Date of Award

Fall 12-2024

Degree Type

Dissertation

Degree Name

PhD Health Sciences

Department

Health and Medical Sciences

Advisor

Genevieve Pinto Zipp, P.T., Ed.D., FNAP

Committee Member

Deborah A. DeLuca, MS. Ch. E, JD

Committee Member

Ning Jackie Zang, PhD, MD, MPH

Keywords

Well-Being, M-PESA System, Readiness, Telehealth, Vodacom, non-Internet Connected Cellphones

Abstract

Background: Healthcare for rural villages in Tanzania has always been rudimentary. Lack of the infrastructure and poverty are among the many obstacles facing this population’s access to healthcare. While, the rise of telehealth has improved access to healthcare in many parts of the world, its use in rural Tanzania has been extremely limited to poor internet access. However, given the availability of non-internet connected mobile phones in rural Tanzania, the potential to use this devise to improve healthcare access exists. Individuals using mobile phones for financial transactions may be motivated to access healthcare via telehealth by using their non-internet connected mobile phones.

Study Objective: Given the absence of evidence identifying the readiness of rural populations to use their non-internet connected phones for healthcare access, this study provides foundational insights. Specifically, this study explored the readiness of Tanzanian villagers to adopt a new way of using their mobile phone to access medical care, factors that impact the readiness of Tanzanian villagers to adopt a new way of using their mobile phone, and whether the use of mobile money (M-Pesa) would positively impact Tanzanian villagers' readiness to adopt telehealth.

Methods: The study employed a qualitative approach to explore the factors involved in changing behavior, in this case, the adoption of a new use of the simple cellphone. The design was descriptive, phenomenological and exploratory. The phenomenological research approach facilitated the exploration of characteristics specific to the population being studied. This enabled a better understanding of the lived experience of the participants in relation to the phenomena of readiness surrounding cellphone use, mobile money experience (M-Pesa) and healthcare access. Twelve (N = 12) participants were engaged in a semi-structured, face-to-face, recorded interview. The coding process began with a fishbowl randomization participant sampling process. Saturation was reached when no new codes or categories emerged from the participants responses. Subsequent to saturation, codes, categories, and thematic analysis statements were developed, and 100% intercoder agreement was reached.

Results: Study participants consistently demonstrated that their use of the M-Pesa system had significantly benefited their well-being. They also showed their willingness to adopt a new way of using their mobile phones in order to improve their access to healthcare.

Conclusion: The expressed motivation of rural villagers to change their behavior, exemplified by their willingness to use their mobile phones in new way, leads us to infer that they are ready to use the M-Pesa system as a tool to improve their access to medical care via telehealth.

Keywords: Well-Being, M-PESA System, Mobile Money, Readiness, Rural Villagers, Adoption, Telehealth, non-Internet Connected Cellphones, Tanzania, Vodacom.


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