{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T08:58:31Z","timestamp":1774601911583,"version":"3.50.1"},"reference-count":45,"publisher":"Association for Computing Machinery (ACM)","issue":"CSCW1","license":[{"start":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T00:00:00Z","timestamp":1713312000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.acm.org\/publications\/policies\/copyright_policy#Background"}],"funder":[{"DOI":"10.13039\/501100006374","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R21MH127992"],"award-info":[{"award-number":["R21MH127992"]}],"id":[{"id":"10.13039\/501100006374","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dl.acm.org"],"crossmark-restriction":true},"short-container-title":["Proc. ACM Hum.-Comput. Interact."],"published-print":{"date-parts":[[2024,4,17]]},"abstract":"<jats:p>The development and adoption of eHealth in low- and middle-income countries has potential to advance the quality of care in healthcare settings that are challenged by weak infrastructure. Especially in the countries where HIV rates are high, there is need to implement electronic medical record systems to enhance care and improve treatment outcomes. Due to the sensitivity of HIV-related information, eHealth applications in HIV care necessitate the attention and prioritization of data security and privacy. We explored diverse stakeholders' views on data security and privacy in Malawi's public HIV care program to expand the understanding of gaps and opportunities in improving data protections. This work connects data security and privacy goals and practices with previous work on mobile device usage as well as global best practices for security and privacy in healthcare settings. A key finding articulated by stakeholders is the importance of establishing strong data security governance.<\/jats:p>","DOI":"10.1145\/3637323","type":"journal-article","created":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T10:05:31Z","timestamp":1714385131000},"page":"1-26","update-policy":"https:\/\/doi.org\/10.1145\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["eHealth Data Security and Privacy: Perspectives from Diverse Stakeholders in Malawi"],"prefix":"10.1145","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6490-4776","authenticated-orcid":false,"given":"Lisa","family":"Orii","sequence":"first","affiliation":[{"name":"University of Washington, Seattle, WA, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8152-6754","authenticated-orcid":false,"given":"Caryl","family":"Feldacker","sequence":"additional","affiliation":[{"name":"University of Washington, Seattle, WA, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8247-1273","authenticated-orcid":false,"given":"Hannock","family":"Tweya","sequence":"additional","affiliation":[{"name":"University of Washington &amp; International Training and Education Center for Health (I-TECH), Seattle, WA, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7283-7219","authenticated-orcid":false,"given":"Richard","family":"Anderson","sequence":"additional","affiliation":[{"name":"University of Washington, Seattle, WA, USA"}]}],"member":"320","published-online":{"date-parts":[[2024,4,26]]},"reference":[{"key":"e_1_2_1_1_1","doi-asserted-by":"publisher","DOI":"10.18489\/sacj.v50i1.176"},{"key":"e_1_2_1_2_1","first-page":"102409","article-title":"edical, Ehui Adovor, Mathias Czaika, Fr\u00e9d\u00e9ric Docquier, and Yasser Moullan. 2021. Medical brain drain: how many, where and why","volume":"76","year":"2021","unstructured":"021)]% adovor2021medical, Ehui Adovor, Mathias Czaika, Fr\u00e9d\u00e9ric Docquier, and Yasser Moullan. 