Supporting Non-communicable Disease Prevention Through a mHealth Application in Decentralized Healthcare Systems: Action Design Research in Eswatini

This study addresses the issue of non-communicable diseases (NCD) in decentralized healthcare in developing countries (e.g. in eSwatini). Countries relying on decentralized healthcare employ community health workers (CHW) to provide healthcare to their inhabitants. Although relying on CHWs as a solution to supply healthcare and to substitute for the insufficient healthcare infrastructure, certain issues arise due to the lack of experience and education. For instance, providing NCD care requires medical equipment and specific knowledge, which will not be provided for CHWs. To tackle this problem, this study addresses the implementation of a mobile application that supports CHW in their daily NCD care and counseling. Through an action design research approach, the application is iteratively developed based on the evaluation of healthcare experts, policymakers (e.g., the ministry of health) and tested by potential users. This study is expected to provide not only tangible utility through the instantiation and use of the application, but also to provide extensive knowledge on how to design applications in other instances of NCD care in developing countries with decentralized healthcare systems to pursue the goal of the long-term health and social impact