Investigating the Use and Sustainable Adoption of Digital Health Tools for Public Health Emergencies in Primary Healthcare Centres in Northern Nigeria

Download Article

DOI: 10.21522/TIJAR.2014.11.04.Art014

Authors : Maureen O. Anyanwu

Abstract:

There is a dearth of information on factors affecting the use and sustainable adoption of digital health tools by primary healthcare workers. Improved digital health frameworks require more field evidence. We assessed factors affecting the use and sustainable adoption of the digital health tools in primary healthcare centres in Northern Nigeria. A cross-sectional facility-based study was conducted among PHC staff in Abuja, Niger and Nasarawa States. Purposive and simple random sampling were used to collect data from healthcare practitioners using a pretested, semi-structured questionnaire. The study used a Chi-square test for bivariate analysis and Structural Equation Modeling (SEM) for complex relationships between variables. A p-value of less than 0.05 indicated statistical significance and a 95% confidence level. The results showed that age (χ² = 203.64, p < 0.001), sex (χ² = 136.92, p < 0.001), marital status (χ² = 44.64, p < 0.001), education level (χ² = 8.37, p = 0.007), rate of IT knowledge (χ² = 228.22, p < 0.001), profession (χ² = 151.55, p < 0.001), geographical location (χ² = 212.79, p < 0.001) were factors that influenced adoption. There is a significant relationship between perceived usefulness, relative advantage, awareness, data security and the adoption of digital health tools (χ² = 39.57, p < 0.001), (χ² = 123.55, p < 0.001), (χ² = 102.29, p < 0.001), (χ² = 48.26, p < 0.001) respectively. This study found enabling and hindering elements affecting digital health systems. To promote use and sustainable adoption, all stakeholders must actively overcome challenges.

References:

[1].   United Nations. 2015. Resolution adopted by the General Assembly on 25 September 2015. General Assembly (p. 35). Geneva: United Nations.

[2].   World Health Organization. 2021. Public Health Emergencies: Preparedness And Response.

[3].   World Bank Web site: https://datatopics.worldbank.org/world-development-indicators/stories/universal-health-coverage-as-a-sustainable-development-goal.html

[4].   Gavi. (n.d.). International Health Partnership for UHC 2030. From Gavi Website: https://www.gavi.org/our-alliance/global-health-development/international-health-partnership-uhc-2030.

[5].   IFPMA. 2023. How Universal Health Coverage makes SDGs doable. From IFPMA Web site: https://www.ifpma.org/insights/how-universal-health-coverage-makes-sdgs-doable/

[6].   Ohia, C., Ongolo-Zongo, P., & Fawole, O. I. 2021. Digital health information technology utilization for enhanced health services delivery in Africa: Unravelling barriers to adoption among primary healthcare providers. South Eastern European Journal of Public Health.

[7].   World Health Organization. 2021. Global strategy on digital health 2020-2025 . Geneva: World Health Organization.

[8].   World Health Organization. 2022. Early Warning Alert and Response in Emergencies: An operational guide. Geneva: WHO. From WHO Web site.

[9].   Mace, A. 2023. 9 Health Technologies Every Executive Should Be Excited About in 2023. From Healthcare Weekly: https://healthcareweekly.com/health-technologies/

[10].  Dimitropoulous, L. 2021. How Will Emerging Healthcare Technologies Evolve In 2022? From RTI Health Advance: https://healthcare.rti.org/insights/emerging-healthcare-technologies-2022.

[11].  Olu, O., Muneene, D., Bataringaya, J. E.,Turgeon, Y. 2019. How can digital health technologies contribute to sustainable attainment of universal health coverage in Africa? A perspective. Front Public Health.

[12].  Karamagi, H., Muneene, D., Droti, B., Jepchumba, V., Okeibunor, J., Nabyonga, J., Kipruto, H. 2022. eHealth or e-Chaos: The use of Digital Health Interventions for Health Systems Strengthening in sub-Saharan Africa over the last 10 years: A scoping review. J Glob Health.

[13].  World Health Organization. 2018. Progress Report on Utilizing E-Health Solutions to Improve National Health Sytstems in the African Region . WHO.

