Adoption of eHealth for community monitoring of TB/HIV services and its predictors among staff of Non-Government Organizations in Kampala, Uganda

Abstract

Background: The use of electronic data capture and digital health technologies can greatly improve patient healthcare outcomes, through augmenting diagnosis, prescription and treatment, and patient-centered care. The global strategy on digital health (2020-2025) by the World Health Organization fronts the use of eHealth as important for the achievement of health goals. However, adoption by human resources meant to primarily use it to capture data is still sub-optimal. This study sought to assess the current level of adoption and use of eHealth for community monitoring of TB/HIV services and its predictors among NGO staff in Kampala.

Methods: A cross-sectional study was carried out among 110 staff who were using eHealth in nine clinics from five NGOs providing HIV/TB services in Kampala using quantitative methods of data collection and 9key informant interviews. Quantitatively, interviewer-administered questionnaires were used to collect data. A key informant interview guide was used to collect qualitative data. Quantitative data were analyzed using STATA version 14. Logistic regression was used to determine the factors associated with adoption of eHealth at 95% CI. Qualitative data were analyzed using thematic analysis approach.

Results: Majority of the participants were females (61.8%), not in union (44.3%) and had a mean age of 33.6 years (SD=7.6). Majority had worked in their respective organizations for at least 3 months and attained an education level of a diploma (46.1%). Four out of nine clinics used eHealth at community level. Factors associated with eHealth use included data accuracy [AOR 0.04, 95% CI0.00-0.63)], and interoperability [(AOR0.26, (95% CI 0.08-0.034)]. Other factors facilitating adoption and use included gender, readiness to use, user-friendliness, operation awareness, user-friendliness, having features customized to TB/HIV data capture, training, real-time support and collegial support. The key challenges reported included system slowness, the burden of double entry, human resource gap, limited technology infrastructure, and slow response from technical teams.

Conclusion: Adoption of eHealth for use at community level was low among NGOs offering TB/HIV services. This was attributed to gadget security concerns and lack of the required technology infrastructure. Availing the required infrastructure and offering routine training and real-time technical support to staff mandated to use the systems will improve adoption and usage of eHealth.