Lessons for policy and regulation from mobile applications in public health: the case of community health work in Daspoort, South Africa

Abstract
The extraordinary growth in mobile telecommunications and advances in innovative application development has evolved into a new field of e-health, which includes mobile health (m-health) among others. m-Health is a new technology that is deployed in the Tshwane City health clinic named Daspoort as one of the national health insurance pilots. m-Health has revolutionised the way primary health care is administered in Daspoort in particular and in Tshwane City in general. The purpose of this case study is to establish lessons learned in the implementation of m-health as an alternative to bridging the health access gap. The study is meant to provide a library of lessons learnt and good practices in providing primary health services through the use of mobile technology, in this case m-health. The findings from this research suggest that m-health promotes efficiency and improves access. The results revealed that m-health poses challenges for practitioners in the absence of an e-health policy to fully cater for m-health. The implementation of m-health without a supportive legal framework is a risky exercise for both health professionals and community health-workers. Lack of clear guidelines from the National Department of Heajth in the implementation of m-health brings along a sense of vulnerability among health practitioners should things go unexpectedly wrong. In summary these are some of the key lessons learned: (i) Operating outside a mhealth policy and legal framework is very risky. (ii) Poor co-ordination of initiatives as a result of the lack of a collaborative policy and regulation results in silo efforts which lead to weak results. (iii) Community health workers, although they are part of the mhealth project are not covered by any legal framework; something that can expose them to criminal risk. (iv) m-health policy and legal vacuum result in a poor buy in of mhealth projects as managers are not accountable to take the project forward (v) Poor end of project planning as funded by donors leads to the death of m-health.
Description
Thesis (M.M. (ICT Policy and Regulation))--University of the Witwatersrand, Faculty of Commerce, Law and Management, Graduate School of Public and Development Management, 2013.
Keywords
Public health , Administration , Medical policy , South Africa
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