Developing a Covid-19-focused mHealth system in a low resource setting during the COVID-19 pandemic: Challenges and opportunities

Abstract

Introduction: Approximately three quarters of Ethiopia’s population live in rural areas and access to healthcare is difficult with poor transport infrastructure and long travel times. Telemedicine has the potential to support healthcare access and to minimise COVID-19 transmission through reduced need to travel.
Objectives: This Brief Research Report describes the analysis of qualitative data relating to the development of a mHealth system during the COVID-19 pandemic which would support COVID-19 symptom management in the community in Oromia, Ethiopia.
Methods: Data were 1) meeting notes and WhatsApp group discussions 2) focus group with medical staff 3) interview with a senior hospital leader. A framework method was used for analysis.
Results: Framework analysis was used and three themes identified: 1) Patient-physician relationship 2) New ways of using everyday technology 3) Infrastructure and digital access.
Discussion: We discuss the challenges of developing an mHealth system during a pandemic alongside infrastructural challenges and the preparedness of medical staff and the general population for use of mHealth.
Conclusions: We conclude that there is a need for investment in information technology infrastructure and in access to digital networks alongside a need to improve the digital and health literacy of populations for successful implementation of a patient facing mHealth system. Thus, whilst the policy aspirations are admirable, the potential for technological innovation is great, and the clinicians can see the benefit of using technologies to provide care to those who cannot reach clinics, there is a gap between what is possible given the current reality of infrastructure and patient preparedness and the requirements for a successful telemedicine intervention.

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This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. http://creativecommons.org/licenses/by/4.0/

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DOI

https://doi.org/10.3389/fdgth.2025.1543828

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https://www.research.ed.ac.uk/en/publications/7d3440a2-8b5f-4a67-8518-e21ecd8216f9