Mobile Health (mhealth) Digital Platform for Primary Data Collection for Prostate Cancer Monitoring and Surveillance in Embu County

Abstract

In Sub-Saharan Africa (SAA) prostate cancer mortality is projected to double by the year 2040. Prostate cancer is the 4th cause of death after breast, cervical, and oesophageal cancer respectively with an estimated incidence of 3,412 (8.1%) and a mortality of 1,780 (6.6%) in Kenya. Despite cancer data being a fundamental component of a functional and objective cancer control approach, cancer registration and surveillance in Kenya currently cover an estimated 10% of the population. Most of the developing countries are grappling with insufficient or lack of government resources allocated to strengthen cancer registration. This poses a major impediment to cancer management and control due to the lack of reliable timely data for decision making. The study was conducted in Embu County, which does not form part of the areas covered by the three population-based cancer registries in Kenya. Hence ideal for illustration of innovative approaches to bridge the population-based prostate cancer data gaps. The research thesis aim was to demonstrate the use of a mHealth digital platform prototype in the collection of primary data for prostate cancer control and surveillance. Specifically, the study wanted to determine the data set required for cancer surveillance and decision-making, assess challenges faced in accessing prostate cancer data, and illustrate the use of the mHealth

digital platform in real-time primary data collection. The study adopted a descriptive cross- sectional study design, utilizing a design science research (DSR) strategy. The target

population was healthcare workers, including community health volunteers in Embu County due to their role in data collection and management. The purposive sampling technique was used to identify participants in different phases of the study, a total of (71) respondents for the inspiration Phase, (15) respondents for the ideation phase, and critical case sampling was used to identify (34) community health volunteers (CHVs) from different community health units. Surveys with structured questionnaires were used in data collection, with a response rate of 80.3%. The data collected from this research was subjected to quantitative-descriptive analysis. The questionnaire findings guided the requirement definition, design, and development of the prototype which was tested by the end users. The research established that the existing integrated disease surveillance and response system majorly covers communicable diseases. A gap was also identified in prostate primary data collection from the community. The study found that community reporting was mainly paper-based. Generally, cancer registration is at a rudimental stage majorly focusing on hospital-based data. The adaptability and scalability of the mHealth digital platform in a resource-constrained setup, in addition to real-time access to data was demonstrated through tests and implementation of the prototype application in the community. Finally, the research recommends the expansion of the existing disease surveillance system to include cancer surveillance.