Facilitators and barriers to the implementation of a Mobile Health Wallet for pregnancy-related health care: A qualitative study of stakeholders’ perceptions in Madagascar

Financial barriers are a major obstacle to accessing maternal health care services in low-resource settings. In Madagascar, less than half of live births are attended by skilled health staff. Although mobile money-based savings and payment systems are often used to pay for a variety of services, including health care, data on the implications of a dedicated mobile money wallet restricted to health-related spending during pregnancy–a mobile health wallet (MHW)–are not well understood. In cooperation with the Madagascan Ministry of Health, this study aims to elicit the perceptions, experiences, and recommendations of key stakeholders in relation to a MHW amid a pilot study in 31 state-funded health care facilities. We conducted a two-stage qualitative study using semi-structured in-depth interviews with stakeholders (N = 21) representing the following groups: community representatives, health care providers, health officials and representatives from phone provider companies. Interviews were conducted in Atsimondrano and Renivohitra districts, between November and December of 2017. Data was coded thematically using inductive and deductive approaches, and found to align with a social ecological model. Key facilitators for successful implementation of the MHW, include (i) close collaboration with existing communal structures and (ii) creation of an incentive scheme to reward pregnant women to save. Key barriers to the application of the MHW in the study zone include (i) disruption of informal benefits for health care providers related to the current cash-based payment system, (ii) low mobile phone ownership, (iii) illiteracy among the target population, and (iv) failure of the MHW to overcome essential access barriers towards institutional health care services such as fear of unpredictable expenses. The MHW was perceived as a potential solution to reduce disparities in access to maternal health care. To ensure success of the MHW, direct demand-side and provider-side financial incentives merit consideration

The impact of mobile telephony on developing country micro-enterprises: a Nigerian case study

Informational challenges-absence, uncertainty, asymmetry-shape the working of markets and commerce in many developing countries. For developing country micro-enterprises, which form the bulk of all enterprises worldwide, these challenges shape the characteristics of their supply chains. They reduce the chances that business and trade will emerge. They keep supply chains localised and intermediated. They make trade within those supply chains slow, costly, and risky. Mobile telephony may provide an opportunity to address the informational challenges and, hence, to alter the characteristics of trade within micro-enterprise supply chains. However, mobile telephony has only recently penetrated. This paper, therefore, presents one of the first case studies of the impact of mobile telephony on the numerically-dominant form of enterprise, based around a case study of the cloth-weaving sector in Nigeria. It finds that there are ways in which costs and risks are being reduced and time is saved, often by substitution of journeys. But it also finds a continuing need for journeys and physical meetings due to issues of trust, design intensity, physical inspection and exchange, and interaction complexity. As a result, there are few signs of the de-localisation or disintermediation predicted by some commentators. An economising effect of mobile phones on supply chain processes may therefore co-exist with the entrenchment of supply chain structures and a growing 'competitive divide' between those with and without access to telephony

Human computer interaction for international development: past present and future

Recent years have seen a burgeoning interest in research into the use of information and communication technologies (ICTs) in the context of developing regions, particularly into how such ICTs might be appropriately designed to meet the unique user and infrastructural requirements that we encounter in these cross-cultural environments. This emerging field, known to some as HCI4D, is the product of a diverse set of origins. As such, it can often be difficult to navigate prior work, and/or to piece together a broad picture of what the field looks like as a whole. In this paper, we aim to contextualize HCI4D—to give it some historical background, to review its existing literature spanning a number of research traditions, to discuss some of its key issues arising from the work done so far, and to suggest some major research objectives for the future

Research report: "It’s all about making a life": young female sex workers vulnerability to HIV and prevention needs in Kumasi, Ghana

This study was implemented by Boston University in collaboration with the Kwame Nkrumah University of Science and Technology with support from the President’s Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Agency for International Development under Project SEARCH Task Order No. GHH‐I‐00‐07‐00023‐00, beginning August 27, 2010. The content and views expressed here are the authors’ and do not necessarily reflect the opinion or policy of USAID or the U.S. Government.This report presents findings from a qualitative study examining the vulnerability to HIV of young female sex workers (FSW) in Kumasi, Ghana and their prevention needs. The study was conducted by Boston University’s Center for Global and Health and Development (CGHD) and the Kwame Nkrumah University of Science and Technology (KNUST) as part of the Project SEARCH Program funded by PEPFAR and the United States Agency for International Development Ghana. The objectives of this study were to: 1) Investigate knowledge about and perceptions of HIV in young FSW in the Kumasi Metropolitan area, 2) Explore their risk behaviors, and 3) Identify their most urgent prevention needs. A secondary objective was to provide foundational knowledge to inform the design of future studies of girls and young women engaging in sex work in Ghana.Support from the President’s Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Agency for International Development under Project SEARCH Task Order No. GHH‐I‐00‐07‐00023‐00, beginning August 27, 201

Are Accounting Gurus in Sync with Petty Traders’ Indigenous and Innovative Record-Keeping?

