Applying the ICT4H model to understand the challenges for implementing ICT-based health information services in primary healthcare in South Ethiopia.

Abstract

The implementation of Information and Communication Technology (ICT) in the Primary Level Health Care (PLHC) of low-income countries is at the proof-of-concept level. Despite the wide-ranging efforts over the past 35 years, healthcare facilities are grappling with implementation; the essential health information sources are inaccessible. Consequently, the potential benefits are marred by various challenges. Therefore, the aim of this study is to explore the challenges in the implementation of an ICT-Based Health Information system (ICT-BHIS) in the PLHC facilities of Wolaita Zone, South Ethiopia. We conducted an 8-month ethnographic study to develop and validate the Chibs ICT4H model. More specifically, a total of 160 h of observational data along with 21 key informant interviews were collected in the form of field notes and audio records. Both data were transcribed and entered into the Qualitative Data Analysis mine software version 1.4. Building on the constant comparative method of data analysis, we identified initial themes inductively, revisited the ICT4H model, and expanded and collapsed the themes prior to interpretation to generate new meaning. The findings of this study revealed that infrastructures, financial cost, technical constraints, human capital, stakeholders' engagement, and organizational commitment are the pressing challenges PLHC facilities face in the implementation of ICT-based health information services. This implies the need to shift the paradigm/gaze from piecemeals of multiple solo pilot projects to a unified strategy that touches multiple buttons/challenges for the successful implementation of ICT-BHIS in the context of PLHC facilities.