A Select Study of Mobile Health Applications in Indian Context

Abstract

Mobile health (mHealth) is an essential requirement in healthcare for improving health service delivery. Despite its increasing attention across different countries, there is a dearth of evidence about its usefulness among Indian populations. The literature considers mHealth as “the use of transportation systems such as mobile medical units or vans and/or mobile phone/ICT for providing health service to the people living in a particular locality”. The study aims to answer the research question “how to improve the usefulness of mobile health applications for health service delivery?” by i) analyzing the accessibility and acceptance of mobile health among the rural population; ii) studying affordability in terms of cost to consumer and financial viability of the service provider; and by iii) identifying the awareness level in the use of mobile health applications among the citizens. A convergent mixed method design has been carried out to address the research objectives. A qualitative interview was used to measure the accessibility and acceptance of mHealth among rural regions. The study identified a lack of awareness about the term and government-initiated applications among people and doctors though it has been used for vaccination remainders and cessation programmes. The programmes and applications are available at places where network and its supporting technologies are connected to scheduling vaccinations and conducting regular interventions. The consolidation of interview findings proposed an acceptance model pertaining to rural Indian populations. The affordability of mHealth is measured by conducting interviews among technology entrepreneurs and software developers. Findings illustrated that people’s need and unwillingness, lack of application infrastructure, ecosystem development, governmental policies, and training and support influences mHealth systems implementations. As Twitter in health research is a growing body of work, the study extracts its messages and performs sentiment analysis to analyze emotions and themes surrounding mHealth applications, social media games, social media movement, and mental health. A quantitative survey approach is adopted to study the awareness level in the use of the mobile phone for health communication and delivery, and self-managing health applications among the technical and working staffs and medical and healthprofessionals. The study also tested the relationships between the individual characteristics, adoption characteristics of new product or service, individual cognitive factors, and health-related use behavior. The results showed that personal innovativeness, awareness, and perceived usefulness tends to explain better intention to use than they do individually. A triangulation of studies explains that the dynamics associated with mHealth applications in the real environment are somewhat disorganized and formed a vicious cycle. This resulted in a sense of dissatisfaction among the people, healthcare practitioners, government, and the techno-entrepreneurs. The need for a sensitization programme, the right policy and the governance framework for mHealth applications would contribute to the nation’s health policy objective. Thus, recommendations from healthcare professionals influence users and patients in improving awareness that subsequently improves the intention to use and acceptance for health service delivery. This thesis contributes by integrating multiple theoretical models and methods, i.e., qualitative and quantitative, towards the development of mobile health framework for investigating a research question. Compared to earlier studies, this study examines the relationships across the layers of people, process, and technology for achieving the research question. Future research can consider mHealth accessibility in-terms of the digital divide and medical divide, and the influence of trust, technology anxiety, environmental concerns, health severity, health susceptibility, and behavioral control on awareness and intention to use can be studied.