User-Centered Diabetes Self-Management App (DiabAid Nexus) in Sub-Saharan Africa: Development and Usability Study

Abstract Background Diabetes is a significant global public health concern, with disproportionately high prevalence and poor access to care in low-resource settings, notably in Sub-Saharan Africa. Objective By harnessing the ubiquity of mobile phones, we aim to develop and test a user-centered mobile health (mHealth) app tailored to address the specific needs and challenges of diabetes self-management in Sub-Saharan Africa. Methods A user-centered design approach was used to develop a bilingual mHealth platform for diabetes management. The app was made using Flutter 3.16.2 (Google) and Dart 3.2.2. (Google) and was tested on various Android emulators and smartphones before publishing. A usability study with 13 participants was carried out to assess the app’s real-life impact, quality, and user experience using the user version of the Mobile App Rating Scale (uMARS). A brief semistructured interview was conducted to further evaluate the app’s usability and user experience. Results The mHealth platform called “ DiabAid Nexus ” (GTA) has been developed and tested with 13 people living with diabetes in Ethiopia. The findings show that the app was perceived as simple, easy to use, and relevant to users’ needs. uMARS scores out of 5 showed high ratings for functionality (mean 4.33, SD 0.63), information quality (mean 4.20, SD 0.68), perceived impact (mean 4.20, SD 0.84), and subjective quality (mean 4.10, SD 0.73), indicating that users deemed the app useful, dependable, and valuable for diabetic self-management. The aesthetics subscale likewise obtained a positive score (mean 4.05, SD 0.94), while engagement earned a slightly lower score (mean 3.78, SD 0.95), highlighting the possibility of further boosting interactivity and user motivation. The overall uMARS score of 4.10 suggests a favorable user assessment of the app’s quality and efficacy. Interview responses underlined appreciation for localized content and intuitive design, with users indicating happiness and a readiness to use the app as a tool to support their diabetes self-management journey. Conclusions The findings suggest that the app is a user-friendly and well-received tool with a high potential for promoting diabetes self-management in low-resource settings and across varied contexts.