A Study To Assess The Feasibility Of Hda App; A Health Facility Verification System Intended For Implementation In Uganda

TABLE OF CONTETS

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

APPROVAL ................................................................................................................................. II

DEDICA TION ............................................................................................................................. UI

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

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

ABREVATIONS ......................................................................................................................... IX

LIST OF TABLES ...................................................................................................................... XI

LIST OF FIGURES .................................................................................................................. XII

ABSTRACT .............................................................................................................................. XIV

CHAPTER ONE: INTRODUCTION ......................................................................................... l

1.1. BACKGROUND ...................................................................................................................... I

1.2. STATEMENT OF THE PROBLEM ............................................................................................ 2

1.3. PURPOSE OF THE STUDY ...................................................................................................... 3

1.4. STUDY OBJECTIVES ............................................................................................................. 3

1.4.1. Main Objective ................................................................................................................. 3

1.4.2. Specific Objectives ........................................................................................................... 3

1.5. RESEARCH QUESTIONS ....................................................................................................... 3

1.6. JUSTIFICATION OF THE STUDY ............................................................................................ 4

1. 7. SCOPE OF THE STUDY .......................................................................................................... 4

1.8. CONCEPTUAL FRAMEWORK ............................................................................................... 5

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

2.1. INTRODUCTION .................................................................................................................... 6

2.2. ILLEGAL HEALTH WORKERS AND PROFESSIONAL MISCONDUCT IN UGANDA'S HEALTH

SECTOR ........................................................................................................................................... 6

2.3. COMMON CHALLENGES FACING DESIGN, IMPLEMENTATION AND USE OF MHEALTH

SOLUTIONS .................................................................................................................................... 14

v

3.1. STUDY DESIGN AND METHOD •..•.......••••.•............•.•.•.......•.....•...•••..•••......•..........•......•.••...... 16

3.2. STUDY AREA AND POPULATION ..............•..••••.•........•....•.••..........•.......••.••••...••••••.........•.... 16

3.4 DATA COLLECTION METHOD ..•...••.......•••••......•..•••...........•........•••••••......••••••.....••••••.....••••. 16

3.5 ETHICAL CONSIDERATIONS ..•......•....•.•••••••.............•.•.•....••..•••...•.•....•....•....••.............•••..... 17

3.6 LIMITATIONOFTHESTUDY •••..•.•.•...••••........•••.•••......•..•••....•.......•••.....••••••••..••.•....•........•... 17

3. 7 PRE-TESTS •·······•·•·······•••··············•···•••·······•••···········•··••·········••··•••·······••···········•················ 17

CHAPTER FOUR ••.•..•.......••••...•...........•.•••.•.........•.•••...........•••...........••...•••••...•............•...........•. 18

4.1. PROTOTYPE OF THE HFVS ••...•••...........•••.......•.•..•.............•••.•••...•••••..........•..........•.•••.....• 18

4.1.1. User interfaces ofHFVS on HDA Application .............................................................. 18

4.1.2. Facilities' main list ......................................................................................................... 19

4.1.3. Facilities' Information (Professional Qualifications) ..................................................... 20

4.1.4. Health Professional's Information (Professional Qualifications) .................................. 21

4.2. ASSESSING USABILITY AND ACCEPTABILITY OF THE HFVS ........................................... 22

4.2.1.

4.2.1.1.

4.2.2.

4.2.3.

Usability Assessment using Learnabi1ity and User Interface design ............................. 22

Understanding of Purpose and functiona1ities ofHFVS ............................................ 22

Simplicity of Using HFVS and ease to Memorise ......................................................... 22

Time taken to perform a given task using HFVS ........................................................... 23

4.2.4. Acceptability assessment using Reliability, Security, Data privacy of the Data acquisition

process; Necessity and Effectiveness of the HFVS ...................................................................... 24

4.2.5. Reliability ofHFVS data acquisition process ................................................................ 24

4.2.6. Data Security during the process of obtaining information ........................................... 25

4.2.7. Timeliness and exhaustiveness ...................................................................................... 25

