02956nas a2200277   4500000000100000008004100001653001200042653002600054653003000080653001900110100001600129700001100145700001200156700001600168700001500184700001000199700001500209700001600224700002000240700001600260245015700276856006900433490000700502520215500509022001402664       2019                            d10aMhealth10aChild Health Services10aCommunity case management10aSustainability1 aDharmayat K1 aTran T1 aHardy V1 aChirambo GB1 aThompson M1 aIde N1 aCarlsson S1 aAndersson B1 aO’ Donoghue J1 aMastellos N00aSustainability of ‘mHealth’ interventions in sub-Saharan Africa: A stakeholder analysis of an electronic community case management project in Malawi  uhttp://lup.lub.lu.se/record/e6fe96ff-a842-4145-a2c9-5cc902e852d60 v313 a<p>Background<br />
The global health community and funding agencies are currently engaged in ensuring that worthwhile research-based programmes are sustainable. Despite its importance, few studies have analysed the sustainability of global health interventions. In this paper, we aim to explore barriers and facilitators for the wider implementation and sustainability of a mobile health (mHealth) intervention (Supporting LIFE Community Case Management programme) in Malawi, Africa.<br />
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Methods<br />
Between January and March 2017, a qualitative approach was used to carry out and analyse 13 in-depth semi-structured interviews with key stakeholders across all levels of healthcare provision in Malawi to explore their perceptions with regards to the implementation and sustainability of the mHealth programme. Data were analysed thematically by two reviewers.<br />
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Results<br />
Overall, our analysis found that the programme was successful in achieving its goals. However, there are many challenges to the wider implementation and sustainability of this programme, including the absence of monetary resources, limited visibility outside the healthcare sector, the lack of integration with community-based and nationwide programmes, services and information and communication technologies, and the limited local capacity in relation to the maintenance, further development, and management.<br />
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Conclusions<br />
Future developments should be aligned with the strategic goals and interests of the Ministry of Health and engage with national and international stakeholders to develop shared goals and strategies for nationwide scale-up. These developments should also focus on building local capacity by educating trainers and ensuring that training methods and guidelines are appropriately accredited based on national policies. Our findings provide a framework for a variety of stakeholders who are engaged in sustaining mHealth programmes in resource-poor settings and can be used to develop an evidence-based policy for the utilization of technology for healthcare delivery across developing countries.</p>
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