2021. Medical brain drain: how many, where and why? Journal of Health Economics , Vol. 76 (2021), 102409.","journal-title":"Journal of Health Economics"},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chb.2016.10.023"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1145\/3134652"},{"key":"e_1_2_1_5_1","doi-asserted-by":"publisher","DOI":"10.1145\/3025453.3025961"},{"key":"e_1_2_1_6_1","first-page":"1","article-title":"Use of electronic health records in sub-Saharan Africa: progress and challenges","volume":"14","author":"Akanbi Maxwell O","year":"2012","unstructured":"Maxwell O Akanbi, Amaka N Ocheke, Patricia A Agaba, Comfort A Daniyam, Emmanuel I Agaba, Edith N Okeke, and Christiana O Ukoli. 2012. Use of electronic health records in sub-Saharan Africa: progress and challenges. Journal of Medicine in the Tropics, Vol. 14, 1 (2012), 1.","journal-title":"Journal of Medicine in the Tropics"},{"key":"e_1_2_1_7_1","doi-asserted-by":"publisher","DOI":"10.1145\/3378393.3402244"},{"key":"e_1_2_1_8_1","volume-title":"Twelfth Symposium on Usable Privacy and Security (SOUPS","author":"Bai Wei","year":"2016","unstructured":"Wei Bai, Moses Namara, Yichen Qian, Patrick Gage Kelley, Michelle L Mazurek, and Doowon Kim. 2016. An Inconvenient Trust: User Attitudes toward Security and Usability Tradeoffs for $$Key-Directory$$ Encryption Systems. In Twelfth Symposium on Usable Privacy and Security (SOUPS 2016). 113--130."},{"key":"e_1_2_1_9_1","volume-title":"Policymakers and mHealth: roles and expectations, with observations from Ethiopia, Ghana and Sweden. Global health action","author":"Barkman Catharina","year":"2017","unstructured":"Catharina Barkman and Lars Weinehall. 2017. Policymakers and mHealth: roles and expectations, with observations from Ethiopia, Ghana and Sweden. Global health action, Vol. 10, sup3 (2017), 1337356."},{"key":"e_1_2_1_10_1","doi-asserted-by":"publisher","DOI":"10.1145\/1999927.1999939"},{"key":"e_1_2_1_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2019.04.024"},{"key":"e_1_2_1_12_1","doi-asserted-by":"publisher","DOI":"10.1145\/2675133.2675243"},{"key":"e_1_2_1_13_1","volume-title":"Global Health Informatics. Principles of eHealth and mHealth to Improve Quality of Care, Leo Anthony","author":"Braa J\u00f8rn","unstructured":"J\u00f8rn Braa and Sundeep Sahay. 2017. The DHIS2 Open Source Software Platform: Evolution Over Time and Space. In Global Health Informatics. Principles of eHealth and mHealth to Improve Quality of Care, Leo Anthony, G. Celi, Hamish S. F. Fraser, Vipan Nikore, Juan Sebastian Osorio, and Kenneth Paik (Eds.). The MIT Press."},{"key":"e_1_2_1_14_1","volume-title":"Using thematic analysis in psychology. Qualitative research in psychology","author":"Braun Virginia","year":"2006","unstructured":"Virginia Braun and Victoria Clarke. 2006. Using thematic analysis in psychology. Qualitative research in psychology, Vol. 3, 2 (2006), 77--101."},{"key":"e_1_2_1_15_1","volume-title":"Low Agricultural Productivity, and Slow Structural Transformation (English)","author":"Caruso German Daniel","year":"2022","unstructured":"German Daniel Caruso and Lina Marcela Cardona Sosa. 2022. Malawi Poverty Assessment : Poverty Persistence in Malawi - Climate Shocks, Low Agricultural Productivity, and Slow Structural Transformation (English). World Bank Group (2022). http:\/\/documents.worldbank.org\/curated\/en\/099920006302215250\/P174948072f3880690afb70c20973fe214d"},{"key":"e_1_2_1_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0051631"},{"key":"e_1_2_1_17_1","doi-asserted-by":"publisher","DOI":"10.1145\/3001913.3001919"},{"key":"e_1_2_1_18_1","volume-title":"10th Symposium On Usable Privacy and Security (SOUPS","author":"Chen Jay","year":"2014","unstructured":"Jay Chen, Michael Paik, and Kelly McCabe. 