A Usability Study of a Mobile Health Application for Rural Ghanaian Midwives
Article first published online: 8 JAN 2014
© 2014 by the American College of Nurse-Midwives
Journal of Midwifery & Womens Health
Volume 59, Issue 2, pages 184–191, March/April 2014
How to Cite
Vélez, O., Okyere, P. B., Kanter, A. S. and Bakken, S. (2014), A Usability Study of a Mobile Health Application for Rural Ghanaian Midwives. Journal of Midwifery & Womens Health, 59: 184–191. doi: 10.1111/jmwh.12071
- Issue published online: 3 APR 2014
- Article first published online: 8 JAN 2014
- National Institute of Nursing Research. Grant Number: P30NR010677
- Health Services Resource Administration. Grant Number: 1D11 HP07346
- International Development Research Centre, Rockefeller Foundation, Novartis Fund for Sustainable Development, OpenROSA Consortium, Jonas Center for Nursing Excellence, and the National Library of Medicine. Grant Number: 5 T15 LM007079–20
- sub-Saharan Africa;
- global health;
- international health;
- cellular phones
Midwives in rural Ghana work at the frontline of the health care system, where they have access to essential data about the patient population. However, current methods of data capture, primarily pen and paper, make the data neither accessible nor usable for monitoring patient care or program evaluation. Electronic health (eHealth) systems present a potential mechanism for enhancing the roles of midwives by providing tools for collecting, exchanging, and viewing patient data as well as offering midwives the possibility for receiving information and decision support. Introducing such technology in low-resource settings has been challenging because of low levels of user acceptance, software design that does not match the end-user environment, and/or unforeseen challenges such as irregular power availability. These challenges are often attributable to a lack of understanding by the software developers of the end users’ needs and work environment.
A mobile health (mHealth) application known as mClinic was designed to support midwife access to the Millennium Village-Global Network, an eHealth delivery platform that captures data for managing patient care as well as program evaluation and monitoring, decision making, and management. We conducted a descriptive usability study composed of 3 phases to evaluate an mClinic prototype: 1) hybrid lab-live software evaluation of mClinic to identify usability issues; 2) completion of a usability questionnaire; and 3) interviews that included low-fidelity prototyping of new functionality proposed by midwives.
The heuristic evaluation identified usability problems related to 4 of 8 usability categories. Analysis of usability questionnaire data indicated that the midwives perceived mClinic as useful but were more neutral about the ease of use. Analysis of midwives' reactions to low-fidelity prototypes during the interview process supported the applicability of mClinic to midwives' work and identified the need for additional functionality.
User acceptance is essential for the success of any mHealth implementation. Usability testing identified mClinic development flaws and needed software enhancements.