Individual and contextual level enablers and barriers determining electronic community health information system implementation in northwest Ethiopia

BMC Health Services Research

Research

Lemma Derseh Gezie¹  Binyam Tilahun²  Tesfahun Hailemariam³  Asmamaw Atnafu⁴  Jens Johan Kaasbøll⁵  Jörn Klein⁶ 

[1] Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia;Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia;Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia;Department of Health Informatics, College of Health Sciences, Hawassa, Ethiopia;Department of Health System and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia;Department of Informatics, University of Oslo, Oslo, Norway;Department of Nursing and Health Sciences Campus Porsgrunn, University of South-Eastern Norway, Porsgrunn, Norway;

关键词: eCHIS;    Implementation;    Health data quality;    Use;    Service provision;    CFIR framework;    HEWS;    Wogera;    Northwest;    Ethiopia;   

DOI  :  10.1186/s12913-023-09629-8

 received in 2022-12-30, accepted in 2023-05-31,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe government of Ethiopia has envisioned digitalizing primary healthcare units through the electronic community health information system (eCHIS) program as a re-engineering strategy aiming to improve healthcare data quality, use, and service provision. The eCHIS is intended as a community-wide initiative to integrate lower health structure with higher administrative health and service delivery unit with the ultimate goal of improving community health. However, the success or failure of the program depends on the level of identifying enablers and barriers of the implementation. Therefore, this study aimed to explore individual and contextual-level enablers and barriers determining eCHIS implementation.MethodWe conducted an exploratory study to determine the enablers and barriers to successfully implementing eCHIS in rural Wogera district, northwest Ethiopia. In-depth interviews and key informant interviews were applied at participants from multiple sites. A thematic content analysis was conducted based on the key themes reported. We applied the five components of consolidated framework for implementation research to interpret the findings.ResultsFirst, based on the intervention's characteristics, implementers valued the eCHIS program. However, its implementation was impacted by the heavy workload, limited or absent network and electricity. Outer-setting challenges were staff turnover, presence of competing projects, and lack of incentive mechanisms. In terms of the inner setting, lack of institutionalization and ownership were mentioned as barriers to the implementation. Resource allocation, community mobilization, leaders’ engagement, and availability of help desk need emphasis for a better achievement. With regard to characteristics of the individuals, limited digital literacy, older age, lack of peer-to-peer support, and limited self-expectancy posed challenges to the implementation. Finally, the importance of mentoring and engaging community and religious leaders, volunteers, having defined plan and regular meetings were identified elements of the implementation process and need emphasis.ConclusionThe findings underlined the potential enablers and barriers of eCHIS program for quality health data generation, use, and service provision and highlighted areas that require emphasis for further scale-up. The success and sustainability of the eCHIS require ongoing government commitment, sufficient resource allocation, institutionalization, capacity building, communication, planning, monitoring, and evaluation.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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