A Study to Assess the Feasibility of Hda App; A Drug Information and Verification System Intended for Implementation in Uganda

TABLE OF CONTETS

DECLARATION ......................................................................................................................... !

APPROVAL ............................................................................................................................... !!

DEDICATION .......................................................................................................................... !II

ACKNOWLEDGEMENT ........................................................................................................ IV

TABLE OF CONTETS .............................................................................................................. V

ABREVA TIONS ................................................................................................................... VIII

LIST OF TABLES .................................................................................................................... !X

LIST OF FIGURES ................................................................................................................... X

ABSTRACT ............................................................................................................................. XII

CHAPTER ONE: INTRODUCTION ......................................................................................... 1

1.1. Background ...................................................................................................................... I

1.2. Statement of the problem ................................................................................................. 2

1.3. Purpose of the Study ........................................................................................................ 3

1.4. Study Objectives .............................................................................................................. 3

1.5. Research Questions .......................................................................................................... 3

1.6. Justification of the study .................................................................................................. 3

1.7. Scope of the study ............................................................................................................ 4

1.8. Conceptual frame work ofDIVS ..................................................................................... 5

CHAPTER TWO: LITERATURE REVIEW ............................................................................ 6

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2.1. Introduction ...................................................................................................................... 6

2.2. Counterfeits, substandard medicines, other unsafe medicines (Expired, recalled, banned

and unregistered medicines) and irrational medicine use in Uganda ......................................... 6

2.3. Common Challenges facing design, implementation and use ofmHealth solutions ....... 9

CHAPTER THREE: METHODOLOGY ................................................................................ 12

3 .I. Study design and method ............................................................................................... 12

3 .2. Study area and Population .............................................................................................. 12

3.3. Data collection method ................................................................................................... 12

3.4. Ethical considerations .................................................................................................... 12

3.5. Limitation of the study ................................................................................................... 13

3.6. Pre-tests .......................................................................................................................... 13

CHAPTER FOUR: RESULTS .................................................................................................. 14

4.1. Prototype of the DIVS .................................................................................................... 14

4.2. Assessing Usability and Acceptability of the DIVS ...................................................... 18

4.2.1. Usability Assessment using Learnability and User Interface design ......................... 18

4.2.2. Acceptability assessment using Reliability, Security, Data privacy of the Data

acquisition process; Necessity and Effectiveness of the DIVS ................................................ 20

4.3. Challenges which may arise during implementation and use of the DIVS and possible

recommendations ...................................................................................................................... 31

CHAPTER FIVE: DISCUSSION AND RECOMMENDATIONS ........................................ 35

5.1. Prototype of the DIVS .................................................................................................... 35

5.2. Assessing the usability and acceptability of the DIVS .................................................. 35

5.2.1. Usability assessment using learnability and user interface design ............................. 35

ABSTRACT Background: The Health Directory and Authentication App (HDA App), is an m-Health innovation designed to provide offline information and verification for all medicines, health facilities and health professionals (HPs) by the general public/consumers. The App, which is composed of2 systems i.e. Drug Information and Verification System (DIVS) and Health Facility Verification System (HFVS), is aimed at improving quality and safety of health care services in Uganda, by promoting rational medicine use (RMU) through an improved access to patients' medicine information while reducing professional misconduct, prevalence of illegal health workers and facilities, unsafe medicines (expired, recalled, banned etc.) on the market and potentially substandard/counterfeit drugs. HDA App is also intended to improve public - government collaboration in implementing regulatory functions through an inbuilt feedback mechanism. Study aims: In this work, a feasibility study of the DIVS was conducted aimed at 1) developing a working prototype out of the HDA concept, 2) assessing the level of acceptability and usability of the DVlS and 3) elucidating the challenges which may be associated with its future implementation and use. Study methods: Study pmticipants were key informants who included health professionals, IT specialists and patients in a) public health facilities (n = 17; 22%), b) private facilities (n = 21; 25%), c) non-government organizations (n = 20, 22%), d) regulators i.e. health professional councils and National Drug Authority (n =II; 10%) and e) professional associations (n = 2; 3%) and the general public/patients (n = 16; 18%). This qualitative study involved use of an introductory video, a hands-on demonstration of the App using the developed prototype and both open and closed ended questions in a researcher-guided interview using a questionnaire. SPSS version 20 was used for data analysis. Findings revealed that the developed HDA App prototype was interoperable, allowing synchronization with other existing health sector systems. The DVIS component of the App was found to be feasible to develop and implement in Uganda, with a high potential of acceptability among patients and health workers. 70% of the study population needed but couldn't readily access