CoChat
Sign Up
Cited by 105Mobile Health and mHealth ApplicationsUsability and User Interface DesignICT in Developing Communities

A Usability Study of a Mobile Health Application for Rural Ghanaian Midwives

Open access
Vélez, Olivia, Okyere, Portia Boakye, Kanter, Andrew S., Bakken, Suzanne·2014·Journal of Midwifery & Women's Health
DOI 10.1111/jmwh.12071PMC PMC3976680
Open this paper in CoChat — free accountOpen PDF

Abstract

Introduction: Midwives in rural Ghana work at the frontline of the health care system, where they have access to essential data about the patient population. However, current methods of data capture, primarily pen and paper, make the data neither accessible nor usable for monitoring patient care or program evaluation. Electronic health (eHealth) systems present a potential mechanism for enhancing the roles of midwives by providing tools for collecting, exchanging, and viewing patient data as well as offering midwives the possibility for receiving information and decision support. Introducing such technology in low‐resource settings has been challenging because of low levels of user acceptance, software design that does not match the end‐user environment, and/or unforeseen challenges such as irregular power availability. These challenges are often attributable to a lack of understanding by the software developers of the end users’ needs and work environment. Methods: A mobile health (mHealth) application known as mClinic was designed to support midwife access to the Millennium Village‐Global Network, an eHealth delivery platform that captures data for managing patient care as well as program evaluation and monitoring, decision making, and management. We conducted a descriptive usability study composed of 3 phases to evaluate an mClinic prototype: 1) hybrid lab‐live software evaluation of mClinic to identify usability issues; 2) completion of a usability questionnaire; and 3) interviews that included low‐fidelity prototyping of new functionality proposed by midwives. Results: The heuristic evaluation identified usability problems related to 4 of 8 usability categories. Analysis of usability questionnaire data indicated that the midwives perceived mClinic as useful but were more neutral about the ease of use. Analysis of midwives' reactions to low‐fidelity prototypes during the interview process supported the applicability of mClinic to midwives' work and identified the need for additional functionality. Discussion: User acceptance is essential for the success of any mHealth implementation. Usability testing identified mClinic development flaws and needed software enhancements.

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.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1111/jmwh.12071

Cites

5 of 5 references verified0 citation errors · 0 not checkable

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.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Privacy protection was an important element influencing the success of telehealth projects.

    “Moreover, the existence of an energy source (solar chargers, back-up batteries) for charging devices (28,33), replacement of failing or lost telephones (33), and privacy protection (31,32) were also important elements influencing the success of telehealth projects.”

    From A mixed methods systematic review of success factors of mhealth and telehealth for maternal health in Sub-Saharan Africa (2017) · cites this paper as [31]

    The Results (Heuristic Evaluation; page unavailable) identify privacy as a design concern: because phones were shared, the authors said the application needed password protection. The paper does not establish that privacy protection influenced the success of telehealth projects, so the claim extends beyond the finding reported here. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • User-friendliness of the applications facilitates use of the technology.

    “Similarly, user-friendliness of the applications (e.g., devices with a touch screen, a more readable keyboard, and more aesthetic) would facilitate the use of the technology (26,31).”

    From A mixed methods systematic review of success factors of mhealth and telehealth for maternal health in Sub-Saharan Africa (2017) · cites this paper as [31]

    The Results (Heuristic Evaluation; page unavailable) report greater success with a touch-screen phone and difficulty using and reading the small keyboard. The Discussion (page unavailable) says hardware-related usability problems needed attention before implementation. The paper does not show that a more aesthetic design facilitated use, so that example is unsupported. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • A small telephone keypad was likely to lead to errors in recording data, whereas touch-screen phones were more reliable.

    “For instance, small telephone keypad was likely to lead to errors in the recording of data, whereas touch-screen phones were more reliable (31).”

    From A mixed methods systematic review of success factors of mhealth and telehealth for maternal health in Sub-Saharan Africa (2017) · cites this paper as [31]

  • Giving telephones to end users and training them in their use promotes appropriation and acceptance.

    “Moreover, giving telephones to end users (27) and training them in their use would promote their appropriation and acceptance (31)(32)(33).”

    From A mixed methods systematic review of success factors of mhealth and telehealth for maternal health in Sub-Saharan Africa (2017) · cites this paper as [31]

