Title:	CONTEXTUAL CONTRADICTIONS TO THE SCALING -UP OF MOBILE HEALTH IN ARMED-CONFLICT SETTINGS OF NORTH-EASTERN NIGERIA: A CASE STUDY OF ALMANACH
Author(s):	Nakama David, Muhammadou Kah, Jennifer Tyndall and Olumide Longe
ISBN:	978-989-8704-15-3
Editors:	Miguel Baptista Nunes, Pedro Isaías, Philip Powell and Boyan Bontchev
Year:	2020
Edition:	Single
Keywords:	mHealth, Healthcare Services, Armed-Conflict, ALMANACH, Contradictions
Type:	Full
First Page:	99
Last Page:	106
Language:	English
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Full Contents:	click to dowload
Paper Abstract:	Developing countries are undergoing an unprecedented growth on the adoption of ICT’s. Mobile technologies, digital platforms and services for health care are gaining acceptance and use for detection and response for disease outbreaks, support of the healthcare value chains to facilitate improvements of public health care delivery and services. This study through a case study examines how m-Health platforms and services produce positive results in the context of Sub-Saharan Africa, specifically investigating the challenges of m-Health adoption and use in the Boko Haram settings in Adamawa State, North Eastern Part of Nigeria. Our study also explores the challenges that impede the successful scale-up of m-Health intervention in armed conflict settings of Adamawa State in the North Eastern region of the Federal Republic of Nigeria. We examined the use of ALMANACH in five local government areas (LGAs) namely; Yola south, Girei, Mubi-South, Mubi-North, and Maiha located in the armed-conflict (Boko Haram) settings of Adamawa State, Nigeria. Nineteen PHCs where ALMANACH has been deployed, primarily conducted in children clinics. A m-Health: “Algorithm for the Management of Acute Childhood Illnesses” (ALMANACH) was introduced as a clinical decision support tool into the child health system to aid the management of common acute illnesses in children between 2 months and 5 years. The ALMANACH is an electronic version of the integrated management of childhood illnesses (IMCI) running on mobile tablets. The lens of activity theory has guided the study to unearth the emergence of some developments in ALMANACH adoption and use in our study setting. Activity theory (AT) was used as the analytical lens because it is central for understanding challenges in adoption and use which can present in the form of contradictions. Thus, our findings suggest several challenges in the form of contradictions that can impede the successful scale-up of ALMANACH in peculiar settings of Boko Haram. Hence, a key contribution to the literature from our study is uncovering that contradictions are critical to achieving mHealth scale-up in our study setting.
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