Barriers to the Digitization of Health Information: A Qualitative and Quantitative Study in Kenya and Lao PDR Using a Cloud-Based Maternal and Child Registration System

Tarek Numair, Daniel Toshio Harrell, Nguyen Tien Huy, Futoshi Nishimoto, Yvonne Muthiani, Samson Muuo Nzou, Angkhana Lasaphonh, Khomsonerasinh Palama, Tiengkham Pongvongsa, Kazuhiko Moji, Kenji Hirayama and Satoshi Kaneko
Additional contact information
Tarek Numair: Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523, Japan
Daniel Toshio Harrell: Department of Ecoepidemiology, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan
Nguyen Tien Huy: School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8523, Japan
Futoshi Nishimoto: School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8523, Japan
Yvonne Muthiani: Nairobi Research Station, Nagasaki University-Institute of Tropical Medicine—Kenya Medical Research Institute (NUITM-KEMRI) Project, Nairobi 19993-00202, Kenya
Samson Muuo Nzou: Nairobi Research Station, Nagasaki University-Institute of Tropical Medicine—Kenya Medical Research Institute (NUITM-KEMRI) Project, Nairobi 19993-00202, Kenya
Angkhana Lasaphonh: Savannakhet Provincial Health Department, Savannakhet 13000, Laos
Khomsonerasinh Palama: Savannakhet Provincial Health Department, Savannakhet 13000, Laos
Tiengkham Pongvongsa: Savannakhet Provincial Health Department, Savannakhet 13000, Laos
Kazuhiko Moji: School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8523, Japan
Kenji Hirayama: Department of Immunogenetics, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan
Satoshi Kaneko: Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523, Japan

IJERPH, 2021, vol. 18, issue 12, 1-15

Abstract: Digitalization of health information can assist patient information management and improve health services even in low middle-income countries. We have implemented a mother and child health registration system in the study areas of Kenya and Lao PDR to evaluate barriers to digitalization. We conducted in-depth interviews with 20 healthcare workers (HCWs) who used the system and analyzed it qualitatively with thematic framework analysis. Quantitatively, we analyzed the quality of recorded data according to missing information by the logistic regression analysis. The qualitative analysis identified six themes related to digitalization: satisfaction with the system, mothers’ resistance, need for training, double work, working environment, and other resources. The quantitative analysis showed that data entry errors improved around 10% to 80% based on odds ratios in subsequent quarters compared to first quarter periods. The number of registration numbers was not significantly related to the data quality, but the motivation, including financial incentives among HCWs, was related to the registration behavior. Considering both analysis results, workload and motivation to maintain high performance were significant obstacles to implementing a digital health system. We recommend enhancing the scope and focus on human needs and satisfaction as a significant factor for digital system durability and sustainability.

Keywords: mother and child health; health record digitalization; antenatal care; postnatal care; cloud-based system (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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