Paper short abstract:

Although mobile phone usage increased during the COVID-19 pandemic, significant barriers constrain access to mobile health globally. Based on co-design workshop data, this paper describes barriers and enablers of mobile health promoting early childhood development in Sub-Saharan African countries.

Paper long abstract:

Introduction

Digital platforms have the potential to reduce inequality in access to early childhood development (ECD) information in low-income countries. Indeed, mobile apps, such as Minderoo Foundation’s Thrive by Five, can provide parents and caregivers with crucial information to support a child’s cognitive and socio-emotional development in the first five years of life. Iterative co-design workshops with stakeholders, however, are a critical step in the research and development process of such digital tools to identify the enablers and barriers to the adoption of an ECD app and, in turn, digital transformation of child-rearing practices in resource-limited settings.

Methods

Between 2021-2022, 25 co-design workshops with 85 parents and caregivers and 31 subject-matter experts were held in Cameroon, the Democratic Republic of Congo, Ethiopia, Kenya and Namibia to inform the implementation of Thrive by Five in each country. Workshop notes were coded and the analysis followed an established thematic technique.

Results

Enablers include increased usage of digital platforms for parenting information and a general interest among caregivers in promoting healthy ECD with apps. However, consistent technological barriers to ECD app adoption include the urban-rural digital divide, a lack of digital literacy and literacy in general, scarcity of smartphones, poor internet in rural areas, and challenges with translation and adaptation of the content in local languages. Social barriers such as traditional gender roles in child-rearing also influence interest in accessing ECD apps, particularly among fathers. Further, civil unrest, food insecurity, unemployment, and poverty can affect the demand for ECD apps in low-income households.