A Cross-case Analysis of the Effects of EMR Deployment on Antenatal Care Services in Rural Health Centres in Malawi

Abstract

Background and Purpose : The use of Electronic Medical Records in developing countries is considered important for monitoring and facilitating the achievement of health-related Millennium Development Goals. Many studies have analysed the effects of EMRs in supporting care provision in hospitals, mostly with a focus on HIV/AIDS services. However, there are limited studies on EMR use for maternal health services in small primary care facilities in rural settings. This paper aims to address this gap by presenting findings from evaluation of two EMR systems implemented to support Antenatal care in two rural health centres in Malawi. Methods : This study was undertaken as part of an Action Research project exploring the use of EMRs in Malawi. The paper presents a qualitative analysis of the effects of EMRs on Antenatal care services in two rural health centres. Data was collected through interviewing end-users and pregnant women, participant observation of health services, and analysis of Antenatal care data. Results : The study reveals that EMRs have the effects of redistributing work and increasing collaboration among different types of health workers; increasing attention and knowledge on the health domain, and redistributing risks in care and data quality. Conclusions : The findings highlight the need for EMR system designs that support coordination of work and provide for easy correction of errors. The study also shows that introducing EMRs can facilitate learning about the healthcare domain in addition to gaining computer skills. Keywords: Antenatal care, EMR systems, evaluation, effects, rural health centres, developing countries, Malawi, qualitative research.