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

Flagged first, then by citations

Research works printed but not linked: 20

  1. [3]Snyder-Halpern R Corcoran-Perry S Narayan S Developing clinical practice environments supporting the knowledge work of nurses Comput Nurs Jan-Feb 2001 19 1 17 23 quiz 24–16 11210450
  2. [6]Jolles DR Brown WW King KB Electronic Health Records and Perinatal Quality: A Call to Midwives J Midwifery Womens Health 2012 57 4 315 320 22758354
  3. [7]McCurdie T Taneva S Casselman M The Case for User-Centered Design Horizons 2012 23039777
  4. [9]Martinez A Villarroel V Seoane J del Pozo F Analysis of information and communication needs in rural primary health care in developing countries IEEE Trans Inf Technol Biomed 3 2005 9 1 66 72 15787009
  5. [10]Gerber T Olazabal V Brown K Pablos-Mendez A An Agenda For Action On Global E-Health Health Aff 2 1 2010 29 2 233 236 20348066
  6. [11]Blaya JA Fraser HSF Holt B E-Health Technologies Show Promise In Developing Countries Health affairs (Millwood, Va) 2010 29 2 244 251 20348068
  7. [12]Tamrat T Kachnowski S Special Delivery: An Analysis of mHealth in Maternal and Newborn Health Programs and Their Outcomes Around the World Maternal and Child Health Journal 2011 1 10 21688111
  8. [14]Braa J Hanseth O Heywood A Woinshet M Shaw V Developing health information systems in developing countries: the flexible standards strategy MIS Quarterly 2007 31 2 381
  9. [15]Gordon AN Hinson RE Towards a sustainable framework for computer based health information systems (CHIS) for least developed countries (LDCs) International journal of health care quality assurance 2007 20 6 532 544 18030970
  10. [17]Fraser HS Blaya J Implementing medical information systems in developing countries, what works and what doesn’t AMIA Annu Symp Proc 2010 2010 232 236 21346975 PMC3041413
  11. [18]Waters E Rafter J Douglas GP Bwanali M Jazayeri D Fraser HS Experience implementing a point-of-care electronic medical record system for primary care in Malawi Stud Health Technol Inform 2010 160 Pt 1 96 100 20841657
  12. [25]Yen PY Wantland D Bakken S Development of a Customizable Health IT Usability Evaluation Scale AMIA Annu Symp Proc 2010 2010 917 921 21347112 PMC3041285
  13. [30]Kanter AS Borland R Barasa M Menachemi N Singh S The Importance of Using Open Source Technologies and Common Standards for Interoperability within eHealth: Perspectives from the Millennium Villages Project Advances in Health Care Management 12 Emerald Group Publishing Limited 2012 189 204 PMC3702267 22894051
  14. [31]Calandro C Gillwald A Moyo M Stork C Comparative ICT Sector Performance Review 2009/2010 2 Cape Town, SA Research ICT Africa 2010 http://www.researchictafrica.net/publications/Policy_Paper_Series_Towards_Evidence-based_ICT_Policy_and_Regulation_-_Volume_2/Vol_2_Paper_5_-_Comparative_ICT_Sector_Performance_Review_2009_2010.pdf
  15. [32]Bornman E The Mobile Phone in Africa: Has it become a highway to the information society or not? International Conference on Communication, Media, Technology and Design 09–11 May 2012 2012 Istanbul, Turkey
  16. [33]Kaplan WA Can the ubiquitous power of mobile phones be used to improve health outcomes in developing countries? Globalization and Health 2006 2 9 PMC1524730 16719925
  17. [34]Chib A The Aceh Besar midwives with mobile phones project: Design and evaluation perspectives using the information and communication technologies for healthcare development model Journal of Computer-Mediated Communication 2010 15 3 500 525
  18. [36]Adams DA Nelson RR Todd PA Perceived Usefulness, Ease of Use, and Usage of Information Technology: A Replication MIS Quarterly 1992 16 2 227 247
  19. [37]Venkatesh V Morris MG Davis GB Davis FD User acceptance of information technology: Toward a unified view MIS Quarterly 2003 27 3 425 478
  20. [39]Ramachandran D Kam M Chiu J Canny J Frankel JF Social dynamics of early stage co-design in developing regions Paper presented at: SIGCHI conference on Human factors in computing systems 2007 San Jose, California, USA

Cited by

Sorted by citations

Authors
Vélez, O., Okyere, P. B., Kanter, A. S., & Bakken, S.
Affiliations
  • Columbia University Irving Medical Center (US)
  • Columbia University (US)
Corresponding author
Vélez, Olivia
ORCID
Venue
Journal of Midwifery & Women's Health
Publisher
Wiley
Published
2014-01-08
Volume
59
Issue
2
Pages
184-191
ISSN
  • 1526-9523 (ISSN-L)
  • 1542-2011
DOI
10.1111/jmwh.12071
PMC
PMC3976680
OpenAlex
W2157648900
Cited by
105
References
5
Citations by year
2026: 1 · 2025: 8 · 2024: 2 · 2023: 9 · 2022: 14 · 2021: 7 · 2020: 13 · 2019: 16 · 2018: 10 · 2017: 8 · 2016: 8 · 2015: 9
FWCI
15.09
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Journal of Midwifery & Women s Health (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • International Development Research Centre
  • U.S. Public Health Service (1 D11 HP07346)
  • National Institute of Nursing Research (P30NR010677)
  • U.S. National Library of Medicine (T15LM007079)
Topics
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Physical Sciences › Computer Science › Human-Computer Interaction › Usability and User Interface Design
  • Physical Sciences › Computer Science › Information Systems › ICT in Developing Communities
Keywords
mobile health, midwives, rural health care, resource-limited settings, user acceptance, low-fidelity prototyping, heuristic evaluation, program monitoring and evaluation
MeSH terms
Delivery of Health Care, Female, Ghana, Humans, Interviews as Topic, Midwifery, Pregnancy, Surveys and Questionnaires, Cell Phone, Electronic Health Records, Mobile Applications

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