Abstract
Several studies have explored the barriers and facilitators of eHealth adoption in Uganda but hardly any literature investigating these factors using a Systems Thinking perspective, which is the purpose of this study. A search for articles was done in several databases and only 35 articles were fit for the study. Five group model-building sessions were conducted to synthesize the data. As a result, six causal loop diagrams were constructed to provide a theoretical insight of the causation between the different factors. The study revealed that training users in Information and Communication Technology (ICT) improves their digital literacy and general awareness about ICT, which improves their knowledge of telemedicine and subsequently changes their attitude towards the use of eHealth systems. The eHealth trajectory in Uganda is still in its infancy hence, it is imperative for key players in the sector to painstakingly consider the contextual barriers of eHealth and capitalize on the facilitators if eHealth ensue.
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References
Silva, B.M., Rodrigues, J.J., de la Torre DÃez, I., López-Coronado, M., Saleem, K.: Mobile-health: A review of current state in 2015. J. Biomed. Inf. 56, 265–272 (2015). https://doi.org/10.1016/j.jbi.2015.06.003
Namatovu, H.K.: Enhancing antenatal care decisions among expectant mothers in Uganda Namatovu. Hasifah Kasujja Publisher’s PDF, also known as Version of record Publication date. University of Groningen, Groningen (2018)
Zanden, V.A.: WinSenga. Mobile Smartphone-based Electronic Foetal Heart Rate Monitor (2014). https://winsenga.wordpress.com
Boyd: WinSenga. A Mobile Ear for Pregnancy Problems (2012)
Fazekas, R., Moffett, J.: Communication with Youth: Using the Internet and Mobile Phones in Reproductive Health Problems (2009)
Kiberu, V.M., Matovu, J.K., Makumbi, F., Kyozira, C., Mukooyo, E., Wanyenze, R.K.: Strengthening district-based health reporting through the district health management information software system: the Ugandan experience. BMC Med. Inf. Decis. Making 14(1), 1–9 (2014)
Kakaire, S., Mwagale, F.: Mobile Health Projects in Uganda - Narrative Report This report was completed for the inSCALE project by Sauda 2010 (2010)
Ministry of Health: Building a Strong and Interoperable Digital Health Information System for (2019)
Kiberu, V.M., Mars, M., Scott, R.E.: Barriers and opportunities to implementation of sustainable e-Health programmes in Uganda: a literature review. Afr. J. Primary Health Care Fam. Med. 9(1), 1–10 (2017). https://doi.org/10.4102/phcfm.v9i1.1277
Farzianpour, F., Amirian, S., Byravan, R.: An investigation on the barriers and facilitators of the implementation of electronic health records (EHR). Health 7(12), 1665–1670 (2015). https://doi.org/10.4236/health.2015.712180
Juma, K.: Current status of e-Health in Kenya and emerging global research trends. Int. J. Inf. Commun. Technol. Res. 2(1) (2012)
Alvarez, R.C.: The promise of e-Health–a Canadian perspective. ehealth Int. 1, 1–6 (2002)
World Health Organization, WHO guideline (2019)
Alkhaldi, B., Sahama, T., Huxley, C., Gajanayake, R.: Barriers to implementing eHealth: a multi-dimensional perspective. e-Health Continuity Care 875–879 (2014)
Ministry of Health: Republic of Uganda Ministry of Health Uganda National eHealth Policy November 2016 (2016)
Kearney, A.: Improving the evidence for mobile health
Philbrick, W.C.: mHealth and MNCH : State of the Evidence (2013)
Al-Masri, R.A., Spyridopoulos, T., Karatzas, S., Lazari, V., Tryfonas, T.: A systems approach to understanding geopolitical tensions in the middle east in the face of a global water shortage. Int. J. Syst. Dyn. Appl. 10(4), 1–23 (2021). https://doi.org/10.4018/ijsda.289431
Kizito, A., Semwanga, A.R.: Modeling the complexity of road accidents prevention. Int. J. Syst. Dyn. Appl. 9(2), 24–41 (2020). https://doi.org/10.4018/ijsda.2020040102
Zelinka, D., Amadei, B.: A systems approach for modeling interactions among the sustainable development goals Part 2. Int. J. Syst. Dyn. Appl. 8(1), 41–59 (2019). https://doi.org/10.4018/ijsda.2019010103
Zelinka, D., Amadei, B.: Systems approach for modeling interactions among the sustainable development goals Part 1. Int. J. Syst. Dyn. Appl. 8(1), 23–40 (2018). https://doi.org/10.4018/ijsda.2019010102