2014. Exploring internet security perceptions and practices in urban ghana. In 10th Symposium On Usable Privacy and Security (SOUPS 2014). 129--142."},{"key":"e_1_2_1_19_1","doi-asserted-by":"publisher","DOI":"10.1145\/2441776.2441837"},{"key":"e_1_2_1_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10916-006-7405-0"},{"key":"e_1_2_1_21_1","doi-asserted-by":"publisher","DOI":"10.1145\/2909609.2909660"},{"key":"e_1_2_1_22_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000319"},{"key":"e_1_2_1_23_1","doi-asserted-by":"publisher","DOI":"10.1145\/3411763.3443438"},{"key":"e_1_2_1_24_1","doi-asserted-by":"publisher","DOI":"10.1145\/3330482.3330503"},{"key":"e_1_2_1_25_1","doi-asserted-by":"publisher","DOI":"10.1145\/2702123.2702442"},{"key":"e_1_2_1_26_1","volume-title":"Implementing electronic medical record systems in developing countries. Informatics in primary care","author":"Fraser Hamish SF","year":"2005","unstructured":"Hamish SF Fraser, Paul Biondich, Deshen Moodley, Sharon Choi, Burke W Mamlin, and Peter Szolovits. 2005. Implementing electronic medical record systems in developing countries. Informatics in primary care, Vol. 13, 2 (2005)."},{"key":"e_1_2_1_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.329.7475.1142"},{"key":"e_1_2_1_28_1","volume-title":"Proceedings of the Fourteenth USENIX Conference on Usable Privacy and Security","author":"Sambasivan Nithya","year":"2018","unstructured":"Nithya Sambasivan, Garen Checkley, Amna Batool, Nova Ahmed, David Nemer, Laura Sanely Gayt\u00e1n-Lugo, Tara Matthews, Sunny Consolvo, and Elizabeth Churchil. 2018. \"Privacy is Not for Me, It's for Those Rich Women\": Performative Privacy Practices on Mobile Phones by Women in South Asia. In Proceedings of the Fourteenth USENIX Conference on Usable Privacy and Security (Baltimore, MD, USA) (SOUPS '18). USENIX Association, USA, 127--142."},{"key":"e_1_2_1_29_1","volume-title":"eHealth innovations in LMICs of Africa and Asia: a literature review exploring factors affecting implementation, scale-up, and sustainability. health care","author":"Shuvo Tanzir Ahmed","year":"2015","unstructured":"Tanzir Ahmed Shuvo, Rubana Islam, Shahed Hossain, Julie L Evans, Fatema Khatun, Tanvir Ahmed, Rukhsana Gazi, and Alayne M Adams. 2015. eHealth innovations in LMICs of Africa and Asia: a literature review exploring factors affecting implementation, scale-up, and sustainability. health care, Vol. 8, 9 (2015)."},{"key":"e_1_2_1_30_1","doi-asserted-by":"publisher","DOI":"10.1109\/HICSS.2008.141"},{"key":"e_1_2_1_31_1","first-page":"20","article-title":"Privacy at the margins| The poverty of privacy: Understanding privacy trade-offs from identity infrastructure users in India","volume":"12","author":"Srinivasan Janaki","year":"2018","unstructured":"Janaki Srinivasan, Savita Bailur, Emrys Schoemaker, and Sarita Seshagiri. 2018. Privacy at the margins| The poverty of privacy: Understanding privacy trade-offs from identity infrastructure users in India. International Journal of Communication , Vol. 12 (2018), 20.","journal-title":"International Journal of Communication"},{"key":"e_1_2_1_32_1","volume-title":"Layers of silence, arenas of voice: The ecology of visible and invisible work. Computer supported cooperative work (CSCW)","author":"Star Susan Leigh","year":"1999","unstructured":"Susan Leigh Star and Anselm Strauss. 1999. Layers of silence, arenas of voice: The ecology of visible and invisible work. Computer supported cooperative work (CSCW), Vol. 8, 1 (1999), 9--30."