Applying user-centered design to enhance the usability and acceptability of an mHealth supervision tool for community health workers delivering an evidence-based intervention in rural Sierra Leone

Mobile health (mHealth) platforms have the potential to increase access to evidence-based interventions in low-resource settings. This study applied a user-centered design (UCD) approach to develop and evaluate an mHealth supervision tool for community health workers (CHWs) delivering an early childhood development intervention in rural Sierra Leone. We engaged CHWs (N=8) and supervisors (N=4) in focus group discussions, user testing sessions and exit interviews to gather feedback on the mHealth supervision tool's usability and acceptability. Mixed methods findings indicated that the tool was generally well-received and perceived as easy to use, but there were also challenges related to connectivity, phone charging and the need for more comprehensive training and support. Overall, this study suggests that a UCD approach can promote the usability of mHealth tools to support CHWs in delivering evidence-based interventions in low-resource settings, highlighting the importance of addressing contextual challenges and providing adequate training and support to ensure the effectiveness and sustainability of such tools.