Assessing the Organizational Readiness in Using Unstructured Supplementary Service Data (USSD) to Improve Treatment Outcomes for Adolescents Living with HIV Transitioning to Adult Care at Umodzi Family ART Clinic

Introduction Adolescents living with HIV (ALHIV) face challenges transitioning to adult care. Mobile health interventions, particularly Unstructured Supplementary Service Data (USSD), have effectively improved HIV knowledge and treatment outcomes. While mobile penetration in Malawi has increased, there are no USSD interventions specifically for ALHIV. A proposed USSD application aimed to enhance treatment outcomes for this group. This study evaluated the organizational readiness of the Umodzi Family ART Clinic to implement this platform. Methods This qualitative exploratory study was conducted between November 2023 and March 2024 at the Umodzi Family Clinic in Blantyre, Malawi, focusing on healthcare workers and ALHIV transitioning to adult care. We conducted nine in-depth interviews with healthcare professionals and facilitated three focus group discussions with thirty-two ALHIV participants. All interviews and focus group sessions were recorded, transcribed verbatim, and analysed using NVivo 14 software, guided by the theory of organizational readiness to identify key themes. Results Our findings indicate a strong willingness among both ALHIV and healthcare workers to use the application to improve treatment outcomes during the transition to adult care. Key features like access to treatment information and reminders were recognized as vital for enhancing adherence, retention, and viral suppression. The presence of digital platforms at the facility, widespread mobile access among ALHIV, and the facility’s prior experience with digital health initiatives were major facilitators for the App's success. Nevertheless. enhancements in privacy, security, interoperability, and overall app design were highlighted as critical features for successful app adoption. Conclusion The findings demonstrate a significant readiness to embrace the proposed application to enhance treatment outcomes. Additionally, our results underscore essential pillars of organizational readiness that are vital in designing and implementing mHealth applications. The study's results are critical for developing and implementing USSD applications to support treatment outcomes for ALHIV transitioning to adult care.