Barriers to pilot mobile teleophthalmology in a rural hospital in Southern Malawi

INTRODUCTION Malawi has one of the highest HIV prevalences in Sub-Saharan Africa. The rate of eligible HIV-infected people being initiated on antiretroviral therapy (ART) and retained in HIV-care is currently far from adequate. Consequently, many people continue present with advanced immunosuppression at public health facilities, often with undiagnosed opportunistic infections (OIs). METHODS In this context, mHealth was the innovation chosen to assist Eye Clinical Officers in early diagnosis of HIV-related diseases having eye manifestations in a rural hospital in Thyolo, Southern Malawi. RESULTS The mTeleophthalmology program began in October 2013, but was stopped prematurely due to organizational and technological barriers that compromised its feasibility. CONCLUSION Sharing these barriers might be useful to inform the design of similar innovations in other resource-limited settings with a high HIV prevalence and a dearth of eye specialists with capacity to diagnose HIV-related retinopathies.