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FINAL Eric Akosah Final Thesis After Defence Submission To.Pdf KWAME NKRUMAH UNIVERSITY OF SCIENCE AND TECHNOLOGY KUMASI, GHANA COLLEGE OF HEALTH SCIENCES SCHOOL OF PUBLIC HEALTH DEPARTMENT OF HEALTH POLICY, MANAGEMENT AND ECONOMICS FEASIBILITY AND ACCEPTABILITY OF THE USE OF MOBILE TECHNOLOGY FOR ADOLESCENT COUNSELING IN SEXUAL AND REPRODUCTIVE HEALTH IN THE AMANSIE WEST DISTRICT (RURAL DISTRICT IN GHANA) BY: ERIC AKOSAH NOVEMBER, 2016 COLLEGE OF HEALTH SCIENCES SCHOOL OF PUBLIC HEALTH DEPARTMENT OF HEALTH POLICY, MANAGEMENT AND ECONOMICS FEASIBILITY AND ACCEPTABILITY OF THE USE OF MOBILE TECHNOLOGY FOR ADOLESCENT COUNSELING IN SEXUAL AND REPRODUCTIVE HEALTH IN THE AMANSIE WEST DISTRICT (RURAL DISTRICT IN GHANA) BY ERIC AKOSAH (PG 6018211) (MPH-HSPM) A THESIS SUBMITTED TO THE DEPARTMENT OF HEALTH POLICY, MANAGEMENT AND ECONOMICS, COLLEGE OF HEALTH SCIENCES, SCHOOL OF PUBLIC HEALTH, IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF PUBLIC HEALTH IN HEALTH SERVICE PLANNING AND MANAGEMENT NOVEMBER, 2016 i DECLARATION I hereby do declare that except for the references to other people’s work which has been duly acknowledged, this piece of work is my own composition and neither in whole nor in part has this work been presented for the award of a degree in this university or elsewhere. SIGNATURE ………………………………. DATE………………………… ERIC AKOSAH (PG 6018211) SIGNATURE ………………………………. DATE………………………… DR. PETER AGYEI-BAFFOUR ACADEMIC SUPERVISOR SIGNATURE ………………………………. DATE………………………… NAME: ………………………………………………… HEAD OF DEPARTMENT ii DEDICATION This work is dedicated to my deceased mum, Sarah Duah for her good parenting even as a single mother and her enormous contribution in my education. I also wish to mention my dear wife Mrs. Joana Akosah and my children Nana Afia Kwane Akosah, Afia Agyemang Akosah and Sekyere Marfo Akosah for their love and support. May the Almighty God bless them. iii ACKNOWLEDGEMENT I wish to first and foremost express my sincere thanks and gratitude to God Almighty for the strength and guidance throughout the times. I also wish to express my deepest gratitude to all those who helped me in diverse ways through this programme. My thanks and gratitude again goes to all adolescents in Amansie West district, especially those who availed themselves to provide information for this study. I salute education officers, health professionals, community members, Deputy Ashanti Regional Director of Health (PH), Ashanti Regional Director of Social Welfare and Ashanti Regional School Health Education Coordinator for providing information and sharing their views on the research topic. These enabled me to put together the data for analysis and drawing conclusion for this work. May the Almighty God reward them all for their time and energy well spent on this work. My appreciation and gratitude go to the Department of Community Health as a whole and to my lecturers; Dr. Easmon Otupiri, Dr. Ellis Dabo, Dr. Harry Tagbor, Dr. Samuel Akor, Dr. Addai Donkor, Prof (MRs) Addy, Dr. Anthony Edusei and Mr. Emmanuel Nakuah for their encouragement and support in various ways. I am indebted to my supervisor Dr. Peter Agyei Barffour (Piero) for his kind support and directions. I thank my family who throughout the period of the study showed immense support and love. Furthermore, I wish to thank my friends and colleagues in Millennium Villages Project for their support, love and encouragement with special mention of Mr. Samuel Afram (Team Leader, MVP) and Dr. Patricia Mechael, mHealth and eHealth expert. Last but not least, I thank Mr. Amos Adusei, M&E Manager of MVP, Mr. Nicholas Addofo, KCCR-KNUST and Mr. Reindolf Anokye of Garden City University, Kenyasi- Ghana for their valuable support to this work. iv DEFINITION OF TERMS Feasibility: Possibility of using mobile technology to address issues related to sex and reproduction Acceptability: Sustainability of using mobile technology to address issues related to sex and reproduction Mobile Technology: Portable equipment that can be used to address issues related to sex and reproduction Adolescent: Youthful residents of Amansie West District whom the study targeted. Counselling: Education and guidance on sex and reproduction Sexual and Reproductive Health: Health issues related to sex and reproduction v ABBREVIATIONS/ACRONYMS STI - Sexually Transmitted Infection HIV – Human Immunodeficiency Virus AIDS – Acquired Immune Deficiency Syndrome MDGs – Millennium Development Goals UNICEF – United Nations International Children Emergency Fund UNFPA - United Nations Population Fund Agency WHO – World Health Organization TML - Technology-Mediated Learning and AT - Activity Theory CSCL - computer-supported collaborative learning BCC - Behavior Change Communication MDNet - Mobile Doctors Network ICT – Information Communication Technology MOH - Ministry of Health