Mobile health data collection at primary health care in Ethiopia: a feasible challenge Araya Abrha Medhanyie a,b,c, * , Albine Moser b , Mark Spigt a,b,c,d , Henock Yebyo a , Alex Little c,e , GeertJan Dinant b , Roman Blanco c,e a Department of Public Health, College of Health Sciences, Mekelle University, P.O. Box 1871, Mekelle, Ethiopia b Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Peter Debyeplein 1, 6229 HA Maastricht, P.O. Box 616, 6200 MD Maastricht, The Netherlands c Department of Surgery, School of Medicine, University of Alcala, 28871, Alcal a de Henares, Madrid, Spain d Department of General Practice, Tromso University, Tromso, Norway e Digital Campus, 21 North Drive, Littletown, Winchester, S0226QA, England, United Kingdom Accepted 4 September 2014; Published online 22 October 2014 Abstract Objectives: Feasibility assessment of mobile health (mHealth) data collection at primary health care in Ethiopia. Study Design and Setting: A total of 14 health workers were recruited from 12 primary health care facilities to use smartphones, installed with customized data collection application and electronic maternal health care forms for assessing pregnant women’s health for 6 months. Qualitative approaches comprising in-depth interviews and field notes were used to document the users’ perception and expe- rience in using the application and forms. Results: All health workers had never had previous exposure to smartphones and electronic forms, but they got used to them easily. Over 6 months, all health workers completed a total of 952 patient records using the forms on smartphones. Health workers’ acceptability and demand for the application and forms were high. In introducing the application, nontechnical challenges were more difficult to solve than technical challenges. Conclusion: Introducing an mHealth application at primary health care for routine collection of health data relevant to maternal health at a small scale was feasible. Nonetheless, implementing a system of assigning unique and consistent patient identifier, standardization of health services, and improving mobile network coverage would be prerequisites for scaled-up usage of such an application. Ó 2015 Elsevier Inc. All rights reserved. Keywords: mHealth; Electronic forms; Community health workers; Maternal health; Primary health care; Mobile technologies 1. Introduction For years, paper forms have been used for routine collec- tion of patient and epidemiologic data. However, with the recent rapid advancement of high-functionality smartphones and growth of mobile phone subscriptions across the globe, there is a widespread interest in using mo- bile health (mHealth) applications for routine collection of health data [1e3]. The fact that smartphones are portable, have Internet access, and can run third party applications makes them a natural fit for data collection and transfer. By exploiting the Internet capabilities of smartphones, near real-time transfer of data collected using electronic forms on smartphones from remote areas to a center can be achieved [3,4]. This might reduce the costs related to data processing, such as duplicating paper forms, carrying and storing paper forms, and data entry. Systematic reviews showed that virtually all studies related to mHealth have been in the developed world. Many of these studies dealt with the role of short message ser- vices (SMS) and voice call reminders for a one-time survey Funding: This study was made possible through primary funding pro- vided by Mekelle University (Ethiopia) (http://www.mu.edu.et). Venture Strategies Innovations (http://vsinnovations.org), AECID (http://www. aecid.es), and Alcala University (http://www.uah.es) also gave additional funding. Software development was supported by Digital Campus Ltd (http://www.digitalcampus.org), a UK-based not-for-profit company. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Conflict of interest: None. * Corresponding author. Tel.: þ251-034-441-6690; fax: þ251-034- 441-6681. E-mail address: araya.medhanyie@gmail.com (A.A. Medhanyie). http://dx.doi.org/10.1016/j.jclinepi.2014.09.006 0895-4356/Ó 2015 Elsevier Inc. All rights reserved. Journal of Clinical Epidemiology 68 (2015) 80e86