Service quality dynamics of mHealth in a developing country

Abstract

mHealth, a new paradigm of an emerging information technology (IT) artifact, transforms health care delivery in the developing world by making it more accessible, affordable and available. Although mHealth is transforming health care in developing countries, there are growing concerns about the perceived service quality of such service systems and their overall effects on satisfaction, continuance intentions and quality of life. In developing countries, expanding access or low costs are not enough if one’s confidence in the quality of health services is low. If mHealth cannot be trusted to guarantee a threshold level of quality, it will remain underutilized, be bypassed or be used as a measure of last resort. However, there are few studies which have developed models to measure the components and consequences of mHealth service quality. Thus, to fill this knowledge gap, this study developed a service quality model for mHealth by framing its association with satisfaction, continuance intentions and quality of life. To validate the model, the study used a quantitative-positivist approach as a research paradigm, cross-sectional design as a survey method, cluster sampling as a sampling technique and component-based structural equation modeling (SEM) as a data analysis technique. The findings of the study show that mHealth service quality is a third-order construct model with three primary dimensions and nine subdimensions which have a significant positive association with consequential latent variables. Theoretically, the study extends service quality research by reframing the concept as a reflective, hierarchical model and framing its impact on satisfaction, continuance intentions and quality of life in the context of mHealth in a developing country. Methodologically, the study validates that component-based SEM can be used to estimate the parameters of a higher-order construct and its association outcome variables in a nomological network. Practically, the study provides managers with a service quality model for conducting integrated analysis and design of service delivery systems. Overall, the study makes a significant contribution to achieve patronage for firms, better health outcomes for patients and above all, an improved quality of life for the community in developing countries.