AAD - American Academy of Dermatology GAN - Global Authentication Network MoTeCH – Mobile Technology for Community Health CHCs - Community Health Compounds MVP - Millennium Villages Project GOe - Global Observatory for eHealth PDAs - Personal Digital Assistants DALY - Disability-Adjusted Life Year Telcos – Telecommunication Operators vi ABSTRACT Background: Recently, healthcare professionals and researchers have introduced more and more technological solutions into the healthcare system, particularly mobile Health (mHealth). The study sought to investigate the feasibility and acceptability of the use of mobile technology to address the sexual-reproductive health concerns of adolescents in rural district of Amansie West. Method: The study adopted a cross-sectional design using both qualitative and quantitative approaches to collect data. A sample size of 425 respondents were used for the study. A purposive sampling technique was also used to select stakeholders for the study. Adolescent between the ages of 10-21years were selected from each sub-district by the use of simple random sampling technique. Both primary and secondary data were used for the study. Results: The findings revealed that Majority of the respondents indicated that mobile network is available in their communities. Cost implications of the use of Mobile technology in Amansie West District is moderately low taking into consideration the cost of the phone, recharge cards, power to charge the phones and the cost of repairs cumulatively. Majority of the respondents were of the view that Mobile phone would be the best medium for discussing reproductive health of adolescents. They further indicated that using mobile phone to address adolescents’ health concerns will be effective due to its convenience. Stakeholders are interested in investing in tele-health for the adolescent in the district and they were of the view that mobile technology is appropriate for counseling adolescent on sexual reproduction as it will help reduce shyness, cost of traveling to the health facilities and help with keeping clients information confidential. Stakeholders in the health sector should advocate for the implementation of the use of mobile technology in addressing the health concerns of adolescents. vii Conclusion: E-health is an important tool for adolescents counselling in sexual and reproductive health and feasible to roll out in underserved communities based on the availability of mobile infrastructure, interest of the stakeholders and its affordability. viii TABLE OF CONTENTS DECLARATION .......................................................................................................... ii DEDICATION ............................................................................................................. iii ACKNOWLEDGEMENT .............................................................................................iv DEFINITION OF TERMS ............................................................................................. v ABBREVIATIONS/ACRONYMS ................................................................................vi ABSTRACT ............................................................................................................... vii TABLE OF CONTENTS ..............................................................................................ix LIST OF TABLES ..................................................................................................... xiii LIST OF FIGURES..................................................................................................... xiv LIST OF APPENDICES .............................................................................................. xv CHAPTER ONE .......................................................................................................... 1 INTRODUCTION ........................................................................................................ 1 1.1 Background to the study ........................................................................................... 1 1.2 Problem Statement ................................................................................................... 4 1.3 Rationale for the study .............................................................................................. 6 1.4 Research Questions .................................................................................................. 6 1.5 Research Hypothesis ................................................................................................ 7 1.6 Research objective .................................................................................................... 8 1.6.1 General Objective: ................................................................................................
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