Lessons learned for the next generation of mHealth applications supporting maternal care services in Ghana

Background Globally, many technological innovations have been introduced for universal health coverage by increasing accessibility. mHealth ( mobile phone based health ) shows potentiality in improving maternal health service delivery with the help of communication between health care providers and beneficiaries. With the fastest growing mobile market over the last five years in low income setting (LIS) like Sub-Saharan Africa, Government and development partners are being encouraged to use mHealth. This study aims to see recurrent challenges from the program experiences of maternal health care (MHC)-focused mHealth initiatives from Ghana as country case study and how they address those challenges and secondly, supplemented by mHealth experiences in other LIS. Methods Qualitative data was collected mainly from 11 key informant interviews (KIIs) of senior officials of Ghana Health service, development organizations, government facility based health care providers- physician, community health nurse, ICT personnel, e-health specialist, Health MIS analyst and academic searchers. Interviews were face to face and via skype. Findings from Ghana were supplemented by literature review. Data was analysed via thematic analysis and stakeholder analysis was done to see their respective position for overcoming challenges using mHealth. Results Lack of national data ownership & non-sustainable plan for the skilled health force from the MOH, financial and double work burden of community health workers (CHWs), conflict of interest among collaborative partners & inter government departments, incomplete & inconsistent reporting due to distorted mobile network & data bundle and internet disruption, poor infrastructure of electricity and finally, business promotion strategy of telecommunication industries were the key challenges found in Ghana. Though they adapt some local strategies to minimize the acute problem, but like other low income settings, Ghana could not produce adequate scientific research evidences using primary data source. Conclusions: Ghana has many similar challenges to other low income settings; however, they adapt their own strategies to overcome. To increase utilization rate of maternal care, mHealth has been tested by different organizations in Ghana. To expand/scale up, high level negotiation & coordination among the profitable industries and government is necessary especially in staff development. Furthermore, more mHealth field research is expected before developing sustainable plan. Keywords: mHealth, Ghana, Maternal Care, Low income setting (LIS)msc_inhunpub2343_ethesesunpu