Reducing Avoidable Deaths through Technology: Deployment of Persuasive Technology-Based Model in the Prevention and Control of Malaria in Nigeria (Preprint)

Abstract

Malaria is one of the leading causes of illnesses and deaths in Africa at large and Nigeria in particular, especially amongst pregnant women and children under the age of five years. Our research revealed that though the government has deployed so many intervention systems to contend with this death-causing vector—the mosquitoes, malaria related deaths (MRDs) have continued to increase. This is because people have not sufficiently adopted those intervention systems to protect themselves. Further enquiries into the ineffective compliance of the people to the intervention systems revealed that the interventions are passive in nature. Based on these, we set up three measurable research outcomes to enable us to determine the appropriateness of persuasive technology in solving the malaria problem. We technically avoided a one-size-fits-all design approach and adopted Participatory System Design (PSD) and User-Centered Design (UCD) approaches in our system design methodologies. Well-structured questionnaires were used to extract information from the participants. The data obtained from the research survey was used in modeling the intervention system. The research was conducted in three phases: baseline, development and deployment of an intervention system—the Malaria Prevention and Control Support System (MPCSS), and an evaluation study to determine the performance of the intervention system. The research led to the following achievements: (1) encouraged an increase in the number of people who participated in malaria prevention and control activities by lowering the rate of malaria cases from 96.9% to 68.5% and increasing ownership of mosquito nets from 54% to 85.5%; (2) demonstrated that persuasive technology could be used to increase public awareness and knowledge of a given subject as noted in our evaluation result; and (3) demonstrated that persuasive technology is a veritable active intervention to combat malaria.

To ascertain the relevance of persuasive technology in addressing the challenges of malaria.

The study adopted multiple methodological approaches otherwise known as triangulation which included: 1) Survey, 2) Persuasive System Design (PSD) model and 3) Object-oriented Analysis and Design Methodology. This hybridized method was chosen to maximize the benefits of each component method in studying an existing system, identifying problem areas, and designing a better system for the future. Semi-structured survey questions were also utilized to learn more about the factors that influence positive health behaviors in relation to malaria prevention and control. Using a convenient sample technique, some pregnant women and nursing mothers were identified as the targeted audience from three local government areas. The instrument was administered orally and through self-administration. Moreover, the survey questions focused on the gains, hindrances, and consequences of disregarding positive health behaviours, as well as social and cultural challenges to the adoption of appropriate malaria prevention and control measures, basic mobile technology knowledge and its relevance. The sample questions can be found at https://forms.gle/D1VsWi2W1AUG35AE8.

i. 68.% of the participants fell sick of malaria as against 96.9% that fell sick within the period of baseline ii. 85.5% of the participants now own ITN as against 54% recorded in the baseline iii. 84.2% of the participants now see malaria as a deadly sickness 78.6% recorded in baseline iv. 97.4% net-proofed their doors and window against 87.5% recorded in the baseline.

In order to arrive at the set goal of this research as enumerated in the research outcomes, the researcher followed Fogg’s postulate on the processes that PT designers should follow to design PT interventions. Fogg classified these processes into eight distinct steps (Fogg, 2009). This study was carried to arrive at a solution that could take care of the flaws observed in the existing systems, using the framework stated above. Summarily therefore, this research was able to achieve the following based on the stated research outcomes: Summarily therefore, this research was able to achieve the following based on the stated research outcomes: 1. Established that there is an increased number of adherence by the people to malaria prevention and control activities. This was reflected in the number of people that now own ITN and visits hospital for malaria treatment. This alluded to the fact that mobile phone intervention can be used to motivate increased adherence of people to engage in malaria prevention and control activities as can be seen in evaluation result (i & ii). 2. Established that the application of persuasive technology could be used to reduce the number of times people fall sick of malaria by strictly adhering to the malaria prevention and control techniques through proper sensitization on the danger of malaria. This was demonstrated in our evaluation result (iii). 3. Established that there is strong relationship between technology and malaria prevention and control. This alluded to the research outcome number three which sought to prove that there exist relationship between mobile phone-based intervention system and malaria preventive and control measures. 4. We developed a mobile persuasive system (MPCSS) that was used to persuade people to adopt positive malaria prevention and control behaviours Conclusively, this research targeted mainly the pregnant mothers and mothers with children within the age of five years. The reason for this group of people is because they are the worst affected. The mothers prepare the bed and it is expected that the reminders should help to remind them to setup their mosquito nets after preparing the bed for both the husband and the children. After all, it is the duty of the mothers to take care of their homes. Finally, the Oinas-Kukkonen postulate on technology use, which was founded on empirical and conceptual analysis, stated that technology can never be neutral as it must use either direct or indirect routes to influence people however justifies this study. Persuasion must start small and then increment without being obtrusive (Oinas-Kukkonen et al., 2008).