MULTI DIMENSIONAL MODEL FOR E-HEALTH IMPLEMENTATION IN PUBLIC HEALTH CARE FACILITIES: A CASE OF EASTERN UGANDA

Abstract

Healthcare systems consist of mechanisms intended to provide medical care, advance public health and guarantee that everyone has access to healthcare resources. The challenges facing the public healthcare sector in developing countries are mainly associated with weak healthcare systems. Weak and poor-quality health information systems contribute to failure of information flow across integrated health systems pathways; hence there is growing need to strengthen the components of Health Information Systems. It is also agreeable that health information systems have immense benefits, yet their implementations vary greatly among different countries; hence benefits to beneficiary translational gap. It is further notable that, the adoption, diffusion, acceptance and utilization of this innovation in the healthcare context are lagging. The study addressed these concerns by examining the factors influencing eHealth in public healthcare facilities and develop a multi-dimensional model for eHealth implementation in developing countries, a case of eastern Uganda. This was achieved through a survey, encompassing both quantitative and qualitative strategies. Three healthcare facility study sites were identified through predetermined selection criteria in Eastern Uganda region. The respondents cut across the different cadres of health workers, administrator, and IT staff. The collected quantitative data was descriptively and inferentially analyzed, through different analytical techniques using STATAv17, while qualitative data was thematically analyzed. From the identified study sites, key leaders were identified to respond to interview questions for qualitative data. IT personnel were interviewed to give expert response. Further, observation protocol aided data collection which equally was analyzed qualitatively, together with documents analysis. A significance test of the model components was done from which the following results were observed social factors with p-value = 0.000, Organisational factors had a p-value = 0.012, Environmental factors with a p-value = 0.024 and Technological factors that had a p-value = 0.047. A multi dimensional model was developed from the study’s outcomes to guide and support effective eHealth implementation. The model was informed by a conceptual framework which was tested and validated using a structural equation model.