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Midwives in Ghana provide the majority of rural primary and maternal healthcare services, but have limited access to data for decision making and knowledge work. Few mobile health (mHealth) applications have been designed for midwives. The study's purpose was to design and test an mHealth application (mClinic) that can improve data access and reduce the reporting burden for midwives at the Millennium Villages Project site in Ghana.

From the design science field, the Information Systems Research Framework guided this study through two research cycles: 1) Relevance, and 2) Design. The first phase of the Relevance Cycle took a user-centered approach to assess the people, organizations, and technology of the midwives’ environment through participant observation, contextual inquiry, and interviews. In the second phase, structured requirements specification was used to categorize the data into goals, system qualities, and constraints. From the categorized data, use cases were developed for patient registration, antenatal care, malaria, family planning, and referrals. Use cases then informed the development of functional requirements. In the Design Cycle, we first used functional requirements for patient registration and malaria to develop the mClinic prototype as part of a coded-in-country initiative. Next, we examined usability of the mClinic prototype by conducting field testing, heuristic evaluation, and usability surveys. Additionally, low-fidelity prototyping was used to determine applicability of the other use cases to the midwives’ environment.

Midwives reported inability to access critical data, high patient loads, and extensive reporting requirements. Low technical self-efficacy and inadequate infrastructure were identified as barriers to implementation. Heuristic evaluation noted issues related to hardware selection, workflow, and security. Midwives ranked the tool as useful in the usability survey; however, ease-of-use rankings were neutral. Interviews indicated this was related to low technical self-efficacy. Applicability checks found support for touch-entry prototypes over those that included lengthy forms or text-entry.

In this paper we present a study comparing speech and dialed input voice user interfaces for farmers in Gujarat, India. We ran a controlled, between-subjects experiment with 45 participants. We found that the task completion rates were significantly higher with dialed input, particularly for subjects under age 30 and those with less than an eighth grade education. Additionally, participants using dialed input demonstrated a significantly greater performance improvement from the first to final task, and reported less difficulty providing input to the system.

In this paper we present the results of a field study of Avaaj Otalo (literally, “voice stoop”), an interactive voice application for small-scale farmers in Gujarat, India. Through usage data and interviews, we describe how 51 farmers used the system over a seven month pilot deployment. The most popular feature of Avaaj Otalo was a forum for asking questions and browsing others’ questions and responses on a range of agricultural topics. The forum developed into a lively social space with the emergence of norms, persistent moderation, and a desire for both structured interaction with institutionally sanctioned authorities and open discussion with peers. For all 51 users this was the first experience participating in an online community of any sort. In terms of usability, simple menu-based navigation was readily learned, with users preferring numeric input over speech. We conclude by discussing implications of our findings for designing voice-based social media serving rural communities in India and elsewhere.

Providing health information to low health literate audiences remains a challenge. Beyond message design, realistic delivery models are needed for delivering information to a traditionally hard-to-reach audience. This study investigated two e-health interventions to provide health information on mobile devices – one providing diabetes information and one offering childcare information. Both were well-received, and most of the subjects’ usability issues related to the translation of these interventions to the mobile device’s smaller screen. The diabetes website was effective in providing information to study participants (as measured by pre- and post-tests of knowledge), while the childcare website was not. Continued work in this area could explore improved design strategies for mobile devices – a delivery model that could be used in doctors’ offices, for example. Effective delivery of health information to low health literate audiences is an important issue, and this research highlights a critical element by targeting another potential delivery model.

Results of proof-of-concept testing for an mHealth solution for reproductive health in Uttar Pradesh, India. The text messaging tool based on FrontlineSMS, is a family planning service that relies on the Standard Day Method system of birth control. This method of birth control depends on the woman's fertility cycles to avoid pregnancy. Women can text the date of their menses and user receives their fertility status. Additionally, women can receive information about other family planning options, and support. Presented are observations on the appropriatenss of the technology from focus group discussions. The authors share the input given by target users in the product and service design. Women tested the solution to give insight on feasibility and design.

Implementation of Monitoring and Evaluation (M&E) programmes are predominantly dependant on paper forms to measure organisational impact. These forms are then manually captured into an electronic system for analysis. This methodology results in high costs, questionable data accuracy and long turnaround times. Additionally inadequately skilled employees, remote locations and high staff turnover add to these challenges. A solution that allows for flexibility and extendibility within the NGO sector is required to decrease costs and allow for NGO’s to focus their attentions on their main areas of expertise. One potential solution is the use of mobile phones to collect the data.

This paper presents the experiences of implementing a mobile phone based M&E system and the lessons learnt in scaling this system from pilot to national. These include system flexibility, easy-to-learn interfaces, identification of champions and detailed site assessments. Today the system is being used nationally, with over 70 000 electronic surveys submitted and over 300 facilitators using the system.

This paper provides an overview of the implications of this trend for the delivery of healthcare services and population health. In addition to addressing how mobile phones are changing the way health professionals communicate with their patients, a summary is provided of current and projected technologic capabilities of mobile phones that have the potential to render them an increasingly indispensable personal health device. Finally, the health risks of mobile phone use are addressed, as are several unresolved technical and policy-related issues unique to mobile phones. Because these issues may influence how well and how quickly mobile phones are integrated into health care, and how well they serve the needs of the entire population, they deserve the attention of both the healthcare and public health community.

This study reports results of an ethnographic action research study, exploring mobile-centric internet use. Over the course of 13 weeks, eight women, each a member of a livelihoods collective in urban Cape Town, South Africa, received training to make use of the data (internet) features on the phones they already owned. None of the women had previous exposure to PCs or the internet. Activities focused on social networking, entertainment, information search, and, in particular, job searches. Results of the exercise reveal both the promise of, and barriers to, mobile internet use by a potentially large community of first-time, mobilecentric users. Discussion focuses on the importance of selfexpression and identity management in the refinement of online and offline presences, and considers these forces relative to issues of gender and socioeconomic status.