Strategies to implement mobile health interventions for diabetes management in Ethiopia

Abstract

Rapid mobile device penetration allows developing countries like Ethiopia to integrate Mobile Health (mHealth) technologies to improve healthcare delivery and diabetes management effectiveness. The high diabetes prevalence and the required quality of management necessitate enhanced interventions like mHealth. This study intended to investigate opportunities for the development of mHealth for diabetes management and design strategies for its implementation in Ethiopia. The research was conducted in selected health centres in Addis Ababa, Ethiopia. A sequential exploratory mixed design was used to investigate mHealth opportunities and acceptance by healthcare professionals. An integrative literature review was conducted following the PRISMA-P protocol, and the findings were used to develop a second-phase quantitative data collection instrument. Multi-stage and purposive sampling techniques were used to select healthcare professionals and senior experts. Data were collected from articles, healthcare professionals, and experts using a data extraction form, questionnaire, and modified Delphi technique. A thematic analysis was used for qualitative data, and the Statistical Package for Social Sciences (SPSS) and AMOS software were used for quantitative data analysis. mHealth strategies were developed, revised, and validated using modified Delphi techniques. The mHealth interventions domains were patient education, patient communication, and support for Diabetes Self-management (DSM), maintaining personal health records, screening, and using a clinical decision support system treatment/therapy plan. Most healthcare professionals (HCPs) accepted the identified mHealth domains and opportunities as practical, easy to use or less complex. The structural equation model analysis demonstrated that the perceived usefulness and ease of use or complexity of mHealth were predictors for the intention to use mHealth by HCPs for diabetes management. On the other hand, the attitude towards mHealth opportunities and capacity building in mHealth affected the intention to use by HCPs for diabetes management. Strategies were developed to highlight the opportunities for using mHealth for diabetes management and to address possible challenges that may hinder effective implementation. The study concluded that there are opportunities for using mHealth in managing chronic conditions such as diabetes in Ethiopia. Successful implementation of mobile technologies requires a positive attitude and acceptance by HCPs to enhance the quality of diabetes management in primary health care settings.