title: Building quality mHealth for low resource settings.
abstract: In low- and middle-income countries (LMIC), community health care workers (CHCW) are the primary point of care for millions of people. Mobile phone health applications (mHealth app) are the preferred technology platform to deliver clinical support to CHCW. In LMIC, limited regulatory oversight exists to guide quality and safety for medical devices, including mHealth. During the development of a mHealth app to assist CHCW with patient assessment and clinical diagnosis in rural South Africa, we applied human-centred design (HCD) and a bioethics consultation. The HCD approach enabled us to develop a mHealth app that responded to the needs and capacities of CHCW. The bioethics consultation prompted early consideration of safety concerns, social implications of our mHealth app and our technology's impact on the CHCW-patient relationship. In this study, we found that combining a HCD approach with bioethics consultation improved the design quality and reduced safety concerns for our mHealth app.
authors: a Mural Institute , San Francisco , CA , USA.
authors: Kate Michi
authors: KM
authors: Ettinger
authors: b Physiotherapy Department , University of the Western Cape , Belleville , South Africa.
authors: Hamilton
authors: H
authors: Pharaoh
authors: c Syte Institute , Hamburg , Germany.
authors: Reymound Yaw
authors: RY
authors: Buckman
authors: d Ukwanda Rural Research Centre, Faculty of Medicine and Health Sciences, Stellenbosch University , Worcester , Cape Town , South Africa.
authors: Hoffie
authors: H
authors: Conradie
authors: e Department of Health Sciences and Technology , ETH Zurich, Mobile Health Systems Lab , Zurich , Switzerland.
authors: Walter
authors: W
authors: Karlen
mesh_terms: D000328:Adult; D003153:Community Health Services; D003150:Community Health Workers; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D012424:Rural Population; D000068997:Smartphone / Q000706:statistics & numerical data; D013019:South Africa; D017216:Telemedicine; D055815:Young Adult
keywords: Usability; bioethics; development; mobile health; safety