4.2.8. Necessity of the HFVS to Uganda's Health care system ............................................... 26

4.2.9. Desire to know more about the professional qualifications ofHFs and HPs, weather such

information is obtained, current sources of information and most ideally preferred sources ....... 28

4.2.9.1. Information/data privacy ............................................................................................ 32

4.2.10. Assessing primary benefits of disclosing professional qualifications of both Health

professionals and facilities ............................................................................................................ 33

4.2.11. Benefits of feedback from the public to the government about HFs, HPs and health

Services through HFVS ................................................................................................................ 35

VI

4.2.12. People's responses about the potential benefits ofHFVS .......................................... 36

4.2.13. Responses about Risks which health workers may face following disclosure of

professional Qualifications to the public through the HFVS ........................................................ 38

4.2. CHALLENGES WHICH MAY ARISE DURING IMPLEMENTATION AND USE OF THE HFVS AND

POSSIBLE RECOMMENDATIONS ...............................................................••................................... 39

4.2.14.

4.2.15.

Suggested Possible Challenges which may face implementation and use ofHFVS .. 39

Recommendations to improve or reduce challenges that may face HFVS during

implementation and use ................................................................................................................ 40

CHAPTER FIVE: DISCUSSION OF RESULTS .......................•.......................•.................... 42

5.1. PROTOTYPE OF THE HFVS ······························································································· 42

5.1.1. Prototype development ................................................................................................... 42

5.1.2. Challenges faced during prototype development.. ......................................................... 42

5.2. ASSESSING THE USABILITY AND ACCEPTABILITY OF THE HFVS ..................................... 42

5.2.1. Usability assessment using learnability and user interface design ................................. 42

5.2.2. Assessing acceptability using reliability, security, data privacy of the process designed

for obtaining all information about Health facilities and professionals; and the necessity and

effectiveness of the HFVS ............................................................................................................ 43

5.2.2.1. Reliability of the process ............................................................................................ 43

5.2.2.6. Data Security and Privacy .......................................................................................... 43

5.2.2.7. Timeliness and exhaustiveness ................................................................................... 43

5.2.2.8. Necessity ofHFVS to Uganda's health care system .................................................. 44

5.2.2.9. Desire to know more about the professional qualifications of HFs and HPs, weather

such information is obtained, current sources of information and most ideally preferred sources

44

5.2.2.1 0. Information/data privacy ............................................................................................ 45

5 .2.2.11. Assessing primary benefits of disclosing professional qualifications of both Health

professionals and facilities ............................................................................................................ 45

5.2.2.12. Benefits of feedback from the public to the government about HFs, HPs and health

Services through HFVS ................................................................................................................ 46

5.2.2.13. People's responses about the potential benefits ofHFVS .......................................... 46

VII

5.2.2.!2. Benefits of feedback from the public to the government about Hfs, HPs and health

Services through HFVS ................................................................................................................ 46

5.2.2.13. People's responses about the potential benefits of HFVS .......................................... 46

5.2.2.14. Responses about Risks which health workers may face following disclosure of

professional Qualifications to the public through the HFVS ........................................................ -17

5.3. CHALLENGES WHICH MAY ARISE DURING IMPLEMENT A T!ON AND USE OF THE HFVS AND

POSSIBLE RECOMMENDATIONS .................................................................................................... 47

5.3.1. Suggested Possible Challenges which may face implementation and use ofHFVS ..... 47

5.3.2. Recommendations to improve or reduce challenges that may face HFVS during

implementation and use ................................................................................................................ 48

CHAPTER SIX ........................................................................................................................... 51

6.0. CONCLUSIONS AND RECOMMENDATIONS ......................................................................... 51

6.1. RECOMMENDATION ........................................................................................................... 51

6.2. CONCLUSIONS .................................................................................................................... 51

REFERENCES ............................................................................................................................ 52

APPENDIX I: BUDGET ............................................................................................................ 54

APPENDIX II: WORK PLAN ................................................................................................... 55