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Article

Barriers to the Digitization of Health Information: A Qualitative and Quantitative Study in Kenya and Lao PDR Using a Cloud-Based Maternal and Child Registration System

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Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523, Japan
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Department of Ecoepidemiology, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan
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Dell Medical School, The University of Texas in Austin, Austin, TX 78712, USA
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School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8523, Japan
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Nairobi Research Station, Nagasaki University-Institute of Tropical Medicine—Kenya Medical Research Institute (NUITM-KEMRI) Project, Nairobi 19993-00202, Kenya
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Health Sciences Unit, Faculty of Social Sciences, Tampere University, 33014 Tampere, Finland
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Centre for Microbiology Research, Kenya Medical Research Institute (KEMRI), Nairobi 54840-00200, Kenya
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Savannakhet Provincial Health Department, Savannakhet 13000, Laos
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Department of Immunogenetics, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan
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Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Int. J. Environ. Res. Public Health 2021, 18(12), 6196; https://doi.org/10.3390/ijerph18126196
Received: 7 May 2021 / Revised: 29 May 2021 / Accepted: 4 June 2021 / Published: 8 June 2021
Digitalization of health information can assist patient information management and improve health services even in low middle-income countries. We have implemented a mother and child health registration system in the study areas of Kenya and Lao PDR to evaluate barriers to digitalization. We conducted in-depth interviews with 20 healthcare workers (HCWs) who used the system and analyzed it qualitatively with thematic framework analysis. Quantitatively, we analyzed the quality of recorded data according to missing information by the logistic regression analysis. The qualitative analysis identified six themes related to digitalization: satisfaction with the system, mothers’ resistance, need for training, double work, working environment, and other resources. The quantitative analysis showed that data entry errors improved around 10% to 80% based on odds ratios in subsequent quarters compared to first quarter periods. The number of registration numbers was not significantly related to the data quality, but the motivation, including financial incentives among HCWs, was related to the registration behavior. Considering both analysis results, workload and motivation to maintain high performance were significant obstacles to implementing a digital health system. We recommend enhancing the scope and focus on human needs and satisfaction as a significant factor for digital system durability and sustainability. View Full-Text
Keywords: mother and child health; health record digitalization; antenatal care; postnatal care; cloud-based system mother and child health; health record digitalization; antenatal care; postnatal care; cloud-based system
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MDPI and ACS Style

Numair, T.; Harrell, D.T.; Huy, N.T.; Nishimoto, F.; Muthiani, Y.; Nzou, S.M.; Lasaphonh, A.; Palama, K.; Pongvongsa, T.; Moji, K.; Hirayama, K.; Kaneko, S. Barriers to the Digitization of Health Information: A Qualitative and Quantitative Study in Kenya and Lao PDR Using a Cloud-Based Maternal and Child Registration System. Int. J. Environ. Res. Public Health 2021, 18, 6196. https://doi.org/10.3390/ijerph18126196

AMA Style

Numair T, Harrell DT, Huy NT, Nishimoto F, Muthiani Y, Nzou SM, Lasaphonh A, Palama K, Pongvongsa T, Moji K, Hirayama K, Kaneko S. Barriers to the Digitization of Health Information: A Qualitative and Quantitative Study in Kenya and Lao PDR Using a Cloud-Based Maternal and Child Registration System. International Journal of Environmental Research and Public Health. 2021; 18(12):6196. https://doi.org/10.3390/ijerph18126196

Chicago/Turabian Style

Numair, Tarek, Daniel T. Harrell, Nguyen T. Huy, Futoshi Nishimoto, Yvonne Muthiani, Samson M. Nzou, Angkhana Lasaphonh, Khomsonerasinh Palama, Tiengkham Pongvongsa, Kazuhiko Moji, Kenji Hirayama, and Satoshi Kaneko. 2021. "Barriers to the Digitization of Health Information: A Qualitative and Quantitative Study in Kenya and Lao PDR Using a Cloud-Based Maternal and Child Registration System" International Journal of Environmental Research and Public Health 18, no. 12: 6196. https://doi.org/10.3390/ijerph18126196

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