Bogale Tariku Nigatu, Teklehaimanot Selamawit Meressa, Fufa Debela Tilahun, Enyew Daniel Berhanie, Nigusse Bedada Abebe, Dufera Kebebew Segni, Nigusie Weldeab Adane, Wolde Daka Dawit, Willems Herman Jozef, Bekele Tadesse Alemu
John Snow, Inc. (JSI), Addis Ababa, Ethiopia.
Department of Health Service Management, School of Public Health, Jimma University, Jimma, Ethiopia.
Front Digit Health. 2023 Jun 7;5:1162239. doi: 10.3389/fdgth.2023.1162239. eCollection 2023.
The electronic community health information system (eCHIS) has been implemented in Ethiopia to support health services delivered by community health workers. Despite the many benefits of digitizing community health information systems, the implementation of the eCHIS is challenged by many barriers resulting in low uptake. This study assessed the barriers, facilitators, and motivators of eCHIS use among health workers with focus on health extension workers (HEWs) in Ethiopia.
Phenomenological approach was used to assess the barriers, facilitators and motivators of eCHIS use in Amhara, Harari, Oromia, Sidama, South West Ethiopia and Southern Nation Nationalities and People's regions of Ethiopia. Data were collected from 15-29 May 2022. A total of 54 face-to-face in-depth interviews were conducted among HEWs, HEW supervisors, health information technicians and managers. The interviews were audiotaped using Open Data Kit, transcribed verbatim and translated into English. OpenCode 4.03 software was used for coding and categorizing the data. Thematic analysis was used to analyze the data.
The HEWs and other eCHIS users reported lack of infrastructure and resources; poor quality of training, follow-up, and supervision; parallel recording using the manual and electronic system; and HEWs' workload as barriers hindering eCHIS use. Data quality, retrievability, and traceability; tablet portability; encouragement from supervisors; and positive image in the community resulting from HEWs using tablets in their routine activities were the main facilitators of eCHIS use.
The study identified various barriers that adversely affect the use of eCHIS. An integrated and coordinated approach to eCHIS implementation that encompasses removing the barriers, and reinforcing facilitators is required.
埃塞俄比亚已实施电子社区健康信息系统（eCHIS），以支持社区卫生工作者提供的卫生服务。尽管社区健康信息系统数字化有诸多好处，但eCHIS的实施面临许多障碍，导致其使用率较低。本研究评估了埃塞俄比亚卫生工作者（重点是健康推广工作者[HEW]）使用eCHIS的障碍、促进因素和动机。
采用现象学方法评估阿姆哈拉、哈拉里、奥罗米亚、希达莫、埃塞俄比亚西南部以及埃塞俄比亚南方民族和人民地区使用eCHIS的障碍、促进因素和动机。于2022年5月15日至29日收集数据。对HEW、HEW监督员、健康信息技术人员和管理人员共进行了54次面对面深入访谈。访谈使用开放数据工具包进行录音，逐字转录并翻译成英文。使用OpenCode 4.03软件对数据进行编码和分类。采用主题分析法对数据进行分析。
HEW和其他eCHIS用户报告称，缺乏基础设施和资源；培训、跟进和监督质量差；同时使用手动和电子系统进行记录；以及HEW的工作量是阻碍eCHIS使用的障碍。数据质量、可检索性和可追溯性；平板电脑的便携性；监督员的鼓励；以及HEW在日常活动中使用平板电脑在社区中树立的正面形象是eCHIS使用的主要促进因素。
该研究确定了各种对eCHIS使用产生不利影响的障碍。需要采取一种综合协调的方法来实施eCHIS，包括消除障碍和强化促进因素。