Abdollahi, H., Ebrahimi, S.B.: Modeling and investigating the economy and production structure of iran public theater. Int. J. Syst. Dyn. Appl. 8(1), 60–78 (2018). https://doi.org/10.4018/ijsda.2019010104
Shanbhag, N., Pardede, E.: The dynamics of product development in software startups. Int. J. Syst. Dyn. Appl. 8(2), 51–77 (2019). https://doi.org/10.4018/ijsda.2019040104
Namatovu, H.K., Semwanga, A.R.: A systems dynamics approach to understanding the determinants of antenatal care utilization in low-and middle-income countries. Int. J. Syst. Dyn. Appl. 9(4), 111–128 (2020). https://doi.org/10.4018/ijsda.2020100106
Bridgeland, D.M., Zahavi, R.: Business simulation. In: Business Modeling. A Practical Guide to Realizing Business Value, pp. 291–343. The MK/OMG Press (2009)
Pagoni, E.G., Patroklos, G.: A system dynamics model for the assessment of national public–private partnership programmes’ sustainable performance. Simul. Model. Pract. Theory 97, 101949 (2019)
Angues, R.V., et al.: A real-time medical cartography of epidemic disease ( Nodding syndrome ) using village- based lay mHealth reporters. PLoS Negl. Trop. Dis. 12(6), 1–20 (2018)
Yagos, W.O., Tabo Olok, G., Ovuga, E.: Use of information and communication technology and retention of health workers in rural post-war conflict Northern Uganda: findings from a qualitative study. BMC Med. Inf. Decis. Making 17(1), 1–8 (2017). https://doi.org/10.1186/s12911-016-0403-3
Muhaise, H., Kareyo, M., Muwanga-Zake, J.W.F.: Factors influencing the adoption of electronic health record systems in developing countries: A case of Uganda. Am. Sci. Res. J. Eng. Technol. Sci. (ASRJETS) 61(1), 160–166 (2019)
Olok, G.T., Yagos, W.O., Ovuga, E.: Knowledge and attitudes of doctors towards e-health use in healthcare delivery in government and private hospitals in Northern Uganda: A cross-sectional study. BMC Med. Inform. Decis. Mak. 15(1), 10 (2015). https://doi.org/10.1186/s12911-015-0209-8
Destigter, K.: A Successful Obstetric Care Model in Uganda, pp. 41–44 (2012)
Isabalija, S.R., Mayoka, K.G., Rwashana, A.S., Mbarika, V.W.: Factors affecting adoption, implementation and sustainability of telemedicine information systems in Uganda. J. Health Inf. Dev. Countries 5(2), 299–316 (2011)
Kabukye, J.K., de Keizer, N., Cornet, R.: Assessment of organizational readiness to implement an electronic health record system in a low-resource settings cancer hospital: A cross-sectional survey. PLoS ONE 15(6), 1–17 (2020). https://doi.org/10.1371/journal.pone.0234711
Namatovu, H.K., Oyana, T.J.: ICT uptake as a determinant of antenatal care utilization in Uganda. Int. J. ICT Res. Africa Middle East 10(1), 11–32 (2021). https://doi.org/10.4018/ijictrame.2021010102
Wandera, S.O., et al.: Facilitators, best practices and barriers to integrating family planning data in Uganda’s health management information system. BMC Health Serv. Res. 19(1), 1–13 (2019). https://doi.org/10.1186/s12913-019-4151-9
Uganda Ministry of Health: Uganda National eHealth Policy:Ministry of Health, p. 35 (2016)
Kiberu, V.M., Mars, M., Scott, R.E.: Development of an evidence-based e-health readiness assessment framework for Uganda. Health Inf. Manage. J. 50(3), 140–148 (2021). https://doi.org/10.1177/1833358319839253
Meyer, A.J., et al.: Implementing mhealth interventions in a resource-constrained setting: case study from Uganda. JMIR mHealth uHealth 8(7), 10 (2020). https://doi.org/10.2196/19552
Cargo, K., Merry, M., Viljoen, P.: Mobile for Development (2015)
Konduri, N., et al.: Digital health technologies to support access to medicines and pharmaceutical services in the achievement of sustainable development goals. Digit. Health 4, 1–26 (2018). https://doi.org/10.1177/2055207618771407
Huang, K., et al.: Use of technology to promote child behavioral health in the context of pediatric care: a scoping review and applications to low- and middle-income countries. Front. Psychiatry 10, 806 (2019). https://doi.org/10.3389/fpsyt.2019.00806
Roberts, S., Birgisson, N., Julia Chang, D., Koopman, C.: A pilot study on mobile phones as a means to access maternal health education in eastern rural Uganda. J. Telemed. Telecare 21(1), 14–17 (2015). https://doi.org/10.1177/1357633X14545433
