Date of Award

December 2016

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Nursing

First Advisor

Lucy Mkandawire-Valhmu

Committee Members

Amy Coenen, Simone C.O. Conceição, Leanne M. Currie, Peninnah M. Kako

Keywords

HIV, Malawi, Mobile Phones, Qualitative, Sociotechnical, Support Group

Abstract

The use of mobile phones are becoming ubiquitous with growing interest by healthcare providers to utilize mobile phone technology for various health-related applications, called mHealth. This is especially true in low-income countries such as those in sub-Saharan Africa. When implementing mHealth applications, it is important to understand the dynamic social, cultural and environmental factors where mHealth will be implemented to ensure that interventions developed are effective. A qualitative study to explore the sociotechnical factors experienced by women participating in an HIV support group in urban Malawi was conducted to enhance our understanding of women’s experience with mobile phone use and its implications on their health. Ten individual interviews and one focus group interview were completed with women, using narrative methods and a sociotechnical view to inform data analysis. Narrative structural and thematic analysis were used to analyze the individual interview data, and thematic analysis was used to analyze the focus group interview data. This study offers valuable insights into the sociotechnical factors impacting mobile phone use and its implications on health within this urban context. Findings are discussed under four main areas: 1. Health-related activities and tasks; 2. Social related activities and tasks; 3. Income generation activities and tasks; and 4. Technical challenges. Implications for policy discussed include the scaling up of programs incorporating mobile phones in sub-Saharan Africa as part of the HIV prevention and treatment plan and partnering with NGO’s and churches to leverage funding and existing community based resources. Implications for future research include an opportunity for further theory development around community health frameworks that are sensitive to the African world view of person and community in addition to further exploring the utility of mobile phone technology in enhancing health outcomes for people living with HIV.

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