Does mobile phone ownership matter? Insights on engagement in mHealth and e-government interventions from Southern Africa

The proliferation of mobile phones across the world has contributed to the rise of mHealth interventions as a complementary means for improving health outcomes in areas where health facilities are limited. However, community members who do not own or have access to mobile devices feel excluded from such interventions. In this paper, we seek to understand and explore engagement strategies that support the inclusion of non-mobile phone owners in mHealth interventions. We conducted a review of mHealth and community engagement literature to gauge the strategies different studies have employed to engage non-mobile phone owners and users. We further reflected on two Southern African case studies from health and citizen engagement sectors to gain insights on ways non-mobile phone owners may feel included in mHealth interventions. Through a process of thematic analysis, we have identified three areas that mHealth implementers could draw from when designing more inclusive mHealth interventions. These strategies include the need for sensitising communities, using multi-stakeholder and multi-sectoral collaboration, and embracing a braided approach to communication technologies. We hope that this paper will inform mHealth project implementers on different strategies they can use to include community members, regardless of whether they own mobile phones or not.