Mangwi Ayiasi, R., Atuyambe, L.M., Kiguli, J., Orach, C.G., Kolsteren, P., Criel, B.: Use of mobile phone consultations during home visits by community health workers for maternal and newborn care: community experiences from Masindi and Kiryandongo districts Uganda global health. BMC Publ. Health 15(1), 1–13 (2015). https://doi.org/10.1186/s12889-015-1939-3
Namatovu, H.K., Oyana, T.J., Sol, H.G.: Barriers to eHealth adoption in routine antenatal care practices: Perspectives of expectant mothers in Uganda–A qualitative study using the unified theory of acceptance and use of technology model. Digit. Health 7(1–20), 2021 (2021). https://doi.org/10.1177/20552076211064406
Huang, F., Blaschke, S., Lucas, H.: Beyond pilotitis: Taking digital health interventions to the national level in China and Uganda. Global. Health 13(1), 1–11 (2017). https://doi.org/10.1186/s12992-017-0275-z
Baryashaba, A., Musimenta, A., Mugisha, S., Binamungu, L.: Metadata of the chapter that will be visualized in online. In: Information and Communication Technologies for Development. Strengthening Southern-Driven Cooperation as a Catalyst for ICT4D (2009)
Matin, S.B., et al.: Feasibility of a mobile health tool for mothers to identify neonatal illness in rural Uganda: acceptability study. JMIR mHealth uHealth 8(2), e16426 (2020). https://doi.org/10.2196/16426
Ggita, J.M., et al.: Patterns of usage and preferences of users for tuberculosis-related text messages and voice calls in Uganda. Int. J. Tuberc. Lung Dis. 22(5), 530–536 (2019). https://doi.org/10.5588/ijtld.17.0521.Patterns
Campbell, J.I., et al.: The technology acceptance model for resource-limited settings (TAM-RLS): a novel framework for mobile health interventions targeted to low-literacy end-users in resource-limited settings. AIDS Behav. 21(11), 3129–3140 (2017). https://doi.org/10.1007/s10461-017-1765-y
Isabalija, S.R., Mbarika, V., Kituyi, G.M.: A framework for sustainable implementation of E-medicine in transitioning countries. Int. J. Telemed. Appl. 2013 (2013). https://doi.org/10.1155/2013/615617
Larocca, A., Moro Visconti, R., Marconi, M.: Malaria diagnosis and mapping with m-Health and geographic information systems (GIS): evidence from Uganda. Malar. J. 15(1), 1–12 (2016). https://doi.org/10.1186/s12936-016-1546-5
Boatin, A., Ngonzi, J., Bradford, L., Wylie, B., Hospital, M.G., Medical, H.: Education across two continents. Open J. Obstet. Gynecol. 5(13), 754–761 (2015). https://doi.org/10.4236/ojog.2015.513106.Teaching
Kiberu, V.M., Scott, R.E., Mars, M.: Assessing core, e-learning, clinical and technology readiness to integrate telemedicine at public health facilities in Uganda: a health facility–based survey. BMC Health Serv. Res. 19, 1–11 (2019)
Chang, L.W., Njie-Carr, V., Kalenge, S., Kelly, J.F., Bollinger, R.C., Alamo-Talisuna, S.: Perceptions and acceptability of mHealth interventions for improving patient care at a community-based HIV/AIDS clinic in Uganda: a mixed methods study. AIDS Care 25(7), 874–880 (2013). https://doi.org/10.1080/09540121.2013.774315.Perceptions
Okunade, K., et al.: Understanding data and information needs for palliative cancer care to inform digital health intervention development in Nigeria, Uganda and Zimbabwe: protocol for a multicountry qualitative study. BMJ Open 9(10), 1–9 (2019). https://doi.org/10.1136/bmjopen-2019-032166
US State Department: PEPFAR Uganda Country Operational Plan (COP) 2019 Strategic Direction Summary (2019)
Acknowledgement
I would like to extend sincere gratification to the Government of Uganda, through the Makerere University, Research and Innovations Fund for funding this research. In addition, gratitude goes out to the research assistants who helped in the literature search and synthesis.
Funding
This research received funding from the Government of Uganda through the Makerere University Research and Innovations Fund.
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Namatovu, H.K., Magumba, M.A. (2023). Deciphering Barriers and Facilitators of eHealth Adoption in Uganda Using the Systems Thinking Approach - A Systematic Review. In: Saeed, R.A., Bakari, A.D., Sheikh, Y.H. (eds) Towards new e-Infrastructure and e-Services for Developing Countries. AFRICOMM 2022. Lecture Notes of the Institute for Computer Sciences, Social Informatics and Telecommunications Engineering, vol 499. Springer, Cham. https://doi.org/10.1007/978-3-031-34896-9_14
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