Understanding the Factors that Influence the Primary Appraisal of mHealth Tools in Developing Countries: An Exploratory Case-Study in Nigeria

Shortages of health workers, infrastructural deficiencies, limited access to medical care are just a few of the many barriers to care in developing countries. The integration of smartphones and mobile devices into healthcare systems has been proposed to address some of the physical barriers to care and service delivery. These mHealth solutions extend the reach of medical care into rural areas of developing countries. However, it is not clear how mHealth solutions designed and tested in one developing region can be positively appraised for use in others. This study frames this problem using a coping theory approach based on an exploratory case-study to understand the factors that influence primary appraisal of smartphone-enabled clinical guidelines (mHealth tool) for accessing, classifying and eliciting treatment recommendation for sick children under the age of five by rural healthcare workers (RHCWs). Findings identified a set of factors which are bound as an emerging explanatory positivity model that influence primary appraisal of an mHealth tool in a new context. These factors are the set of individual and social factors that governments, funding bodies and non-governmental organisations should consider before embarking on the introduction of an mHealth tool in rural communities of developing countries. It is envisaged that by understanding the factors that influence primary appraisal, that is, either as an opportunity or a threat, practitioners and organisations will support positive appraisal and minimise the occurrence of negative ones when introducing mHealth tools. These findings have implications for theory, practice, and future research as explained in the concluding section of this paper.