An interview with Joseph Nwankpa on ‘Leapfrogging Healthcare Service Quality in Sub-Saharan Africa: The Utility-Trust Rationale of Mobile Payment Platforms’

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Could you please introduce yourself, and tell us more about your research?

My name is Joseph Nwankpa, and I am a faculty member at the Farmer School of Business at Miami University in Oxford, Ohio. My area of expertise is primarily in digital technologies, and I am in the Information Systems Analytics department. It is my primary department. But in terms of research, I tend to research multiple areas to see how firms can leverage technology to drive better processes. More recently, I’ve been more focused on understanding information and communication technologies and how these technologies can be used to foster developing countries. Thus, more specifically, I look at, for example, the healthcare sector and developing countries. In terms of developing countries, how can stakeholders leverage the digital technologies and emerging technologies that we have today to meet the challenges of developing countries where you might not necessarily have the type of infrastructure or the type of resources that tends to be available in much-developed societies.

Could you elaborate as to why this topic is so important?

In my current research, one of the things that we tried to do was to understand how we can leverage emerging technologies to improve the healthcare service quality, especially within the sub-Saharan African region. Think of the Sub-Saharan African region, which makes up about 13% of the world population but contributes more than 24% of the global disease burden. Part of that stems from poor healthcare service. Sub-Saharan Africa has attained high mobile penetration in terms of the number of mobile usages, even though they lack a lot of infrastructures. The mobile adoption rate for the region is more than 46%. Thus, the question is, can we leverage mobile devices? Can we take advantage of mobile technology to improve healthcare service quality? That is what we were hoping to investigate in our study. We investigated whether we can try to use mobile devices to mitigate some of those challenges that patients typically face regarding healthcare service quality. One of them would be concerning the payment process of healthcare. Payment is always a big issue whenever you think of the Sub-Saharan African healthcare system. For instance, we’ve had cases whereby people travel long distances to go to hospitals, but by the time they get there, they don’t have enough cash. In such a case, it is not that simple to go to the bank to get the money because the banks are so far away and, in most cases, inaccessible. Patients are left to carry huge amounts of cash, which poses serious security implications. There are multiple instances when patients get to the clinic or hospital but have to leave the hospital and go to an off-location financial institution to make payments in a healthcare process that is primarily based on out-of-pocket, with patients paying before the healthcare service offering. This is one of the issues that patients in the region and in most developing nations have to grapple with. Thus, the question we examined is how we can leverage the mobile device they already have with them to mitigate the concerns when it comes to healthcare service quality. In our study, we tried to test whether a mobile payment system and platform can affect health care service quality for sub-Saharan Africans, and more specifically, Nigeria as our test site.

Could you elaborate on the connection between your research and medical practice?

In our study, one of the interesting things we found was that mobile payment platforms impacted healthcare service quality. In fact, one of the challenges that we noted in our study was that when people utilize mobile payment devices, it allows these patients to be able to build trust, not from the healthcare service provider, but trust primarily on the use of the technology. Also, we saw that trust did in fact, transfer to the type of healthcare services that they needed to receive. When patients used the mobile payment platform, they were able to make informed decisions, they were able to understand their treatment options better, and they were about to overcome the lack of transparency in terms of the payment details. Also, they were able to drill down and get to details about what they were paying for, which helped them build trust with the healthcare provider, especially in developing countries where there’s always mutual distrust between the healthcare providers and patients. Thus, once they had that mobile device on hand and were able to see beyond the payment information black box, it helped create a commitment to continue to visit those clinics. In the past, mobile devices have played critical roles in developing nations’ socioeconomic landscapes. For example, when you think about Burkina Faso, where the government launched an mHealth interactive health system, healthcare providers were able to use the app to connect with HIV patients. We have seen from prior studies that using mobile devices as a payment platform can be applied to healthcare services. What is new is that we can use mobile usage to drive positive healthcare service quality by building trust. Mobile payment platforms can inspire transparency in terms of what a patient can expect when they visit the clinic. The availability of mobile payment platforms can give patients a clearer picture of what they’re getting. One of the things that we’ve noticed, from a practical perspective, was in the past, we tend to see a situation when people get to the hospital, they don’t have enough money to pay, and then they have to go out of the site to get the payment, by the time they show up, the expert physician is already gone. As a result, visiting patients are left to deal with the nonexperts. However, with mobile payment, you eliminate all those delays making it much easier for them to have better-quality care. It goes without saying that prior studies have demonstrated that people tend to develop trust in healthcare technology over time and that there’s a linkage or an association between medical equipment and healthcare service quality. What we didn’t know and what our study did reveal is that this positive association can be extended to non-medical devices, in this case, a mobile device. When people have positive beliefs and attitudes through the use of a healthcare provider’s mobile payment system, they will feel that the healthcare process is streamlined the process is being very efficient, leading to a positive relationship with the healthcare provider and a perception of superior healthcare service quality.

Where could your work lead you next? What are the next steps and the dream outcomes?

Right now, we are looking at, for example, what else we can do with mobile devices. How else can we use mobile devices to improve the healthcare outcome itself? Not necessarily the service offering, but the healthcare itself. For instance, can we use mobile devices as a way to monitor certain health conditions? Can we use mobile devices as a way to deal with early disease discovery, and how can we implement that? What about, you know, diagnosis? We can start looking at these areas where communication and information gathering are of critical importance. If users have access to a mobile app, how would the usage lead to sustainable healthcare service quality, maybe getting more robust information and integrating health education? As a result, we think sustainable healthcare is one area that we have to start looking at right now in terms of how we can continue leveraging mobile platforms to better manage infectious diseases in developing countries, especially the Sub-Saharan African region.

You can read and discover Joseph Nwankpa’s research here.

Leapfrogging Healthcare Service Quality in Sub-Saharan Africa: The Utility-Trust Rationale of Mobile Payment Platforms is published in PLOS

Photo Credits: Miami University

Disclaimer: This is a transcript of a video conversation. You can listen to the recording on Researcher.