Medicine

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Browsing Medicine by Author "Chikoko, L."

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    RoadMApp: a feasibility study for a smart travel application to improve maternal health delivery in a low resource setting in Zimbabwe
    (2020) Nyati-Jokomo, Z.; Dabengwa, I.M.; Makacha, L.; Nyapwere, N.; Dube, Y.P.; Chikoko, L.; Vidler, M.; Makanga, P.T.
    Background: Travel time and healthcare financing are critical determinants of the provision of quality maternal health care in low resource settings. Despite the availability of pregnancy-related mHealth and smart travel applications, there is a lack of evidence on their usage to travel to health facilities for routine antenatal care and emergencies. There is a shortage of information about the feasibility of using a custom-made mobile technology that integrates smart travel and mHealth. This paper explores the feasibility of implementing a custom-made geographically enabled mobile technology-based tool (RoadMApp) to counter the adverse effects of long travel times for maternal care in Kwekwe District, Zimbabwe. Methods: We frame the paper using the first two steps (listen & plan) of the Spiral Technology Action Research (STAR model). The paper uses an exploratory case study design and Participatory Learning Approaches (PLA) with stakeholders (community members) and in-depth interviews with key informants (health care service providers, pregnant women, transport operators). One hundred ninety-three participants took part in the study. We conducted focus group discussions with pregnant women, women of childbearing age, men (household heads), and elderly women. The discussion questions centered on travel time, availability of transport, cellular network coverage, and perceptions of the RoadMApp application. Data were analysed thematically using Nvivo Pro 12. Results: Most parts of rural Kwekwe are far from health facilities and have an inefficient road and telecommunications network. Hence, it is hard to predict if RoadMApp will integrate into the lives of the community - especially those in rural areas. Since these issues are pillars of the design of the RoadMApp mHealth, the implementation will probably be a challenge.
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    The Potentials of a Maternal Mobile Wallet: a Qualitative Case Study on Opportunities and Challenges From Zimbabwe
    (2020-12-30) Nyati-Jokomo, Z.,; Dabengwa, I.M.; Chikoko, L.; Makacha, L.; Nyapwere, N.; Makanga, P.T.
    Background: There are no systems put in place regarding mobile money for maternal savings in Zimbabwe. Therefore, this paper aims to highlight: (a) existing strategies and experiences about maternal savings in Kwekwe District and, (b) examine the implications of household dynamics and current savings behaviour towards the feasibility of implementing the RoadMApp Maternal Healthcare Mobile Wallet (MHMW). Methods: Out of the 49 health facilities in Kwekwe, 2 hospitals (rural and urban), 4 rural health centres, 2 peri-urban, and 2 urban clinics were purposively selected for the study. Participants were recruited from these health facilities. 193 people took part in the study, through 11 Focus Group Discussions, 17 In-Depth Interviews, and 3 Community Meetings. The Socio ecological Model’s categories are applied to interpret the results taking into consideration the barriers and enablers of maternal savings. Results: There is a paucity of information on strategies for maternal savings in Kwekwe District, Zimbabwe. The critical enabler for the implementation of an MHMW could be the use of existing community structures, like the burial societies and other savings clubs. Some of the essential barriers include low access to mobile phones, inadequate network coverage, power outages, a general lack of saving culture by communities, and the hyperinflationary environment in the country. Conclusion: Although, the socio-economic status of households may be the best predictor of maternal savings, ancillary factors such as financial literacy, educational level, cultural norms, and religion will help to understand the psychosocial reasons why communities engage in maternal savings. When implementing an MHMW, specific attention should be paid to individual and community/institutional level factors such as subsidies/interests on amounts saved, enforcing financial discipline, building local level mobile network infrastructure, and relying on locally available persons/systems.
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    The Potentials of a Maternal Mobile Wallet: a Qualitative Case Study on Opportunities and Challenges From Zimbabwe
    (2020) Nyati-Jokomo, Z.; Dabengwa, I.M.; Chikoko, L.; Makacha, L.; Nyapwere, N.; Makanga, N.
    Background: There are no systems put in place regarding mobile money for maternal savings in Zimbabwe. Therefore, this paper aims to highlight: (a) existing strategies and experiences about maternal savings in Kwekwe District and, (b) examine the implications of household dynamics and current savings behaviour towards the feasibility of implementing the RoadMApp Maternal Healthcare Mobile Wallet (MHMW). Methods: Out of the 49 health facilities in Kwekwe, 2 hospitals (rural and urban), 4 rural health centres, 2 peri-urban, and 2 urban clinics were purposively selected for the study. Participants were recruited from these health facilities. 193 people took part in the study, through 11 Focus Group Discussions, 17 In-Depth Interviews, and 3 Community Meetings. The Socioecological Model’s categories are applied to interpret the results taking into consideration the barriers and enablers of maternal savings. Results: There is a paucity of information on strategies for maternal savings in Kwekwe District, Zimbabwe. The critical enabler for the implementation of an MHMW could be the use of existing community structures, like the burial societies and other savings clubs. Some of the essential barriers include low access to mobile phones, inadequate network coverage, power outages, a general lack of saving culture by communities, and the hyperinflationary environment in the country. Conclusion: Although, the socio-economic status of households may be the best predictor of maternal savings, ancillary factors such as financial literacy, educational level, cultural norms, and religion will help to understand the psychosocial reasons why communities engage in maternal savings. When implementing an MHMW, specific attention should be paid to individual and community/institutional level factors such as subsidies/interests on amounts saved, enforcing financial discipline, building local level mobile network infrastructure, and relying on locally available persons/systems.