Stakeholder Management in a Community mHealth Initiative in Malawi


  • Mphatso Nyemba-Mudenda University of Cape Town
  • Wallace Chigona University of Cape Town



Background and Purpose: Varying interests and expectations of different stakeholders have implications on successful implementation of Information and Communication Technologies for Health (ICT4H) interventions. Research has shown that proper management of stakeholders’ interests has a positive bearing on the effectiveness and sustainability of Information and Communication Technologies for Development (ICT4D) initiatives. However, there is a dearth of studies on stakeholder management in ICT4H research, especially the mobile for health (mHealth) domain. This could be due to the mHealth field still being in its infancy and many projects being implemented for a short period without being evaluated. This paper reports on management of stakeholders in an mHealth intervention from the community perspective. The study examined how management of stakeholders from the community affected the effectiveness and sustainability of the mHealth intervention.

Methods: The case of a Mobile System for Safe Motherhood intervention in maternal health in a developing country context was analysed. The study employed an interpretive approach using qualitative methods. Documentary review and semi-structured interviews were used to collect data, and the data was analysed using content analysis.

Results: Different expectations of mothers and other community agents were not given adequate voice and attention in reaching the common good towards achieving the main objectives of the intervention. Stakeholder management from the community perspective was inadequate due to: 1) less consultation of key community stakeholders in some stages of the project; 2) poor communication; 3) lack of formal procedures in operations; and 4) exclusion of tradition information systems.

Conclusions: Management procedures such as face to face meetings, training, effective communication using formal channels, and community empowerment would help in building winning coalitions that improve performance of interventions and enhance effectiveness and sustainability.

Keywords:  mHealth, Community involvement, Stakeholder management


Download data is not yet available.

Author Biographies

  • Mphatso Nyemba-Mudenda, University of Cape Town
    Information Systems departmentPhD Student
  • Wallace Chigona, University of Cape Town
    Information Systems DepartmentAssociate Professor


Qiang CZ, Yamamichi M, Hausman V, Altman D. Mobile applications for the health sector. World Bank; 2012 Apr.

Chudi PI. Healthcare problems in developing countries. Medical Practice and Reviews. 2010;1(1):9-11.

Noordam AC, Kuepper BM, Stekelenburg J, Milen A. Improvement of maternal health services through the use of mobile phones. Tropical Medicine & International Health. 2011;16(5):622-6.

Kaplan WA. Can the ubiquitous power of mobile phones be used to improve health outcomes in developing countries? Globalization and Health, BioMed Central. 2006;2(9).

Lester RT, van der Kop M, Taylor D, Alasaly K, Coleman J, Marra F. m-health: Connecting patients to improve population and public health. BCMJ. 2011;53(5):218-9.

Chigona W, Nyemba-Mudenda M, Metfula A. A review on mHealth research in developing countries. The journal of community informatics [Internet]. 2012 [cited 2013 Jun 04];9(2): [about 5 p.]. Available from:

Krishna S, Boren SA, Balas EA. Healthcare via cell phones: A systematic review. Telemedicine and e-Health. 2009;15(3):231-40.

Pade CI, Mallinson B, Sewry D. An exploration of the categories associated with ICT project sustainability in rural areas of developing countries: A case study of the Dwesa project. Proceedings of the 2006 annual research conference of the South African institute of computer scientists and information technologists on IT research in developing countries; 2006; South Africa; 2006. p. 100-06.

Chigona W, Roode D, Nabeel N, Pinnock B. Investigating the impact of stakeholder management on the implementation of a public access project : the case of Smart Cape. South African Journal of Business Management. 2010;41(2): 39-49.

Bailur S. Using stakeholder theory to analyze telecenter projects. Information Technologies & International Development. 2006;3(3):61-80.

Flak LS, Nordheim S, Munkvold BE. Analyzing stakeholder diversity in G2G efforts: Combining descriptive stakeholder theory and dialectic process theory. E-Service Journal. 2008;6(2):3-23.

Gomes RC. Who are the relevant stakeholders to the local government context? Empirical evidences on environmental influences in the decision-making process of English local authorities. BAR.Brazilian Administration Review. 2004;1(1):34-52.

Norris AC, Stockdale RS, Sharma S. A strategic approach to m-health. Health Informatics Journal. 2009 Sep 01;15(3):244-53.

Klasnja P, Pratt W. Healthcare in the pocket: Mapping the space of mobile-phone health interventions. J Biomed Inform. 2012 Feb;45(1):184-98.

Free C, Phillips G, Watson L, Galli L, Felix L, Edwards P, et al. The effectiveness of mobile-health technologies to improve health care service delivery processes: a systematic review and meta-analysis. PLoS medicine Public Library of Science. 2013 [cited 2013 Aug 15]; 10(1): [about 10 p.]. Available from

Mechael P, Batavia H, Kaonga N, Searle S, Kwan A, Goldberger A, et al. Barriers and Gaps Affecting mHealth in Low and Middle Income Countries: Policy White Paper. Columbia University: Earth Institute & mHealth Alliance; 2010 May.

