Factors influencing township consumers’ adoption of last-mile pharmaceutical delivery services

Abstract

Background: This study investigates factors influencing consumers’ adoption of last-mile delivery (LMD) services for pharmaceutical products in South African townships, contributing to understanding technology acceptance in emerging markets.
Aim: Grounded in the Technology Acceptance Model (TAM), the study examines the effects of behavioural intention (BI), attitude (ATT), perceived ease of use (PEOU) and perceived usefulness (PU) on LMD adoption, and tests the mediating role of PU in the relationship between PEOU and use behaviour (UB).
Setting: A cross-sectional quantitative survey was conducted among 127 customers of a private retail pharmacy in Nkowankowa Township, Limpopo, South Africa.
Methods: Structured questionnaires were administered through convenience sampling, with researcher-assisted translation into Xitsonga or Sepedi where required. Constructs were measured using validated multi-item Likert scales. Confirmatory factor analysis assessed the measurement model, while structural equation modelling tested six hypotheses in IBM SPSS 29.0 and AMOS 29.0. Mediation was assessed using bias-corrected bootstrapping.
Results: Consumers reported positive ATT towards LMD pharmaceutical services, and BI strongly predicted UB. PEOU and PU significantly influenced ATT, while PEOU strongly enhanced PU. PU primarily operated through indirect pathways rather than directly influencing UB, supporting the mediated TAM structure.
Conclusion: Township consumers are receptive to LMD pharmaceutical services. Adoption is driven mainly through cognitive-affective pathways rather than usefulness alone, indicating that interventions should strengthen the pathway from ease of use through attitude formation to intention.
Contribution: As the first South African study of LMD adoption factors for pharmaceuticals in a township setting, this study offers novel insights into technology acceptance and emerging-market healthcare delivery.