Evaluating mHealth Interventions in an Underserved Context Using Service Design Strategy: A Case of Kenya

Abstract

mHealth interventions have been widely adopted across health systems in attempts to improve healthcare delivery particularly in underserved contexts, Kenya included. This has made mHealth more established as opposed to telemedicine. However, the effectiveness of the interventions is questionable as there lacks a clear sustenance and scale-up strategy for successful implementation, despite mHealth having been adopted as one of the pillars for Kenya's national e-health strategy. Apparently, there is a paucity of empirical evidence to understand the complex nature of technology use in mHealth services from design thinking perspective. Also, the role of stakeholders in designing these services has not been well recognized. This paper focuses on mHealth as a healthcare service facilitated by technologies that incorporate mobile technologies. Objectives of the study include: (1) To identify and engage relevant stakeholders, (2) To establish design characteristics of the desired solution, (3) To design & develop context-specific solutions, (4) To evaluate new services in-use situation. A generic model is proposed to guide design and evaluation process for mHealth services, using both lens of service design research and stakeholder theory. Two distinct phases were added to the double diamond process of service design i.e. 'engage context' as pre-implementation evaluation phase at the start and 'evaluate in-use' as post-implementation evaluation phase at the end of the process. The new model was empirically tested by fifteen participants (n=15), of which the outcome met expectations according to validation scorecard. In so doing, our study extends and complement existing body of knowledge.