhattarai, D., Anyasodor, A. E., Antwi-Adjei, E. K., Ekemiri, K., Armitage, J. A., & Osuagwu, U. L. (2023) · medRxiv · doi:10.1101/2023.12.05.23299482 · Cited by 2 · see citing works
Designing Okuma: A Digital Health Tool for Type 2 Diabetes in Nigeria
Arueyingho, O., O’Kane, A. A., Marshall, P., Aprioku, J. S., Nkwo, M. S., & Shivam, R. (2025) · African Human Computer Interaction Conference (AfriCHI) · doi:10.1145/3757232.3757233 · Cited by 2 · see citing works
Diabetes self-management education
Ojo, I., Ojo, E. F., & Olubiyi, S. K. (2023) · Journal of Integrative Nursing · doi:10.4103/jin.jin_105_22 · Cited by 2 · see citing works
de Paula, D. F. O., Bueno, J. Z., & Viljoen, A. (2021) · Hawaii International Conference on System Sciences (HICSS) · doi:10.24251/hicss.2021.601 · Cited by 1 · see citing works
Nenzhelele, T. E. (2023) · International Journal of Research in Business and Social Science (2147-4478) · doi:10.20525/ijrbs.v12i9.2671
Ranthako, R., & Mujinga, M. (2024) · Studies in systems, decision and control · doi:10.1007/978-3-031-65207-3_8
Mubuke, F., Najeeb, A. A.-S., & Namakula, S. J. (2024) · i-manager s Journal on Mobile Applications and Technologies · doi:10.26634/jmt.11.2.21448
Ehteshami, F., Verjans, A., Cassidy, R., Tediosi, F., Fink, G., & Munoz, D. C. (2026) · Public health reviews · doi:10.3389/phrs.2026.1608655
- Authors
- Petersen, F., Brown, A., Pather, S., & Tucker, W. D.
- Affiliations
- University of the Western Cape (ZA)
- Corresponding author
- Petersen, Fazlyn
- Venue
- THE ELECTRONIC JOURNAL OF INFORMATION SYSTEMS IN DEVELOPING COUNTRIES
- Publisher
- Wiley
- Published
- 2019-08-15
- Volume
- 86
- Issue
- 5
- ISSN
- 1681-4835 (ISSN-L)
- OpenAlex
- W2966987645
- Cited by
- 31
- References
- 58
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 4 · 2023: 6 · 2022: 3 · 2021: 4 · 2020: 7 · 2019: 1
- FWCI
- 5.11
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Electronic Journal of Information Systems in Developing Countries (publishedVersion)
- UWC Research Repository (University of the Western Cape) (submittedVersion)
- Funders
- National Research Foundation (116819)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Social Sciences › Decision Sciences › Information Systems and Management › Technology Adoption and User Behaviour
- Health Sciences › Health Professions › Health Information Management › Health, Technology, Consumer Behavior
- Keywords
- diabetes self-management, information and communication technologies, technology adoption barriers, technology acceptance model, primary care, patient attitudes, educational factors, economic factors, sociocultural factors, Western Cape
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review