Despite the significance of user engagement for efficacy of mobile health (mHealth) in the Global South, many such interventions do not include user-engaging attributes. This is because socio-technical aspects are frequently not considered during the design, development, and implementation, stages of such initiatives. In addition, there is little discussion in the literature about the role socio-technical factors play in user-centered design processes for mHealth. This research posits consideration of socio-technical factors is required as techno-centric approaches to mHealth design and user engagement, as well as those relying on existing universal frameworks for user-centered design, have proven to be ineffective with the result that most mHealth projects in the Global South fail to sustain. This research examines projects in Sierra Leone where semi-structured interviews were conducted with mHealth designers and developers in order to explore their attitudes towards user engagement in this case. Barriers and facilitators to user engagement were identified and classified as either technical or socio-technical. Findings from the study indicate that adoption of a techno-centric approach without consideration of socio-technical factors can negatively affect user's engagement. Based on these findings, we propose to develop a new design framework for more effective inclusion of user-engaging attributes in mHealth.
Designing Mobile Health for User Engagement: The Importance of Socio-Technical Approach