The implementation of a maternal mHealth project in South Africa: Lessons for taking mHealth innovations to scale

MomConnect is a mHealth programme in South Africa targeted at improving antenatal and maternal health. This study explored the barriers and facilitators to implementing the MomConnect programme in South Africa and the applicable lessons for scaling mHealth programmes in Africa. We reviewed the published literature and collected data through semi-structured interviews of project partners and leaders who worked on the MomConnect project. We asked study participants to identify any barriers and/or facilitators in the implementation of the MomConnect project and how they would overcome those barriers and strengthen the facilitators. We employed the Consolidated Framework for Implementation Research (CFIR) to inform the identification of a priori codes for the directed content analysis. Based on the analysis, the key components that supported the implementation of the MomConnect project included (1) strategic partnership and coordination across partner levels, (2) cost-effective technology and sustainable funding measures, (3) adequate adaptation of the innovation to local and national settings, and (4) guiding mHealth policy and legislation frameworks. The study’s results suggest that strong political will and a robust partnership are essential to lead the strategic implementation process of mHealth projects. Such mHealth projects thrive in a policy framework that can support the planning and implementation process. In addition, understanding the accessibility needs of the project’s target population as identified in this study is critical to developing mHealth projects that are sustainable in the long term by adapting to cost-effective technologies.