Lack of ownership of mobile phones could hinder the rollout of mHealth interventions in Africa

  1. Justin T Okano
  2. Joan Ponce
  3. Matthias Krönke
  4. Sally Blower  Is a corresponding author
  1. University of California, Los Angeles, United States
  2. University of Cape Town, South Africa

Abstract

Mobile Health interventions, which require ownership of mobile phones, are being investigated throughout Africa. We estimate the percentage of individuals who own mobile phones in 33 African countries, identify a relationship between ownership and proximity to a health clinic (HC), and quantify inequities in ownership. We investigate basic mobile phone (BPs) and smartphones (SPs): SPs can connect to the internet, BPs cannot. We use nationally representative data collected in 2017-2018 from 44,224 individuals in Round 7 of the Afrobarometer surveys. We use Bayesian Multilevel Logistic regression models for our analyses. We find 82% of individuals in the 33 countries own mobile phones: 42% BPs, 40% SPs. Individuals who live close to an HC have higher odds of ownership than those who do not (adjusted odds ratio [aOR]: 1.31, Bayesian 95% Highest Posterior Density [HPD] region: 1.24-1.39). Men, compared with women, have over twice the odds of ownership (aOR: 2.37, 95% HPD region: 1.96-2.84). Urban residents, compared with rural residents, have almost three times the odds (aOR: 2.66, 95% HPD region: 2.22-3.18) and, amongst mobile phone owners, nearly three times the odds of owning an SP (aOR: 2.67, 95% HPD region: 2.33-3.10). Ownership increases with age, peaks in 26-40 year olds, then decreases. Individuals under 30 are more likely to own an SP than a BP, older individuals more likely to own a BP than an SP. Probability of ownership decreases with the Lived Poverty Index; however, some of the poorest individuals own SPs. If the digital devices needed for mHealth interventions are not equally available within the population (which we have found is the current situation), rolling out mHealth interventions in Africa is likely to propagate already existing inequities in access to healthcare.

Data availability

All data used in the paper is freely available at: https://afrobarometer.org/data/merged-data

Article and author information

Author details

  1. Justin T Okano

    Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, United States
    Competing interests
    The authors declare that no competing interests exist.
  2. Joan Ponce

    Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, United States
    Competing interests
    The authors declare that no competing interests exist.
  3. Matthias Krönke

    nstitute for Democracy, Citizenship and Public Policy in Africa, University of Cape Town, Cape Town, South Africa
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0001-8387-9193
  4. Sally Blower

    Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, United States
    For correspondence
    sblower@mednet.ucla.edu
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0003-4342-3911

Funding

National Institute of Allergy and Infectious Diseases (R56 AI152759)

  • Justin T Okano
  • Joan Ponce
  • Sally Blower

National Institute of Allergy and Infectious Diseases (R01 AI167713)

  • Justin T Okano
  • Joan Ponce
  • Sally Blower

Afrobarometer / the Institute for Democracy, Citizenship and Public Policy in Africa

  • Matthias Krönke

The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.

Reviewing Editor

  1. Bavesh D Kana, University of the Witwatersrand, South Africa

Publication history

  1. Received: April 20, 2022
  2. Preprint posted: May 10, 2022 (view preprint)
  3. Accepted: October 3, 2022
  4. Accepted Manuscript published: October 18, 2022 (version 1)
  5. Version of Record published: November 7, 2022 (version 2)

Copyright

© 2022, Okano et al.

This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.

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  1. Justin T Okano
  2. Joan Ponce
  3. Matthias Krönke
  4. Sally Blower
(2022)
Lack of ownership of mobile phones could hinder the rollout of mHealth interventions in Africa
eLife 11:e79615.
https://doi.org/10.7554/eLife.79615

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