Qualitative analysis of health education need and mHealth feasibility in Chikwawa, Malawi

Abstract

Background: Early marriage and teenage pregnancy are significant issues in Malawi, particularly within rural regions. Preventative health education of these issues is the responsibility of overburdened and under staffed village health centres, consequently reproductive health knowledge is poor. The introduction of a culturally tailored mHealth health education programme, addressing the needs of youth, could help to increase contraceptive knowledge and behaviour change. This study aimed to examine the feasibility of implementing a mHealth messaging service in rural Malawi, and to engage local participants’ in its design and execution. Methods: Seventy-five participants were recruited from two villages, Chimoto and Sikenala, for 8 focus group discussions (4 male and 4 female). Focus groups were conducted in Chichewa, transcribed verbatim and translated into English. Thematic analysis was used to analyse the data. Findings: Five themes emerged from the data, reflecting the opinions and beliefs of the participants; Recognised Need for Health Education, Practical Implementation, Barriers to Phone Access, Trust and Sustainability. Participants indicated they would engage with the service and provided in depth examples of health information they require, however expressed concern over accessibility in terms of mobile phone ownership, user ability and financial limitations. Discussion: Participants provided support for the messaging service, and engaged in discussion around cultural and financial barriers as well as preferences in regards to the real-world application of the service. Moving forward, effort needs to be focused on overcoming accessibility barriers in the area and applying the results to the implementation of the mHealth intervention pilot.