[14].  Digital Health Africa. 2021. Expanding The Scope of Health Care Services With Effective Digital Health Technologies. From Digital Health Africa Web site: https://www.biihealthtech.com/digihealthafrica/

[15].  O'Brien, N., Li, E., Chaibva, C. N., Gomez Bravo, R., Kovacevic, L., Kwame Ayisi-Boateng, N., & Neves, A. L. 2023. Strengths, Weaknesses, Opportunities, and Threats Analysis of the Use of Digital Health Technologies in Primary Health Care in the Sub-Saharan African Region: Qualitative Study. Journal of Medical Internet Research.

[16].  Mu’awiyyah, et al. 2021. Knowledge attitude and perception of healthcare workers on use of electronic medical records in ahmadu bello university teaching hospital, Zaria, Kaduna State, Northwest Nigeria. J Med Bas Sci Res, 1-12.

[17].  Odekunle, F., Odekunle, R., & Shankar, S. 2017. Why sub-Saharan Africa lags in electronic health record adoption and possible strategies to increase its adoption in this region. Int J Health Sci.

[18].  Guttmacher, S., Vana, P., & Ruiz-Janecko, Y. 2010. Community-Based Health Interventions. Wiley.

[19].  Luna, D; Almerares, A; Mayan, J. C; Bernaldo, F. G; Otero, C. 2014. Health informatics in developing countries: going beyond pilot practices to sustainable implementations: A review of current challenges. Healthcare Informatics Research, 3-10.

[20].  Zayyad, M., & Toycan, M. 2018. Factors affecting sustainable adoption of e-health technology in developing countries: an exploratory survey of Nigerian hospitals from the perspective of healthcare professionals. PeerJ.

[21].  Bryant, J H; Richmond, J E. 2008. Alma-Ata and Primary Health Care: An Evolving Story. Elsevier Press (in press).

[22].  Park, S; Abrams, R. 2019. Alma-Ata 40th birthday celebrations and the Astana Declaration on Primary Health Care 2018. British Journal of General Practice, 220-221.

[23].  United Nations Economic and Social Council. 2022. Progess towards the Sustainable Development Goals. United Nations.

[24].  Kristina, M., Susan, C., & Andrew, B. E. 2017. Real-Time Surveillance in Emergencies Using EWARN. Emerging Infectious Diseases.

[25].  Fatiregun, A. A., & Isere, E. E. 2017. Epidemic preparedness and management: A guide on Lassa fever outbreak preparedness plan. Nigerian Medical Journal: Journal Of The Nigeria Medical Association.

[26].  Long, L. A., Pariyo, G., & Kallander, K. 2018. Digital technologies for health workforce development in low-and middle-income countries: a scoping review. Global Health: Science and Practice, S41-S48.

[27].  Maeda, A., & Socha-Dietrich, K. 2021. Skills for the future health workforce: preparing health professionals for people-centred care. OECD Working Paper.

[28].  Ibeneme, S., Ukor, N., Ongom, M., Dasa, T., Muneene, D., & Okeibunor, J. 2020. Strengthening capacities among digital health leaders for the development and implementation of national digital health programs in Nigeria. BMC Proc, 14(Suppl 10):9.

[29].  My Guide Nigeria. 2023. North Central Region. From My Guide Nigeria Web site: https://www.myguidenigeria.com/regionalinfo/north-central-region

[30].  Granić, A., & & Marangunić, N. 2019. Technology acceptance model in educational context: A systematic literature review. British Journal of Educational Technology, 2572–2593.

[31].  Al-Adwan, A. S., & Berger, H. 2015. Exploring physicians’ behavioural intention toward the adoption of electronic health records: An empirical study from Jordan. International Journal of Healthcare Technology and Management, 89-111.

[32].  Love B., Ayamolowo, L. B., Irinoye, O. O., & Olaniyan, A. S. 2023. Utilization of electronic health records and associated factors among nurses in a faith-based teaching hospital,Ilisan, Nigeria. JAMIA Open.

[33].  World Health Organisation. 2023. Universal Health Coverage. From WHO Website: http://www.who.int/healthsystems/universal_health_coverage/en/

[34].  World Health Organization. 2021. The Global Health Observatory. From WHO Web site: https://www.who.int/data/gho/data/themes/topics/indicator-groups/indicator-group-details/GHO/sdg-target-3.8-achieve-universal-health-coverage-%28uhc%29-including-financial-risk-protection

[35].  Akwaowo, C., Sabi, H., Ekpenyong, N., Isiguzo, C., Andem, N., Maduka, O., Uzoka, F. 2022. Adoption of electronic medical records in developing countries—A multi-state study of the Nigerian healthcare system. Front. Digit. Health.

