title: An investigation of users' attitudes, requirements and willingness to use mobile phone-based interactive voice response systems for seeking healthcare in Ghana: a qualitative study.
abstract: OBJECTIVE
  In implementing mobile health interventions, user requirements and willingness to use are among the most crucial concerns for success of the investigation and have only rarely been examined in sub-Saharan Africa. This study aimed to specify the requirements of caregivers of children in order to use a symptom-based interactive voice response (IVR) system for seeking healthcare. This included (i) the investigation of attitudes towards mobile phone use and user experiences and (ii) the assessment of facilitators and challenges to use the IVR system.
  
  
  METHODS
  This is a population-based cross-sectional study.
  
  
  METHODS
  Four qualitative focus group discussions were conducted in peri-urban and rural towns in Shai Osudoku and Ga West district, as well as in Tema- and Accra Metropolitan Assembly. Participants included male and female caregivers of at least one child between 0 and 10 years of age. A qualitative content analysis was conducted for data analysis.
  
  
  RESULTS
  Participants showed a positive attitude towards the use of mobile phones for seeking healthcare. While no previous experience in using IVR for health information was reported, the majority of participants stated that it offers a huge advantage for improvement in health performance. Barriers to IVR use included concerns about costs, lack of familiarly with the technology, social barriers such as lack of human interaction and infrastructural challenges. The establishment of a toll-free number as well as training prior to IVR system was discussed for recommendation.
  
  
  CONCLUSIONS
  This study suggests that caregivers in the socio-economic environment of Ghana are interested and willing to use mobile phone-based IVR to receive health information for child healthcare. Important identified users' needs should be considered by health programme implementers and policy makers to help facilitate the development and implementation of IVR systems in the field of seeking healthcare.
authors.affiliation: University of Bielefeld, School of Public Health, Department of Public Health Medicine, P.O. Box 100131, D-33501, Bielefeld, Germany; Department of Biological, Environmental, Occupational Health Sciences, School of Public Health, University of Ghana, P.O. Box LG13, Legon, Ghana. Electronic address: johanna_katharina.brinkel@uni-bielefeld.de.
authors.forename: J
authors.initials: J
authors.lastname: Brinkel
authors.affiliation: University of Ghana, School of Public Health, Department of Social and Behavioural Sciences, P.O. Box LG13, Legon, Accra, Ghana.
authors.forename: P
authors.initials: P
authors.lastname: Dako-Gyeke
authors.affiliation: University of Bielefeld, School of Public Health, Department of Public Health Medicine, P.O. Box 100131, D-33501, Bielefeld, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Krämer
authors.affiliation: Bernhard Nocht Institute for Tropical Medicine, Infectious Disease Epidemiology Unit, Bernhard Nocht-Str. 74, D-20359, Hamburg, Germany.
authors.forename: J
authors.initials: J
authors.lastname: May
authors.affiliation: University of Ghana, School of Public Health, Department of Biological, Environmental, Occupational Health Sciences, P.O. Box LG13, Legon, Accra, Ghana.
authors.forename: J N
authors.initials: JN
authors.lastname: Fobil
mesh_terms: D001290:Attitude; D001292:Attitude to Computers; D017028:Caregivers; D040421:Cell Phone / Q000706:statistics & numerical data*; D002648:Child; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D005260:Female; D017144:Focus Groups; D005869:Ghana; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D036301:Qualitative Research; D012424:Rural Population; D012959:Socioeconomic Factors; D017216:Telemedicine / Q000295:instrumentation / Q000379:methods*
keywords: Interactive voice response; Seeking healthcare; Sub-Saharan Africa; User needs; mHealth