Examining Trust as a Key Determinant of eHealth Adoption in Malawi

Abstract

Abstract Background There is value in having the general public take initiative in taking care of personal health. With the heavy burden of finances and shortage of healthcare personnel, patient-centered healthcare is increasingly becoming important especially through eHealth. The way technology is accepted and utilized may have significant hypothetical and concrete inferences. Thus, eHealth, like any other technology, has little value unless it is used. Nevertheless, there are many factors that potentially promote or hinder uptake and use of eHealth services. This study particularly focused on the role that trust plays in determining an individual’s decision to use eHealth services. Methods Using the Unified Theory of Acceptance and Use of Technology (UTAUT) model as the primary model of inference, two new constructs were introduced to determine whether trust is a significant contributor in consumers’ decision to use eHealth. Through convenience sampling, participant responses were collected over a period of 6 weeks and evaluated using Structural Equation Modeling (SEM) technique. Results A total of 400 responses were collected and outcomes of the analysis showed that Performance Expectancy (PE), Effort Expectancy (EE), Social Influence (SI), and Facilitating Conditions (FC), had an affirmative effect on Behavioral Intentions to use eHealth. Performance Expectancy indirectly had a positive effect on Behavioral Intentions to use eHealth services via Trust in Internet (ToI) and Trust in Online Healthcare Providers (ToH). However, ToI had an insignificant effect while ToH had a positive effect. Conclusion Trust is indeed an important element in a user’s determination to use eHealth services. However, it depends on what exactly it is that users place trust in. Consumers are less trusting in the internet to facilitate accessing health related services but are more trusting in online healthcare service providers to ably assist with relevant services. The study also shows that it is essential for key stakeholders such as public policy actors and web designers to take into consideration specific target groups and user preferences which will enhance greater engagement of eHealth services.

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