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Keeping secrets in the cloud: Mobile phones, data security and privacy within the context of pregnancy and childbirth in Tanzania

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  • Hackett, Kristy M.
  • Kazemi, Mina
  • Sellen, Daniel W.

Abstract

Growing evidence points to the potential value of mobile phone-based technologies ('mHealth') to help strengthen community health systems in low- and middle-income countries, but mHealth approaches also carry considerable risks with respect to data security, individual privacy, and confidentiality. We examined the perspectives of frontline community health workers and their female clients regarding data security and privacy within the context of an mHealth intervention to improve women's uptake of maternal health services from October 2013 to July 2014 in rural Tanzania. Qualitative findings demonstrate that the use of new technologies to capture health service user data during pregnancy and childbirth has both positive and negative impacts on perceptions of personal privacy and confidentiality. Women's concerns regarding privacy aligned closely with a belief that pregnancies and expected delivery dates must be kept secret, reflecting fears that pregnancy renders women vulnerable to witchcraft by jealous neighbors. Women also shared concerns that health workers' male partners could access their private information. Strong community-based engagement is recommended from the outset when developing a mHealth intervention to integrate beliefs and gender dynamics that may influence acceptability and implementation of new technologies.

Suggested Citation

  • Hackett, Kristy M. & Kazemi, Mina & Sellen, Daniel W., 2018. "Keeping secrets in the cloud: Mobile phones, data security and privacy within the context of pregnancy and childbirth in Tanzania," Social Science & Medicine, Elsevier, vol. 211(C), pages 190-197.
    • Handle: RePEc:eee:socmed:v:211:y:2018:i:c:p:190-197
    DOI: 10.1016/j.socscimed.2018.06.014
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    References listed on IDEAS

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    1. Kristy Hackett & Curtis Lafleur & Peter Nyella & Ophira Ginsburg & Wendy Lou & Daniel Sellen, 2018. "Impact of smartphone-assisted prenatal home visits on women’s use of facility delivery: Results from a cluster-randomized trial in rural Tanzania," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-20, June.
    2. Chapman, Rachel R., 2003. "Endangering safe motherhood in Mozambique: prenatal care as pregnancy risk," Social Science & Medicine, Elsevier, vol. 57(2), pages 355-374, July.
    3. Spangler, Sydney A. & Bloom, Shelah S., 2010. "Use of biomedical obstetric care in rural Tanzania: The role of social and material inequalities," Social Science & Medicine, Elsevier, vol. 71(4), pages 760-768, August.
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    Cited by:

    1. Fidan Kurtaliqi & Mustafeed Zaman & Romain Sohier, 2022. "The psychological reassurance effect of mobile tracing apps in Covid-19 Era," Post-Print hal-04219653, HAL.
    2. Danny Ronald Nyatuka & Retha De La Harpe, 2021. "Service Design as a Catalyst for Patient-Centered eHealth Innovation: An Architectural Design Framework for Cloud-Based Maternal Health Information Service in Underserved Setting," International Journal of Information System Modeling and Design (IJISMD), IGI Global, vol. 12(3), pages 62-85, July.
    3. Hampshire, Kate & Mwase-Vuma, Tawonga & Alemu, Kassahun & Abane, Albert & Munthali, Alister & Awoke, Tadesse & Mariwah, Simon & Chamdimba, Elita & Owusu, Samuel Asiedu & Robson, Elsbeth & Castelli, Mi, 2021. "Informal mhealth at scale in Africa: Opportunities and challenges," World Development, Elsevier, vol. 140(C).

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