A Mobile Health Framework for Public Private Mix in Tuberculosis Prevention and Care in Southwestern Uganda

Abstract

Ensuring that presumptive tuberculosis patients referred from private hospitals have reached their points of referral is key to achieving better tuberculosis control efforts. Although mobile health technologies have been recommended by the World Health Organization as emerging opportunities for closing gaps through enhancing public private mix, there is a lack of frameworks to guide the development of these interventions. The user-centered design approach was adopted in this research to develop a mobile health framework for designing a mobile application to support the follow-up of presumptive TB patients referred from private to public hospitals in southwestern Uganda. The research employed mixed qualitative and quantitative methods to achieve its objectives. The research involved 35 in-depth interviews with healthcare workers purposively selected from both private and public facilities and 35 interviewer-administered surveys with the same respondents. Mobile health may offer low-cost alternative approaches for supplementing and enhancing private hospitals’ tuberculosis care efforts. A mobile health framework for guiding the design of a mobile health application to support the following up of presumptive TB patients referred from private to public hospitals was developed. Subsequently, a mobile health app (known as Tuuka) was developed to demonstrate the potential of the developed framework and to validate it. A policy framework emerged from lessons learned and suggestions for implementation of the developed mobile application in Uganda. This thesis identifies mobile health interventions utilized for public private mix, demonstrates how a mobile health framework can be developed and presents how a policy framework for implementing the developed mHealth intervention.