Ethical, legal and social issues in the use of mobile technologies and archived cellphone data in the East African region: A Scoping Review (Preprint)

Abstract

Mobile phone adoption and the implementation of mobile health (mHealth) interventions to overcome health system challenges is on the rise in Africa and elsewhere in the world. Data derived from mobile phones hold great promise for transforming healthcare delivery and public health research. To date, little is known about the ethical, legal and social concerns related to the use of these data in Africa.

We conducted a scoping review to explore the existing literature in order to understand the current ethical issues that arise when using mobile technology interventions and call detail records for public health research in the context of East Africa.

We searched PubMed database for published studies describing ethical challenges while using mobile technologies and data in public health research between 2000 and 2020. A predefined search strategy was used as inclusion criteria with search terms such as “East Africa”, “mHealth”, “mobile phone data”, “public health”, “ethics”, or “privacy”. We followed five stages of a published framework for scoping reviews by Arksey and O’Malley. These stages include: (1) identifying the research question; (2) identifying relevant studies; (3) study selection; (4) charting the data; and (5) collating, summarizing, and reporting the results. Studies were screened using pre-specified eligibility criteria through a two-stage process by two independent reviewers. Data extracted included title, publication year, target population, geographic region, setting, and relevance to mHealth and ethics.

Of the 94 studies identified from PubMed, 33 met the review inclusion criteria for the final scoping review. The included studies were conducted in three out of five countries in the East African Community. Five themes emerged as major concerns for using mHealth interventions and mobile phone data: privacy and confidentiality, data security and protection concerns, sociocultural issues, regulatory and legal and, adequate informed consent process.

This scoping review identified major crosscutting concerns related to use of mobile technologies and mobile phone data common to the East African region. A comprehensive framework that accounts for ethical, sociocultural, legal and regulatory concerns and, adequate consent process is needed to guide the safe use of mobile technology data for public health research purposes.