Browsing by Author "Mutula, Martin Wambua"

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    Adaptability, Scalability and Sustainability of Mhealth Projects Performance in Low and Medium-Income Countries: A Systematic Review
    (Global Press Hub, 2026-03) Mutula, Martin Wambua; Sang, Paul
    Mobile health (mHealth) initiatives have immense potential to revolutionize healthcare service delivery in terms of accessibility, quality, and outcomes in low- and middle-income countries (LMICs). However, the progress of mHealth initiatives in LMICs is often marred by the challenge of "pilotitis," wherein successful pilots do not result in scalable or sustainable mHealth initiatives. This independent study paper is an attempt at conducting an in-depth systematic review of recent literature (2020-2025) to explore the various interrelated factors that affect the adaptability, scalability, and sustainability of mHealth initiatives in LMICs. The overall objective is to explore the various barriers and facilitators that affect the long-term performance and institutionalization of mHealth initiatives. For the systematic review, a desktop systematic review methodology was conducted by searching various prominent databases like PubMed, Scopus, and Web of Science to retrieve relevant peer-reviewed articles and systematic reviews on mHealth initiatives, scalability, and sustainability in LMICs. The results have identified a number of key challenges that can affect the scalability and sustainability of mHealth projects. These include a lack of infrastructure such as a stable electricity supply and a lack of good internet connectivity, the cost of mobile data communication, a lack of digital literacy among healthcare professionals, and a lack of compatibility with existing healthcare information systems. The study thus underscores the need to move beyond technology-focused strategies to health systems strategies in the design and implementation of mHealth interventions. Flexibility in accommodating local contexts has thus been identified as a key factor that influences the sustainability of mHealth interventions. As a result, the study has made several recommendations, including the use of context-sensitive evaluation approaches, such as the HOT-FIT-BR model, to move beyond pilot interventions to sustainable mHealth in LMICs