Daka Dawit Wolde, Senay Asaye Birhanu, Abdi Ketema Lemma, Yilma Tesfahun Melese, Taddese Asefa Adimasu, Mamuye Adane Letta, Endehabtu Berhanu Fikadie, Abraham Loko, Tadesse Rabeal, Melkamu Gemechis, Wendrad Naod, Kaba Oli, Mohammed Mesoud, Jebessa Matebu Gezahegn, Kumala Chaluma, Kebede Eyerusalem, Wordofa Muluemebet Abera, Alemayehu Yibeltal Kiflie
Department of Health Policy and Management, Jimma University, Jimma, Ethiopia.
Capacity Building and Mentorship Program, Jimma University, Jimma, Ethiopia.
Health Res Policy Syst. 2025 Sep 1;23(1):109. doi: 10.1186/s12961-025-01355-3.
BACKGROUND: Assessing the maturity level of digital solutions and the ability of digital systems to meet the changing needs and demands related to their purposes is essential. Despite Ethiopia's significant efforts in expanding the electronic Community Health Information System (eCHIS), the results have been below expectations, varying by location and hindered by several issues. This research aimed to evaluate the current maturity status, identify implementation gaps and propose future directions for improving eCHIS in Ethiopia. METHODS: Through a consultative workshop, a collaborative assessment was carried out with the participation of key stakeholders and experts. The Stages of Continuous Improvement (SOCI) tool was used to measure maturity levels in 39 subcomponents, 13 components and 5 core domains. The evaluation focussed on the leadership and governance of the digital health system, human resources, information and communication technology (ICT) infrastructure, interoperability and data quality and use. The measurement scales used were Emerging, Repeatable, Defined, Managed and Optimized. RESULTS: The current maturity status of eCHIS is rated as repeatable (2.24/5) and aims to improve to the defined state (3.75/5) by 2025. Comparatively, the leadership and governance domain had the highest level of maturity (2.67/5), followed by the standards and interoperability domain (2.47/5) and the data quality and use domain (2.28/5). The ICT infrastructure (1.67/5) and management and workforce (2.09/5) domains have the lowest level of maturity. Strengths include the presence of a comprehensive HIS strategic plan, updated standard guidelines and operational manuals, a defined organizational structure and processes for eCHIS, defined data management, reporting and use procedures, monitoring and evaluation (M&E) mechanisms for eCHIS and central eCHIS infrastructure capacity. Areas of improvement in the digital solution included the absence of certain aspects such as a standard eCHIS training curriculum (both pre-service and in-service), reliable power supply and connectivity at health facilities, robust business continuity plans, a multiyear budget and a skilled workforce. Furthermore, weaknesses were also found in the enforcement of existing laws, regulations and policies, as well as leadership and coordination within the eCHIS program at lower levels. CONCLUSIONS: The implementation status of eCHIS in Ethiopia was at the repeatable stage, with the ICT infrastructure domain having the lowest level of maturity compared with the other four domains. By 2025, the current maturity status was planned to advance to the defined stage by addressing the identified gaps. To achieve this maturity level, various action points are suggested.
背景:评估数字解决方案的成熟度水平以及数字系统满足与其目的相关的不断变化的需求的能力至关重要。尽管埃塞俄比亚在扩展电子社区卫生信息系统(eCHIS)方面做出了巨大努力,但其结果却未达预期,因地点而异且受到若干问题的阻碍。本研究旨在评估埃塞俄比亚eCHIS的当前成熟度状况,识别实施差距并提出未来改进方向。 方法:通过一次协商研讨会,在关键利益相关者和专家的参与下进行了协作评估。使用持续改进阶段(SOCI)工具来衡量39个子组件、13个组件和5个核心领域的成熟度水平。评估重点关注数字健康系统的领导与治理、人力资源、信息与通信技术(ICT)基础设施、互操作性以及数据质量与使用。所使用的衡量标准为新兴、可重复、已定义、可管理和优化。 结果:eCHIS的当前成熟度状况被评为可重复(2.24/5),目标是到2025年提升至已定义状态(3.75/5)。相比之下,领导与治理领域的成熟度水平最高(2.67/5),其次是标准与互操作性领域(2.47/5)以及数据质量与使用领域(2.28/5)。ICT基础设施(1.67/5)以及管理与劳动力(2.09/5)领域的成熟度水平最低。优势包括存在全面的医院信息系统(HIS)战略计划、更新的标准指南和操作手册、为eCHIS定义的组织结构和流程、定义的数据管理、报告和使用程序、eCHIS的监测与评估(M&E)机制以及中央eCHIS基础设施能力。数字解决方案的改进领域包括缺乏某些方面,如标准的eCHIS培训课程(职前和在职)、卫生设施可靠的电力供应和连接、强大的业务连续性计划、多年预算以及熟练的劳动力。此外,在现有法律法规和政策的执行以及eCHIS项目在较低层面的领导与协调方面也发现了弱点。 结论:埃塞俄比亚eCHIS的实施状况处于可重复阶段,与其他四个领域相比,ICT基础设施领域的成熟度水平最低。到2025年,计划通过解决已识别的差距将当前成熟度状况提升至已定义阶段。为实现这一成熟度水平,提出了各种行动要点。
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