The mobile phone as a tool in improving cancer care in Nigeria

An important feature of most mHealth interventions was that interactions between participants usually took place on the basis of standardized information exchange protocols.

“An important feature of most mHealth interventions was that interactions between participants usually took place on the basis of standardized information exchange protocols [36, 39, 40, 42, 43, 45–47, 49, 52, 54].”

Participating patients or providers usually required only a few days of training on how to use the mobile technology and the consultation procedures.

“Participating patients or providers usually required only a few days of training on how to use the mobile technology (such as the mobile phone and its application software) and the consultation procedures [41, 43, 46–48, 50, 55].”

In 8 included studies, mHealth interventions connected a patient to a provider, directly facilitating patient access to professional care.

“In 8 studies, mHealth interventions connected a patient to a provider, thus directly facilitating patient access to (professional) care [20, 37, 46, 50, 51, 53–55].”

Similar predisposing characteristics were reported for providers: positive attitudes, fluency in the language of the locality, and sufficient training to use the technology.

“Similar predisposing characteristics were also reported for providers, i.e., positive attitudes [38, 40, 52], fluency in the language of the locality [46, 54], and sufficient training to use the technology [47, 52].”

If patients faced access barriers such as long travel times, waiting times, and high travel costs, mHealth interventions were perceived to be useful.

“If patients faced access barriers such as long travel times, waiting times, and high travel costs, mHealth interventions were perceived to be useful [20, 42, 45, 46, 48–50, 52, 53, 55].”

For patients, the most important predisposing characteristic associated with the perception that an mHealth intervention was more useful than an alternative was patients' cultural and social acceptance of the mobile technology, involving familiarity with the technology in the community and absence of negative myths.

“For patients, the most important predisposing characteristic associated with the perception that a mHealth intervention was more useful than an alternative was the patients’ cultural and social acceptance of the mobile technology, which involved familiarity with the technology in the community and absence of negative myths [38, 40, 41, 46, 53, 55].”

Ambulance services and good roads were enabling resources for first-contact providers.

“Enabling resources for first-contact providers were access to basic infrastructure, such as electric power and functioning medical technologies [49, 52], ambulance services and good roads [46, 47], as well as the affordability of telecommunication services and other operating costs [50, 54, 55] (see Table 2).”

A tolerable additional workload was one of the most important enabling resources for specialized healthcare providers.

“For (specialized) healthcare providers, the most important enabling resources were a tolerable additional workload [40, 46, 47], the use of financial incentives [47, 55], and the availability of policy guidelines regarding data protection, phone usage, etc. [40, 43, 45, 52].”

For patients, access to mobile phones was one of the two most important enabling resources necessary for a mHealth intervention to be perceived useful.

“For patients, unsurprisingly, the two most important enabling resources necessary for a mHealth intervention to be (perceived to be) useful were access to mobile phones [37, 45, 46, 50, 53–55] (also possible through borrowing [46, 50]) and the availability of a functioning stable telecommunications network [20, 36, 39, 42, 45, 47, 48, 52, 55].”

Lack of adequate referral and transport systems contributed to specialized providers' perceived usefulness of mHealth.

“Also for (specialized) providers, several need factors contributed to the perceived usefulness of the intervention, including, for example, an over-burdening workload [20, 36, 38–41, 43, 45, 47, 50] and a lack of adequate referral and transport systems [38, 46, 47].”

Experience from Nigeria, where the mHealth intervention was as simple and inexpensive as giving specialists' contact phone numbers to cancer patients, appeared to achieve considerable benefits.

“Experience from Nigeria, where the mHealth intervention was as simple and inexpensive as giving specialists’ contact phone numbers to cancer patients, appeared to achieve considerable benefits (26).”

In the Nigerian cancer patient scheme, more than 25 calls each were made by almost 500 of the patients.

“More than 25 calls each were made by almost 500 of the patients.”

In a Nigerian cancer patient scheme, after 2 years, 19.2% of non-mobile phone patients had maintained their appointments, compared to 97.6% in the intervention group.

“After 2 years, only 19.2% of the non-mobile phone patients had maintained their appointments, compared to 97.6% in the intervention group (26).”