title: Mobile phone-based interactive voice response as a tool for improving access to healthcare in remote areas in Ghana - an evaluation of user experiences.
abstract: To investigate and determine the factors that enhanced or constituted barriers to the acceptance of an mHealth system which was piloted in Asante-Akim North District of Ghana to support healthcare of children.
  
  
  
  Four semi-structured focus group discussions were conducted with a total of 37 mothers. Participants were selected from a study population of mothers who subscribed to a pilot mHealth system which used an interactive voice response (IVR) for its operations. Data were evaluated using qualitative content analysis methods. In addition, a short quantitative questionnaire assessed system's usability (SUS).
  
  
  
  Results revealed 10 categories of factors that facilitated user acceptance of the IVR system including quality-of-care experience, health education and empowerment of women. The eight categories of factors identified as barriers to user acceptance included the lack of human interaction, lack of update and training on the electronic advices provided and lack of social integration of the system into the community. The usability (SUS median: 79.3; range: 65-97.5) of the system was rated acceptable.
  
  
  
  The principles of the tested mHealth system could be of interest during infectious disease outbreaks, such as Ebola or Lassa fever, when there might be a special need for disease-specific health information within populations.
authors.affiliation: School of Public Health, University of Bielefeld, Bielefeld, Germany.|Department of Biological, Environmental, Occupational Health Sciences, University of Ghana, Accra, Ghana.
authors.forename: J
authors.initials: J
authors.lastname: Brinkel
authors.affiliation: Infectious Disease Epidemiology Unit, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
authors.forename: J
authors.initials: J
authors.lastname: May
authors.affiliation: Infectious Disease Epidemiology Unit, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Krumkamp
authors.affiliation: Infectious Disease Epidemiology Unit, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Lamshöft
authors.affiliation: Medical Clinic I, University Clinic Hamburg Eppendorf, Hamburg, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Kreuels
authors.affiliation: Kumasi Centre for Collaborative Research, Kumasi, Ghana.
authors.forename: E
authors.initials: E
authors.lastname: Owusu-Dabo
authors.affiliation: Kumasi Centre for Collaborative Research, Kumasi, Ghana.
authors.forename: A
authors.initials: A
authors.lastname: Mohammed
authors.affiliation: Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Bonacic Marinovic
authors.affiliation: Department of Social and Behavioural Sciences, University of Ghana, Accra, Ghana.
authors.forename: P
authors.initials: P
authors.lastname: Dako-Gyeke
authors.affiliation: School of Public Health, University of Bielefeld, Bielefeld, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Krämer
authors.affiliation: Department of Biological, Environmental, Occupational Health Sciences, University of Ghana, Accra, Ghana.
authors.forename: J N
authors.initials: JN
authors.lastname: Fobil
mesh_terms: D000328:Adult; D040421:Cell Phone; D002648:Child; D002675:Child, Preschool; D005260:Female; D005869:Ghana; D006266:Health Education; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D008297:Male; D010342:Patient Acceptance of Health Care; D011209:Power, Psychological; D011787:Quality of Health Care; D017216:Telemedicine / Q000379:methods / Q000706:statistics & numerical data*; D014831:Voice; D014930:Women
keywords: Afrique subsaharienne; Escala Usabilidad de Sistema; Ghana; System Usability Scale; atención infantil; child care; eSalud; interactive voice response; mHealth; respuesta interactiva a la voz; réponse vocale interactive; soins des enfants; sub-Saharan Africa; África subsahariana; échelle de facilité d'utilisation du système