Exploring Determinants Of M-health Acceptance And Use In Malawi

Despite having a long tradition of providing free healthcare at the point of use,Malawi faces a myriad of financial,policy,and infrastructural challenges healthcare delivery.Reinforcing health information systems(HIS)has the potential to reinforce all other health systems components particularly through mobile health(M-health)technologies.Whereas most M-health projects target Health Surveillance Assistants(HSAs)in Malawi,little is understood about factors that influence acceptance and use of M-health.This study investigated the determinants of acceptance and use of M-health by HSAs using an integration of the Unified Theory of Acceptance and Use of Technology(UTAUT)and trust constructs.Specifically,performance expectancy and effort expectancy,derived from UTAUT,were used and two constructs of trust including trust in intermediaries and trust in the internet were used.Through purposive sampling,participants were selected from 3 districts across the country.A paper-based questionnaire was used to collect data and analyzed using Structural Equation Modeling(SEM)technique through AMOS 22.0 software.A total of 315 usable responses were collected.Results showed that performance expectancy positively correlated with behavioral intentions.On the other hand,effort expectancy did not correlate positively with behavioral intentions.Nevertheless,mediated by the trust constructs,effort expectancy positively affected behavioral intentions.The results have intellectual,policy,technological,and managerial implications for researchers,policymakers,project designers,intermediaries,and managers.By integrating the four constructs,the study confirms the significance of intention beliefs to accept and use M-health.Thus,it is important for national leaders,governments,public institutions,private sector players,development organizations,and international organizations involved in the ICT sector to make sure that there is political will,policies and regulations,and finances to enable access to internet services.Project designers must provide services that provide useful and user-friendly services compared to traditional systems.Moreover,HSAs ought to be involved in the initial stages of consultation with other stakeholders when considering incorporating M-health in service delivery.