Barriers and facilitators for mHealth utilization in pregnancy care: a qualitative analysis of pregnant women and stakeholder's perspectives.

Abstract

Background: Mobile health (mHealth) technologies offer potential benefits for enhancing pregnancy care through timely information and personalized support. Yet, various barriers limit their adoption among pregnant women. This study explored the perspectives of Iranian pregnant women and healthcare stakeholders on the barriers and facilitators influencing mHealth utilization in pregnancy care.

Methods: A qualitative content analysis was conducted involving 21 participants including 14 pregnant women and seven healthcare stakeholders (including two obstetricians, two midwives, two medical informatics specialists, and one sociologist), who recruited via purposive sampling from hospitals affiliated with Mashhad University of Medical Sciences and private clinics in Northeast Iran from May to December 2023. Data were collected through semi-structured, in-depth interviews and analyzed using Hsieh and Shannon's (2005) conventional content analysis approach. Trustworthiness was ensured through triangulation, researcher's prolonged engagement, peer debriefing, member check, and audit trial.

Results: The main theme, "Barriers and facilitators for mhealth utilization in pregnancy care," encompassed four key categories including (1) Digital ecosystem challenges highlighting structural issues like inadequate infrastructure, economic constraints, cultural adaptation gaps, interface complexity, and data security concerns, (2) Healthcare system implementation barriers including integration issues, low digital literacy, and a lack of continuity with traditional healthcare practices, (3) User empowerment and engagement revealing that mHealth can enhance access to information, promote autonomy, and provide personalized support, and (4) Integration of mHealth in the Healthcare system demonstrating the transformative potential of mHealth for improving maternal health monitoring, communication, and evidence-based care strategies.

Conclusion: Addressing digital, financial, and cultural barriers while enhancing usability and user autonomy could significantly improve healthcare access and equity for pregnant women in Iran. Policymakers should prioritize scalable and culturally sensitive mHealth interventions to maximize these benefits across diverse communities.