Simpson LE. Community informatics and sustainability: Why social capital matters. The Journal of Community Informatics. 2005;1(2):102-19.

Kumar R. eChoupals: A study on the financial sustainability of village internet centers in rural madhya pradesh. Information Technologies and International Development. 2004;2(1):45-74.

Freeman, ER. Strategic Management: a stakeholder approach. Boston: Pitman; 1984.

Brugha R, Varvasovszky Z. Stakeholder analysis: A review. Health Policy and Planning. 2000;15(3):239-46.

Clarkson ME. A stakeholder framework for analyzing and evaluating corporate social performance. Academy of management review. 1995;20(1):92-117.

Gavin T, Pinder C. Impact Assessment and Stakeholder Analysis [Internet]. Proving and Improving: a quality and impact toolkit for social enterprise; 1998. Available from

Mishra A, Dwivedi YK. Stakeholder Theory and Applications in Information Systems In: Dwivedi YK, Wade MR, Schneberger SL, editors. Information Systems Theory: Explaining and Predicting Our Digital Society. Springer; 2012; p. 471-88.

Donaldson T, Preston LE. The stakeholder theory of the corporation: Concepts, evidence, and implications. Academy of management Review. 1995;20(1):65-91.

Kaler J. Differentiating stakeholder theories. J Bus Ethics. 2003;46(1):71-83.

Gosling, L, Edwards, M. Toolkits: A practical guide to planning, monitoring, evaluation and impact assessment. London: UK; Save the Children; 2003.

Kaplan B, Maxwell J. Qualitative research methods for evaluating computer information systems In: Anderson J, Aydin C, editors.Evaluating the Organizational Impact of Healthcare Information Systems. 2nd ed. Springer; 2005; p. 30-55.

Walsham G. Interpretive case studies in IS research: Nature and method. European Journal of information systems. 1995;4(2):74-81.

Sandelowski M. Sample size in qualitative research. Res Nurs Health. 1995;18(2):179-83.

Hsieh H, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277-88.

Myers MD. Qualitative research in information systems. MIS Quarterly. 1997 Jun;21(2):241-2.

Malawi NSO, ORC Macro. Malawi Demographic and Health Survey 2010. Zomba: Malawi National Statistical Office; 2011.

UNDP. 2013 Human Development Report. New York: United Nations Development Program; 2013.

ITU. The Role of ICT in advancing growth in least developed countries (LCDs) trends, challenges and opportunities. Geneva: International Telecommunication Union; 2011.

Mtingwi J, Van Belle J. E-Government and M-Government readiness in Malawi In: Mahmood Z, editor. E-Government implementation and practice in Developing Countries. IGI Global; 2013; p. 211-41.

Hogan MC, Foreman KJ, Naghavi M, Ahn SY, Wang M, Makela SM, et al. Maternal mortality for 181 countries, 1980–2008: A systematic analysis of progress towards millennium development goal 5. The Lancet. 2010 May;375(9726):1609-23.

WHO, UNICEF, UNFPA, World Bank. Trends in maternal mortality: 1990-2010 [internet]. World Health Organisation; 2012 [cited 2013 Sep 04]. Available from:

Makoza F, Chigona W. The outcomes of ICT diffusion and human development in Malawi. International Journal of Information Communication Technologies and Human Development (IJICTHD). 2012;4(4):52-70.

Pouloudi A, Whitley EA. Stakeholder identification in inter-organizational systems: Gaining insights for drug use management systems. European journal of information systems. 1997;6(1):1-14.

Wilkinson SE, Callister LC. Giving birth: The voices of Ghanaian women. Health Care Women Int. 2010 Mar;31(3):201-20.

Maimbolwa MC, Yamba B, Diwan V, Ransjö-Arvidson A. Cultural childbirth practices and beliefs in Zambia. J Adv Nurs. 2003;43(3):263-74.

Seljeskog L, Sundby J, Chimango J. Factors influencing women's choice of place of delivery in rural Malawi-an explorative study. Afr J Reprod Health. 2007;10(3):66-75.

Lori JR, Bolye J. Cultural childbirth practices, beliefs, and traditions in post conflict Liberia. Health Care Women Int. 2011;32(6):454-73.

Nyemba-Mudenda M, Chigona W. The Dynamics of Involving Intermediaries on User Experiences and Outcomes of mHealth Initiatives: The Case of a Maternal Healthcare Intervention in Malawi. Proceedings of Health Informatics South Africa (HISA) 2013 Conference; 2013 Jul 3-5; Port Elizabeth, South Africa. Nelson Mandela Metropolitan University; 2013.

Gigler B. Informational capabilities-the missing link for the impact of ICT on development. E-Transform Knowledge Platform, World Bank. 2011.

Garvare R, Johansson P. Management for sustainability–a stakeholder theory. Total Qual Manage. 2010;21(7):737-44.




How to Cite

Stakeholder Management in a Community mHealth Initiative in Malawi. (2013). Journal of Health Informatics in Africa, 1(1).