Evidence from the field (health facility case studies) in Uganda

In terms of scope, the four districts covered per region are; Mbale (Eastern region), Gulu (Northern region), Kabarole (Western region), and Kampala (Central region). These are districts identified for potential pilot or trial of a comprehensive and integrated digitalized medical record system by Infotower East Africa/Uganda. High volume health facilities (hospitals – both referral and general hospitals; and HCIVs) within each of the four districts were covered in the study. In addition, some high volume HCIIIs were also included, especially in cases where a district had only one HCIV for example in Gulu. However, in instances where data could not be accessed from a hospital or HCIV, such facilities were replaced with HCIIIs (e.g. in Mable and Kabarole).
Out of the 11 health facilities covered, five were HCIIIs, located in areas where each facility serves catchment population of 12,000 – 50,000 people . Three of the facilities were HCIVs, and each of them serve between 22,000 – 143,000 people. The rest were hospitals – one general hospital, one regional referral, and one national referral. The regional referral hospital serves about 1.8 million people, and the national referral is designed to serve the entire country.
The case study respondents comprised of health facility staff who are directly involved in medical data (record) generation and report compilation. Majority (70%) were Medical Record Assistants or data/HMIS officers (Table 3). The rest were clinicians such as nurses and midwives, and health facility administrators whose responsibilities include medical record management. On average, they have spent 6 years in their current positions. There was a random perfect balance of gender (male – 50%, female – 50%), and the average age of the respondents in complete years was 39. Majority had tertiary or university education (90%), while the rest were educated up to secondary level. Those that reported working with both paper-based and EMR system comprised of 70% (Table 3), although most of the involvement in using EMR systems (such as OpenMRS and DHIS2) starts after data have been captured manually using papers/HMIS forms, and for the case of DHIS2, it starts after manually aggregating data in HMIS reporting forms. The rest of the respondents work only with paper-based systems (30%), and none works with only EMR. For those who have ever worked with any form of EMR systems, their average years of experience with the systems is five – the highest level of experience is 13 years, and the least is 2 years.
Reasearch conducted by Our Researchers.#InfoTower EastAfrica.



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