Negotiating Mobile Phone Usage for MHealth by Maternal Healthcare Clients Who Do Not Own Mobile Phones in rural Malawi

In poor-resource settings, owning a mobile phone could be an advantage to using developmental interventions based on mobile phones. However, maternal mHealth interventions in these settings are challenged due to low mobile phone ownership among women. Women are less likely to own a mobile phone than their male counterparts. Therefore, for maternal healthcare clients to use maternal mHealth intervention, it is expected that these clients negotiate mobile phone access and usage from owners of mobile phones in their communities. We employed qualitative research methods to understand how maternal healthcare clients who do not own mobile phones negotiate usage of mobile phones for maternal healthcare. Data was collected using semi-structured interviews with maternal healthcare clients and mobile phone owners, and focus group discussions with the maternal healthcare clients. The study found that maternal healthcare clients used cooperative negotiating tactics such as issue-based, compromising, and accommodating to negotiate mobile phone usage. Negotiating mobile phone usage has the potential to enhance digital skills for mobile phone users who do not own mobile phones. The study may inform mHealth implementers on how they may sensitise beneficiaries of mHealth who lack prerequisite technologies on how to negotiate access of mobile phones for mHealth.