How Post-Adoption Expectations Affect Users’ Continuance Intentions to Use mHealth in Malawi: Case of Cstock Application

Donald Flywell Malanga; Wallace Chigona

doi:10.59645/tji.v6i1.808

Authors

Donald Flywell Malanga University of Cape Town
Wallace Chigona University of Cape Town

DOI:

https://doi.org/10.59645/tji.v6i1.808

Keywords:

User Expectations, Post-Adoption Expectations, mHealth, Continuance intention, Cstock, Community Health workers, Malawi, Developing Country, Africa

Abstract

Mobile Health (mHealth) has been seen as a potential game-changer for improving healthcare delivery in developing countries. The key to successful technology adoption is continued use, not just initial acceptance. While research on factors influencing ongoing mHealth use is increasing, there is limited focus on how post-adoption expectations affect users' intention to continue using mHealth, especially in the developing world. This study examines how post-adoption expectations affect satisfaction and ongoing mHealth use among community health workers in Malawi, a developing country. The study developed a framework by expanding the expectation-confirmation model and incorporating elements of the updated information-success model. Using a mixed-methods convergent design, data were collected through surveys and semi-structured interviews with community health workers utilising Cstock, an mHealth app for ordering medical supplies via SMS. The findings confirmed that post-usage perceptions of usefulness, information quality, system quality, and service quality positively influence both satisfaction and the intention to continue using Cstock. The study shows that ongoing mHealth use is driven not only by behavioural expectations (e.g., post-usage usefulness) but also by objective expectations related to system, service, and information quality. These findings can guide policymakers, practitioners, mHealth designers, and stakeholders about key post-user expectations vital for ensuring the sustainability of future mHealth solutions in developing countries, particularly in Malawi.

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Author Biography

Wallace Chigona, University of Cape Town

Wallace Chigona is a professor of information systems at the University of Cape Town, South Africa. He is currently the Director of the Cybersecurity Capacity Centre for Southern Africa (C3SA). His research focuses on Information and Communication Technologies (ICT) policies
and the use of ICTs for human development. He has researched how disadvantaged communities in different African countries use and are affected by ICTs.

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