},{"key":"e_1_2_1_33_1","doi-asserted-by":"publisher","DOI":"10.1145\/2818048.2820006"},{"key":"e_1_2_1_34_1","volume-title":"Work and the division of labor. Sociological quarterly","author":"Strauss Anselm","year":"1985","unstructured":"Anselm Strauss. 1985. Work and the division of labor. Sociological quarterly, Vol. 26, 1 (1985), 1--19."},{"key":"e_1_2_1_35_1","doi-asserted-by":"publisher","DOI":"10.1145\/2675133.2675277"},{"key":"e_1_2_1_36_1","unstructured":"Maria Dolores C Tongco. 2007. Purposive sampling as a tool for informant selection. (2007)."},{"key":"e_1_2_1_37_1","volume-title":"Wingston Ng'ambi, Soyapi L Mumba, Dave Phiri, Luke Kamvazina, Shawo Mwakilama, Henry Kanyerere, Olivia Keiser, et al.","author":"Tweya Hannock","year":"2016","unstructured":"Hannock Tweya, Caryl Feldacker, Oliver Jintha Gadabu, Wingston Ng'ambi, Soyapi L Mumba, Dave Phiri, Luke Kamvazina, Shawo Mwakilama, Henry Kanyerere, Olivia Keiser, et al. 2016. Developing a point-of-care electronic medical record system for TB\/HIV co-infected patients: experiences from Lighthouse Trust, Lilongwe, Malawi. BMC research notes, Vol. 9, 1 (2016), 1--10."},{"key":"e_1_2_1_38_1","unstructured":"UNAIDS\/PEPFAR. 2007. Interim guidelines on protecting the confidentiality and security of HIV information: proceedings from a workshop. https:\/\/data.unaids.org\/pub\/manual\/2007\/confidentiality_security_interim_guidelines_15may2007_en.pdf"},{"key":"e_1_2_1_39_1","doi-asserted-by":"publisher","DOI":"10.1145\/3209811.3209818"},{"key":"e_1_2_1_40_1","doi-asserted-by":"publisher","DOI":"10.1145\/3449165"},{"key":"e_1_2_1_41_1","volume-title":"Nathan Malkin, Michelle L. Mazurek, Manya Sleeper, and Kurt Thomas.","author":"Warford Noel","year":"2021","unstructured":"Noel Warford, Tara Matthews, Kaitlyn Yang, Omer Akgul, Sunny Consolvo, Patrick Gage Kelley, Nathan Malkin, Michelle L. Mazurek, Manya Sleeper, and Kurt Thomas. 2021. SoK: A Framework for Unifying At-Risk User Research. CoRR , Vol. abs\/2112.07047 (2021). showeprint[arXiv]2112.07047 https:\/\/arxiv.org\/abs\/2112.07047"},{"key":"e_1_2_1_42_1","doi-asserted-by":"publisher","DOI":"10.3233\/978-1-60750-588-4-96"},{"key":"e_1_2_1_43_1","doi-asserted-by":"publisher","DOI":"10.1109\/SP46214.2022.9833686"},{"key":"e_1_2_1_44_1","doi-asserted-by":"publisher","DOI":"10.1080\/03768350701577772"},{"key":"e_1_2_1_45_1","volume-title":"AMIA Annual Symposium Proceedings","volume":"2011","author":"Zhang Wen","year":"2011","unstructured":"Wen Zhang, Carl A Gunter, David Liebovitz, Jian Tian, and Bradley Malin. 2011. Role prediction using electronic medical record system audits. In AMIA Annual Symposium Proceedings, Vol. 2011. American Medical Informatics Association, 858. io"}],"container-title":["Proceedings of the ACM on Human-Computer Interaction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dl.acm.org\/doi\/10.1145\/3637323","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/dl.acm.org\/doi\/pdf\/10.1145\/3637323","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T17:14:16Z","timestamp":1755882856000},"score":1,"resource":{"primary":{"URL":"https:\/\/dl.acm.org\/doi\/10.1145\/3637323"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,17]]},"references-count":45,"journal-issue":{"issue":"CSCW1","published-print":{"date-parts":[[2024,4,17]]}},"alternative-id":["10.1145\/3637323"],"URL":"https:\/\/doi.org\/10.1145\/3637323","relation":{},"ISSN":["2573-0142"],"issn-type":[{"value":"2573-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,17]]},"assertion":[{"value":"2024-04-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}