Although record-keeping by small- and medium-scale enterprises (SMEs) has been extensively researched, there is a paucity of research on indigenous and innovative record-keeping. This paper examines the indigenous and innovative record-keeping practices of petty traders in Kumasi, Ghana, with a focus on how they gain a competitive advantage. In addition, it aims to derive a theoretical model from the findings of the study using grounded theory. Lastly, this research seeks to understand if academic and accounting practitioners are in sync with petty traders’ record-keeping. The results from focus group discussions show that petty traders engage in both indigenous (stones or sticks tallying, item or goods tallying, marking of walls, note pad or exercise books, pieces of tied clothes or polythene bags, vendors and customers, family and friends, guarantors and witnesses, susu collectors, and wooden boxes or tin cans) and innovative (mobile money, use of audio-visuals, and videotapes) record-keeping practices. The results also demonstrate that indigenous and innovative record-keeping of petty traders gives them a competitive advantage. A theoretical model is derived from the results using grounded theory. This study adds to the literature on record-keeping practices and has implications for further research

External Evaluation of Mobile Phone Technology-Based Nutrition and Agriculture Advisory Services in Africa: Mobile Phones, Agriculture, and Nutrition in Ghana: Qualitative Follow-Up Study Report

mNutrition is a global initiative supported by the UK Department for International Development, (DFID), organised by Groupe Spéciale Mobile Association (GSMA), and implemented by in-country MNOs and third-party providers. It aims to use mobile technology to improve the health and nutritional status of children and adults in the developing world. The potential to utilise mobile technology to change attitudes, knowledge, behaviours, and practices around health and agriculture for improved nutritional status has been recognised for some time, but to date there have been no rigorous evaluations of m-services at scale. A consortium of researchers from Gamos, the Institute of Development Studies (IDS), and the International Food Policy Research Institute (IFPRI) have been contracted to conduct a rigorous mixed-methods evaluation to estimate the impact of two mNutrition services on children and adults, and to clarify how the context and the components of the mNutrition interventions shape their impact

Blockchain and gender digital inequalities in Africa: A critical afrofemtric analysis

Advances in the technological sphere are synergistic with society’s progression. Technological innovations result in social realities, and these correspondingly remodel technologies to reconcile their functions and values with society’s needs. The birth of blockchain ushered in euphoric pronouncements about its disruptive potentialities for low-resourced societies. While dominant discourses frame it as a tool for enabling grassroots participation in socioeconomic activities, they ignore the societal embeddedness of innovations. A central premise of this study is that the modalities of blockchain’s adoption reflect, and to an extent cement, the inequitable gender power dynamics of its context. Drawing on principles of gender justice from my original critical theory afrofemtrism, technofeminism, and the social construction of technology, I examined the adoption of blockchain technologies in Ghana and its engagement with gender digital inequalities. My empirical data is from 33 qualitative interviews with participants in the blockchain economy. I found that investing and trading in cryptocurrency are the principal blockchain activities in Ghana. This evinces the perception of low entry barriers without needing specialized education. Additionally, participants are overwhelmingly male, and the women in the space navigate a complex existence of relegation and comity. Their presence in this male-dominated space opens them to ridicule, and yet they benefit from better transactional opportunities as people perceive them to be more trustworthy than the average man. Blockchain could engender financial emancipation for women and other marginalized social groups. However, conditions like the compound effect of inhibiting familial, societal, and cultural socialization on gendered interests and progression undercut these affordances. Blockchain in itself is, therefore, not a panacea. Interventions for social change must include gender justice-conscious policymaking, as well as nationwide conscientization of the underpinnings of gender digital disparities. This study’s findings are integral to advancing studies in gender disparities in a sociotechnical arena. It also contributes to knowledge emanating from the Global South, particularly regarding emerging technology

Eco-System Oriented Instrument for Measuring Firm Technology Adoption

The development of the Firm Technology Adoption Model (F-TAM) of measuring firm technology adoption at the SME level addressed an important knowledge gap from a developing country context. The model, however, lacked a measuring instrument to allow researchers to engage the model empirically. In this study, a measuring instrument is designed, taken through self-review, expert review, focus group discussion, and then a pilot test. Statistical analysis of the pilot test shows that the instrument is both a valid and reliable for measuring SME innovation adoption from an ecosystem perspective. This paper, therefore, opens up new avenues for both industry and academic works on the adoption of digital innovations

Digital Divide: Investigating the integration of marketing and ICTs for South African retailers expanding throughout Africa

Information Communication Technologies are increasingly used in organisations’ market expansion strategies. These Information communication technologies provide organisations with opportunities such as ease of communication and movement of resources, making the entry into new markets a faster and less resource heavy process. When expanding throughout the African continent, the challenge presented in using this approach is that many African markets have underdeveloped information communication technology infrastructure. In considering this barrier, the extent to which information communication technology enables market expansion throughout the African continent is the topic which has been fully analysed and discussed. An exploratory research design and a qualitative method have been used in this study. The subjects of the data collection were three key individuals selected from a large South African retailer. These three individuals job roles spanned across the marketing and IT departments and were influential in the organisation’s expansion efforts throughout Africa. The findings of this study show that the levels of information communication technology infrastructure vary vastly from country to country on the African continent, noting South Africa, Kenya, Nigeria, Zambia and Botswana as the more advanced nations with the Democratic Republic of Congo and Uganda lagging in development. The findings also show that for retailers, the retail focused technology available in South Africa is not yet available in other African nations which causes challenges in offering the same value to consumers across the board. However, the finding show that the development of cloud-based systems has assisted in the widespread use of technologies without the need of heavy investments into physical locations