![]() To this end, we are exploring the use of WhatsApp Messenger (‘WhatsApp’), a Mobile Instant Messaging (MIM) platform, as a tool for conducting longitudinal research on health systems use by migrant and mobile communities in South Africa. We identified a gap in methodologies that are able to capture ‘real-time’ data about the healthcare-seeking experiences and interactions with healthcare systems that migrant and mobile populations have over time and place. The Migration, Gender and Health Systems (MiGHS) project-a collaboration between the Universities of Cape Town and the Witwatersrand, the London School of Hygiene and Tropical Medicine, and the South African National Department of Health (NDoH)-is researching the impact of migration and mobility on the South African public healthcare system. Such mobile technologies also offer opportunities for health systems research. ![]() Its application ranges from the use of mobile phones to improve point-of-care data collection, delivery and communication to real-time medication monitoring and adherence support ( Bervell and Al-Samarraie, 2019). ![]() Given the existing structural factors impeding access to healthcare, coupled with high rates of mobile telephone use across the sub-Saharan African region, ‘mobile health’ or ‘mHealth’-broadly defined as the use of mobile phones in health systems ( Noordam et al., 2011)-is consistently recognized as having great potential for improving access to healthcare in this context ( Bloomfield et al., 2014 Hampshire et al., 2015 Lee et al., 2017). The sub-Saharan African region is characterized by mixed migration flows and multiple health challenges, including HIV and tuberculosis, that, due to the inequalities experienced in access to healthcare disproportionately affect many groups-including migrants and mobile populations ( Vearey et al., 2017 Vearey, 2018). We provide recommendations to address these issues for researchers considering using WhatsApp as a data collection tool over time and place.Ī growing body of literature addresses the role that increased ownership and use of mobile phones can play in improving both access to healthcare and health systems research in low-and middle-income countries (LMICs), specifically in sub-Saharan Africa ( Bloomfield et al., 2014 Hampshire et al., 2015 Lee et al., 2017). We found a lack of attention paid to research ethics across the studies, which is concerning given the controversies WhatsApp has faced with regard to data protection in relation to end-to-end encryption. With one exception, the eight studies that employed a qualitative ( n = 6) or mixed-method ( n = 2) design analysed the WhatsApp content generated through a WhatsApp-based programmatic intervention. In the eight quantitative studies identified, seven used WhatsApp to send hyperlinks to online surveys. Across the 16 studies-11 of which were based in LMICs-WhatsApp was primarily used in one of two ways. We extracted data pertaining to the characteristics of the research. We identified 69 articles, 16 of which met our inclusion criteria for review. Five key public health databases were searched for articles containing the words ‘WhatsApp’ and ‘health research’ in their titles and abstracts. A key reason for focusing on WhatsApp is the ability to retain contact with participants when they cross international borders. To inform our study, we conducted a scoping review of published health research that uses WhatsApp as a data collection tool. However, little is known about the opportunities and challenges associated with the use of WhatsApp as a tool for health research. Mobile instant messaging applications, including WhatsApp Messenger, provide new and affordable opportunities for health research across time and place, potentially addressing the challenges of maintaining contact and participation involved in research with migrant and mobile populations, for example. Globally, the use of mobile phones for improving access to healthcare and conducting health research has gained traction in recent years as rates of ownership increase, particularly in low- and middle-income countries (LMICs).
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