Abstract:
Background: Mobile phone text message-based mHealth interventions have shown promise
in improving health service delivery. Despite the promising findings at a small scale and few
contexts, implementing new technologies as part of changes to health care services is
inherently challenging. Though there is a potential to introduce mHealth initiatives to health 10
systems of developing countries, existing evidence on the barriers and facilitators of implementation in different contexts is not adequate. Therefore, this study aimed to explore the
acceptability, barriers and facilitators of implementing mobile text message reminder system
for child vaccination in Ethiopia.
Methods: This study applied a phenomenological study design. The study was conducted in 15
north-west, Ethiopia between July 28 and August 19, 2020. A total of 23 participants were
purposively selected for the in-depth and key informant interviews. We used an interview
guide to collect data and audio-records of interviews were transcribed verbatim. Coding was
done to identify patterns and thematic analysis was conducted using ATLAS ti7 software.
Results: The findings indicated that mothers were receptive to mobile text message reminders 20
for their child’s vaccination. Low mobile phone ownership, access to mobile network, access to
electricity and illiteracy among the target population were identified as barriers that would affect
implementation. Confidentiality and©security-related issues are not barriers to implementation of
text message reminders for child vaccination service. Facilitators for implementation include
stakeholder collaboration, providing orientation/training to users, and willingness to pay by 25
clients.
Conclusion: In this study, using mobile phone text message reminders for child vaccination
services are acceptable by clients. Barriers identified were related to inadequate ICT infrastructure and other technical issues. Addressing the potential barriers and leveraging the
existing opportunities could optimize the implementation in resource-limited settings. Before 30
actual implementation, program implementers should also consider providing orientation to
users of the proposed mHealth program.