[36].  Ahmed M. A, M. M. 2022. Assessment of information communication technology and eHealth use amongst healthcare providers in selected primary health centers in Kano, Nigeria. Journal of Basic and Social Pharmacy Research.

[37].  Sanqui, R., & Declaro-Ruedas, M. 2020. Knowledge and attitudes towards healthcare information technology of the rural health workers in SAMARICA, Occidental Mindoro, Philippines. Asian Journal of Education and Social Studies.

[38].  Jain, R., Dupare, R., Bhanushali, N., & Kumar, V. 2020. Knowledge and utilization of computer among health-care professionals in Mumbai. Journal of Indian Association of Public Health Dentistry.

[39].  Shiferaw, K., Tilahun, B., & Endehabtu, B. 2020. Healthcare providers’ digital competency: a cross-sectional survey in a low-income country setting. BMC Health Sevices Research.

[40].  Buchan, J. D. 2017. Health Employment and Economic Growth: An Evidence Base. Geneva: World Health Organization.

[41].  World Health Organization. 2023. Sex distribution of health workers. From WHO Web site: https://apps.who.int/gho/data/node.main.HWFGRP_BYSEX?lang=en

[42].  World Health Organization. 2018. The invisible boys and girls: Understanding barriers to accessing healthcare among disadvantaged Nigerian youth. From WHO Web site: https://www.afro.who.int/news/invisible-boys-and-girls-understanding-barriers-accessing-healthcare-among-disadvantaged

[43].  Okereke, E. U. 2020. Female clients’ gender preferences for frontline health workers who provide maternal, newborn and child health (MNCH) services at primary health care level in Nigeria. BMC Health Serv Res.

[44].  Blondino, C. K. 2024. The use and potential impact of digital health tools at the community level: results from a multi-country survey of community health workers. BMC Public Health.

[45].  Sampson, S. U.-J. 2024. Assessment of the compliance with minimum quality standards by public primary healthcare facilities in Nigeria. Health Res Policy Sys.

[46].  Ogah, P. U. 2024. Primary health care in Nigeria: best practices and quality of care in Nigeria. BMC Health Serv Res.

[47].  Ekenna, A., Itanyi, I., Nwokoro, U., Hirschhorn, L. R., & Uzochukwu, B. 2020. How ready is the system to deliver primary healthcare? Results of a primary health facility assessment in Enugu State, Nigeria. Health Policy and Planning, Pages i97–i106.

[48].  World Health Organization. 2023. Digital tools positively impact health workers’ performance, new WHO study shows. From WHO Web site: https://www.who.int/europe/news/item/27-07-2023-digital-tools-positively-impact-health-workers--performance--new-who-study-shows

[49].  World Health Organization. 2019. Strengthening health workers capacities through digital health. From WHO Web site: https://www.who.int/news/item/09-07-2019-strengthening-health-workers-capacities-through-digital-health

[50].  Owoyemi, A., Osuchukwu, J. I., Azubuike, C., Ikpe, R. K., Nwachukwu, B. C., 2022. Digital Solutions for Community and Primary Health Workers: Lessons From Implementations in Africa. Frontiers in Digital Health.

[51].  Erku, D; Khatri, R; Endalamaw, A; Wolka, E; Nigatu, F; Zewdie, A; Assefa, Y. 2023. Digital Health Interventions to Improve Access to and Quality of Primary Health Care Services: A Scoping Review. Int. J. Environ. Res. Public Health.

[52].  Kenny, G., O’Connor, Y., Eze, E., Ndibuagu, E., & Heavin, C. 2017. A Ground-Up Approach to mHealth in Nigeria: A Study of Primary Healthcare Workers’ Attitude to mHealth Adoption. Procedia Computer Science, pp. 809-816.

[53].  Shekoni, O., Iversen, S., Diaz, G. J., Aune, A., Ubuane, P. O., Imam, Z., & André, B. 2024. Healthcare workers’ perceptions about the use of mobile health technologies in public health facilities in Lagos, Nigeria. SAGE Open Medicine.

