Table 2 Summary of key findings on the factors influencing the sustainability of the MCBR system
Major themes | Sub-themes | Findings |
|---|---|---|
Individual factors | User satisfaction | Technological constraints make users unsatisfied Diverse ideas of user preference over PBR and MCBR systems |
System access | Technical problems with supported mobile phones Data managers lacking suitable computing devices for data access and management Financial and logistic burden of mobile phone maintenance Financial unsustainability of mobile phone-related costs, especially for national scale-up Insufficient mobile internet access Areas without internet access to be left out in national scale-up of MCBR | |
User support | Poor IT literacy of the ICMVs Not enough training for ICMVs and stakeholders No proper user support system, especially for troubleshooting technological problems | |
Technological factors | System interoperability | Use DHIS2 platform endorsed by Myanmar MoHS |
System scalability | Financial and technological constraints for nationwide scale-up Basic health staff suggested as potential MCBR users | |
System relevance | Data elements of MCBR reflect those of PBR Job-aid function helps ICMVs follow national malaria treatment guidelines Stock management module not covering all stocks Missing auto-alert system for positive case notification | |
System quality | Simple, easy to use, and potentially timely Software bugs and errors, unsatisfactory system response time, unpredictable and unreliable outcomes Inconvenient data management Unsatisfactory output data quality | |
Technology sustainability | Concerns with maintenance and improvement of mobile application (software) | |
Management factors | Ownership of the system | NMCP to take sole ownership of the system IPs thought NMCP is not currently ready to take over the system due to many constraints NMCP believes it is already in position to take over the system |
Human resources | Dropout of ICMVs trained for MCBR No separate focal person to manage MCBR at all levels in both NMCP and IP | |
Policies and operational procedures | Lack of standard procedures and policies for proper operation of MCBR Mobile phone-based reporting not possible in non-government-controlled areas because of local security issues Concerns over standalone use of MCBR without physical documents for future reference | |
Financial sustainability | Completely donor-funded currently Uncertainty about financial support after 2023 | |
Applicability of MCBR data | NMCP and IP do not apply MCBR data for practical applications, relying only on PBR data for such purposes Doubtful effectiveness of MCBR for malaria elimination due to many constraints, despite its potential |