Acceptability and Feasibility of a Mobile Health Application for Enhancing Public Private Mix for TB care among Healthcare workers in Southwestern Uganda

Abstract Background: Mobile health interventions can potentially enhance public-private linkage for tuberculosis care. However, evidence about their acceptability and feasibility is lacking. Objective: To assess the initial acceptability and feasibility of a mobile health application for following up presumptive tuberculosis patients referred from private to public hospitals. Methods: A total of 22 healthcare workers from three private hospitals and one public hospital in southwestern Uganda were trained and received Tuuka mobile application for a period of one month for testing. Testing focused on a variety of issues such as referring cases by private healthcare workers and receiving cases by public healthcare workers, and sending SMS reminders to the referred patients by filling the digital referral forms inbuilt within the app. Study participants participated in qualitative semi-structured in-depth interviews on the acceptability and feasibility of this app. An inductive, content analytic approach, framed by the unified theory of acceptance and use of technology model, was used to analyze qualitative data. Quantitative feasibility metrics and the quantitative assessment of acceptability were analyzed descriptively using STATA. Results: Healthcare workers found the Tuuka application acceptable and feasible with a mean total system usability scale score of 98 (SD 1.97). The application was perceived to be useful in reminding referred patients to adhere to referral appointments, notifying public hospital healthcare workers about the incoming referred patients, facilitating communication across facilities, and enhancing patient-based care. Conclusion: A mobile health application is acceptable and feasible for following up the referred presumptive tuberculosis patients referred from private to public hospitals in southwestern Uganda. Future efforts should focus on incorporating incentives to motivate and enable sustained use among healthcare workers.