[54].  Awokola, B., Abioye-Kuteyi, E., & OA., O. 2022. Computer and internet use by doctors in a Nigerian Teaching Hospital: A survey of the wesley guild unit of Obafemi Awolowo University Teaching Hospitals complex. World Fam Med J.

[55].  Statista. 2024. Electricity Access Rate In The Least Electrified Countries in 2022. From Statista Web site: https://www.statista.com/statistics/264631/number-of-people-without-access-to-electricity-by-region/

[56].  Owhor, G. A., Abdulwahab, A. A., Shomuyiwa, D. O., & Okoli, E. A. 2023. Overview of Digital Health in Sub-Saharan Africa: Challenges and Recommendations. IOSR Journal of Nursing and Health Science (IOSR-JNHS), 19-21.

[57].  Ibeneme, S., Karamagi, H., Muneene, D., Goswami, K., Chisaka, N., & Okeibunor, J. 2022. Strengthening health systems using innovative digital health technologies in Africa. Frontiers in Digital Health.

[58].  Ndayishimiye, C., Lopes, H., & Middleton, J. 2023. A systematic scoping review of digital health technologies during COVID-19: a new normal in primary health care delivery. Health Technol., 273–284.

[59].  Shaw, J., Abejirinde, I.-O., Agarwal, P., Shahid, S., & Martin, D. 2024. Digital health and equitable access to care. PLOS Digit Health.

[60].  Ibrahim, A., Abdel-Aziz, H., & Mohamed, H. e. 2024. Balancing confidentiality and care coordination: challenges in patient privacy. BMC Nurs.

[61].  Federal Ministry of Health. 2022. Digital Pandemic Preparedness Assessment: Country Report-Nigeria. Nigeria.

[62].  Ojo, et al. 2022. ‘Perception of Healthcare Workers on the Integration of Electronic Health Records in Primary Health Centers in Nigeria. CIN - Computers Informatics Nursing, 786-794.

[63].  World Health Organization. 2024. Digital tools can help improve women’s health and promote gender equality, WHO report shows. From WHO Web site: https://www.who.int/europe/news/item/08-03-2024-digital-tools-can-help-improve-women-s-health-and-promote-gender-equality--who-report-shows

[64].  Kipruto, H., Muneene, D., Droti, B., Jepchumba, V., Okeibunor, C. J.-O., & Karamagi, H. C. 2022. Use of Digital Health Interventions in Sub-Saharan Africa for Health Systems Strengthening Over the Last 10 Years: A Scoping Review Protocol. Frontiers in Digital Health.

[65].  Ravi, N., Thomas, C., & Odogwu, J. 2024. How to reload and upgrade digital health to serve the healthcare needs of Nigerians. Frontiers in Digital Health.

[66].  [Naatu, F., Selormey, F., & Naatu, S. 2024. Determinants of digital technology adoption in sub-Sahara Africa: Ghana. International Journal of Emerging Markets.

[67].  Sifat, M. E. 2022. Motivations Toward Using Digital Health and Exploring the Possibility of Using Digital Health for Mental Health in Bangladesh University Students: Cross-sectional Questionnaire Study. JMIR.

[68].  Hossain, A., Quaresma, R., & Rahman, H. 2019. Investigating factors influencing the physicians’ adoption of electronic health record (EHR) in healthcare system of Bangladesh: An empirical study. International Journal of Information Management, 76-87.

[69].  Fowe, I., Adewale, B., & & Oyebanji, O. 2023. Digital Health Technology Awareness and Attitude among Nigerian Health Care Workers during the COVID-19 Pandemic. The Global Health Network Collections.

[70].  Onumajuru, H. D., Hayhoe, R., Kabir, R., & Syed, H. Z. 2024. Digital Health Utilisation in Nigeria: A Scoping Review. AJPHN.

[71].  Kawu, A. A., Elijah, J., Abdullahi, I., Maipanuku, Y. J., Folorunso, S., Basajja, M., Ibrahim, L. H. 2022. FAIR Guidelines and Data Regulatory Framework for Digital Health in Nigeria. Data Intelligence, 174.

[72].  Ahmadi, H. E. 2018. A Narrative Literature Review on the Impact of Organizational Context Perspective on Innovative Health Technology Adoption. Journal of Soft Computing and Decision Support Systems.