The role of technology in value co-creation of maternal healthcare: A service-dominant logic perspective

The need for improved quality of healthcare has led to transforming ways in which healthcare is delivered. The role of information technology (IT) in the transformation is moving towards active participation of patients in healthcare. Active participation of patients in healthcare aligns with the service dominant (S-D) logic in which customers are co-creators of value. Technology has been identified as a key driver for value co-creation however the question of how technology can drive value co-creation in healthcare has not been fully explored. This exploratory study investigates ways in which IT has supported value co-creation in maternal healthcare ecosystem. The study was conducted in Gothenburg Sweden in which mixed research methods were used. Interviews were held with midwife healthcare managers and IT managers, a survey questionnaire was sent out to all midwives in Gothenburg. Results were analyzed using S-D logic value co-creation model. Overall findings show that technology has been used as an operant and operand resource to support value co-creation but mainly for healthcare professionals. Practices are identified on how technology has been used in maternal healthcare. Further investigations on how IT can support pregnant women to actively participate in maternal healthcare especially as an operant resource are suggested

Value of mHealth Apps for Maternal Healthcare Service Delivery

The growing interest in using mHealth to increase access to maternal healthcare can be understood through the context of value co-creation. The value of mHealth apps is co-created with multiple actors, always including the beneficiary. Service dominant (S-D) logic conceptualizes value as value-in-context in which actors co-create and realize value differently in different channels and their experiences may shift over time. It is unclear of what value is co-created with the use of mHealth apps in maternal healthcare from an S-D perspective. In this paper, a case study approach is used to investigate use of two mHealth apps in Uganda. Interviews and focus group discussions were held with app users. Results were analyzed using S-D value co-creation model. Key findings show that mHealth has been used to co-create value beyond maternal healthcare to individuals. Value that is co-created includes adherence to antenatal care (ANC), skilled attendance at birth, improved resource planning and service delivery, prevention of complications, knowledge acquisition and sharing. Individual value includes improved productivity, knowledge, decision making and wellbeing. Further investigations on individuals’ preferences of apps that trigger their active participation, value to family and friends and challenges faced when using mHealth apps to co-create value are suggested

Maternal Healthcare Service Transformation: Exploring Opportunities for IT use in Task Shifting

The transformation of healthcare services is expected to reduce health inequalities and to accelerate gains in health outcomes. Task shifting is one of the strategies adopted in healthcare transformation to make efficient use of human resources. However, limited research exists on how tasks are shifted beyond midwives, to involve community health workers or village health team members (VHTs) and pregnant women, and how IT supports and or triggers execution of shifted tasks. We examine the shifting of tasks in maternal healthcare, by interviewing midwives and VHTs in three districts in Uganda. Findings show four categories of tasks shifted at various levels of healthcare but with limited use of IT to execute tasks. We propose a model depicting opportunities for IT use both as an enabler and a trigger in executing tasks shifted. We recommend further investigations to identify IT opportunities that would trigger service exchange for pregnant women beyond health workers to include families and friends

ADOPTING A SERVICE-DOMINANT LOGIC TO PREDICTION OF PREGNANCY COMPLICATIONS: AN EXPLORATORY STUDY OF MATERNAL HEALTHCARE IN UGANDA

The United Nations listed maternal mortality as a major problem especially in developing countries. Predictive models that predict pregnancy complications have been suggested as an intervention to reduce maternal mortality but at the moment, many are not used in clinical practice. This study proposes a service-dominant perspective as an alternative use of predictive models to create value for maternal healthcare. We conducted an exploratory study in south-eastern Uganda in which we held semi-structured interviews with health practitioners to understand how the maternal healthcare system in Uganda works and how pregnancy complications are predicted. Results were analyzed using components from the service innovation framework. We find that overall, ICT has not been fully exploited to improve access to quality care, improve predictions and to improve collaboration among different practitioners in Uganda. Our findings suggest that by adapting a service-dominant perspective, we can enable predictive models and other technologies to assume an active role in maternal healthcare thereby supporting health practitioners with different skills and knowledge to predict pregnancy complications and hence trigger collaborative value creation. We believe that such an intervention will reduce maternal mortality

Maternal Healthcare in Low-Resource Settings: Investigations of IT as a resource

Maternal mortality is a major problem especially in developing countries. Maternal deaths are partly attributed to the limited access to healthcare and a shortage of medically trained health professionals who can provide maternal healthcare service. Approaches have been adopted to improve access and quality of healthcare. However, the approaches have been challenged by quality of care and limited infrastructure. The quality of healthcare can be improved through transforming healthcare, by managing and organizing care on a value-based system. Thereby, involving multiple actors who integrate resources to co-create value in order to benefit themselves and others. Information technology (IT) has been identified as a key driver of value co-creation in this transformation though, the way in which IT can drive value co-creation in healthcare has not been fully explored. The thesis aims to enhance our knowledge on how IT as a resource contributes to value-based maternal healthcare in low-resource settings. This thesis draws on service dominant logic framework and case study approach. The empirical foundation of the thesis comprises of four studies that are focused on the use and design of IT for maternal healthcare. Three studies were carried out in Uganda and one study was carried out in Sweden. Interviews, observations, focus group discussions and document reviews were used in data collection. Thematic analysis was used to analyze the data that was collected. The studies resulted into the appended five published papers. The findings in this thesis shed light on the empirical understanding of the practices in maternal healthcare that include institutions and structures, and, the existing IT infrastructure that support actors to co-create value. In addition, empirical insights on opportunities in which IT can be designed and used to achieve value-based maternal healthcare are provided. Lastly, findings provide insights into value as perceived by actors at various levels when they use IT to engage in cocreation activities in maternal healthcare. In addition to the empirical insights, the thesis contributes theoretically to information systems research by enhancing knowledge on the role of IT in service innovation. Particularly, this thesis contributes by identifying three aspects in which IT triggers value co-creation. Aspects include recreating relationships among actors, transforming actor capacities and re-organizing tasks in maternal healthcare. Thus, the thesis identifies the importance of IT in resource integration that leads to value. In addition, the interplay of all the three aspects extends understanding on the dynamics and transformative perspective of the service ecosystem that is required to achieve value-based maternal healthcare. Practically, the thesis contributes to valuebased maternal healthcare by identifying managerial implications in the structural and functional roles of IT that overcome opposing demands in the co-creation activities at various levels of healthcare. Another implication is the digital infrastructures that communicate value propositions and provide resource-rich service platforms for resource integration. Lastly, the thesis contributes to policy by suggesting implications on applying task-shifting strategy in low-resource settings and, technology use and designs that support professionals and non-professionals in the task-shifting strategy

Predicting Pregnancy Complications in Low Resource Contexts

The United Nations listed maternal mortality as a major problem especially in developing countries. Predictive models that predict pregnancy complications have been suggested as an intervention to reduce maternal mortality but at the moment, many are not used in clinical practice. This study proposes a service-dominant perspective as an alternative use of predictive models to create value for maternal healthcare. I anticipate that through the use of the service innovation framework and social capital theory, I can study how health practitioners and pregnant women can be empowered with skills and knowledge to predict pregnancy complications and trigger collaborative value creation