Skip to main content
SpringerLink
Log in

Barriers and Facilitators of eHealth Adoption Among Patients in Uganda – A Quantitative Study

  • Conference paper
  • First Online:
Towards new e-Infrastructure and e-Services for Developing Countries (AFRICOMM 2022)

Abstract

The adoption of eHealth has not made great strides in Uganda especially among patients despite its potential in improving patient outcomes through access to care, patient engagement and its ability to reduce unnecessary hospital visits. Previous studies have focused on barriers and facilitators of eHealth in general. None has examined the adoption of eHealth among patients in Uganda, which was the focus of this study. A cross-sectional survey was conducted in four districts across the country. Two hundred ninety two patients of 18 years and above participated in the study and their selection was through simple random sampling. The bivariate analysis results revealed that education level (χ2 = 14.9, ρ < 0.05), gender (χ2 = 4.95, ρ < 0.05) and location (χ2 = 85.9, ρ < 0.05) have a statistical significant relationship with eHealth adoption. The logistic regression model further revealed that male patients (OR = 2.662), those with master’s degree and above (OR = 2.2797) and those residing in Kampala (OR = .012) were more likely to use eHealth systems than their counterparts. The success of eHealth requires players in the health sector to ardently focus on the socio-demographic factors of the users, technological and hospital conditions if eHealth adoption is to ensue.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Silva, B.M., Rodrigues, J.J., de la Torre Díez, 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

    Article  Google Scholar 

  2. World Health Organization: WHO guideline (2019)

    Google Scholar 

  3. Barbabella, F., Melchiorre, M.G., Papa, R., Lamura, G.: How can eHealth improve care for people with multimorbidity in Europe? Health Systems and Policy Analysis, p. 31 (2016)

    Google Scholar 

  4. Natrielli, D., Enokibara, M.: The use of telemedicine with patients in clinical practice: the view of medical psychology. Sao Paulo Med. J. 131(1), 62–63 (2013)

    Article  Google Scholar 

  5. Gagnon, M.P., et al.: Systematic review of factors influencing the adoption of information and communication technologies by healthcare professionals. J. Med. Syst. 36(1), 241–277 (2012). https://doi.org/10.1007/s10916-010-9473-4

    Article  Google Scholar 

  6. Uganda Ministry of Health: Uganda National eHealth Policy: Ministry of Health, p. 35 (2016)

    Google Scholar 

  7. United Nations Development Program, Sustainable Development Goals (2020)

    Google Scholar 

  8. Hoefman, B., Apunyu, B.: Using SMS for HIV/AIDS education and to expand the use of HIV testing and counselling services at the AIDS Information Centre (AIC) Uganda (2009). http://kau.diva-portal.org/smash/get/diva2:357565/FULLTEXT01#page=43

  9. Alliance medicines transparency, Essential medicines and health products information portal World Health Organization resource. Client satisfaction with services in Uganda’s Public Health Facilities (2014)

    Google Scholar 

  10. Angues, R.V., et al.: A real-time medical cartography of epidemic disease ( Nodding syndrome ) using village- based lay mHealth reporters. PLoS Neglected Trop. Dis. 12(6), 1–20 (2018)

    Google Scholar 

  11. Management Science for Health, “Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program. RxSolution Technical Brief. Arlington” (2014). http://siapsprogram.org/wp-content/%0Auploads/2016/03/TechBrief-Tools-RxSolution.pdf

  12. USAID, Systems for Improved Access to Pharmaceuticals and Services Program (Global) (2017)

    Google Scholar 

  13. Martin, 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

    Article  Google Scholar 

  14. 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)

    Google Scholar 

  15. Zanden, V.A.: WinSenga. Mobile Smartphone-based Electronic Foetal Heart Rate Monitor (2014). https://winsenga.wordpress.com

  16. Meyer, A.J., et al.: Implementing mhealth interventions in a resource-constrained setting: case study from Uganda. JMIR mHealth uHealth 8(7), 1 (2020). https://doi.org/10.2196/19552

    Article  Google Scholar 

  17. Hendrixk, H.C.A., Pippel, S., Wetering, R., Batenburg, R.: Expectations and attitudes in eHealth. a survey among clients of Dutch private healthcare organizations abstract and keywords abstract. Int. J. Healthc. Manag. 6(4), 263–268 (2013)

    Article  Google Scholar 

  18. Hoque, M.R.: An empirical study of mHealth adoption in a developing country: the moderating effect of gender concern. BMC Med. Inf. Decis. Making 16(1), 1–10 (2016). https://doi.org/10.1186/s12911-016-0289-0

    Article  MathSciNet  Google Scholar 

  19. Kakaire, S.,Mwagale, F: Mobile Health Projects in Uganda - Narrative Report This report was completed for the in SCALE project by Sauda October 2010 (2010)

    Google Scholar 

  20. Chaaya, M., Campbell, O.M.R., El Kak, F., Shaar, D., Harb, H., Kaddour, A.: Postpartum depression: prevalence and determinants in Lebanon. Arch. Womens. Ment. Health 5(2), 65–72 (2002). https://doi.org/10.1007/s00737-002-0140-8

    Article  Google Scholar 

  21. 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

    Article  Google Scholar 

  22. 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)

    Google Scholar 

  23. 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), 1–12 (2019)

    Google Scholar 

  24. 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), 1 (2015). https://doi.org/10.1186/s12911-015-0209-8

    Article  Google Scholar 

  25. 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

    Article  Google Scholar 

  26. Ggita, J.M., et al.: Related text messages and voice calls in Uganda, vol. 22, no. 5, pp. 530–536 (2019). https://doi.org/10.5588/ijtld.17.0521.Patterns

  27. 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. Inform. Decis. Mak. 17, 1–8 (2017). https://doi.org/10.1186/s12911-016-0403-3

    Article  Google Scholar 

  28. 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)

    Article  Google Scholar 

  29. Namatovu, H.K., Oyana, T.J.: ICT uptake as a determinant of antenatal care utilization in Uganda. Int. J. ICT Res. Afr. Middle East 10(1), 11–32 (2021). https://doi.org/10.4018/ijictrame.2021010102

    Article  Google Scholar 

  30. 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

    Article  Google Scholar 

  31. Destigter, K.: A Successful Obstetric Care Model in Uganda, pp. 41–44 (2012)

    Google Scholar 

  32. Cargo, K., Merry, M., Viljoen, P.: Mobile for Development (2015)

    Google Scholar 

  33. 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)

    Google Scholar 

  34. Namatovu, H.K., Semwanga, A.R., Kiberu, V.M., Ndigezza, L., Magumba, M.A., Kyanda, S.K.: Barriers and facilitators of eHealth adoption among healthcare providers in uganda – a quantitative study. In: Sheikh, Y.H., Rai, I.A., Bakar, A.D. (eds.) e-Infrastructure and e-Services for Developing Countries AFRICOMM 2021. Lecture Notes of the Institute for Computer Sciences, Social Informatics and Telecommunications Engineering, vol. 443, pp. 234–251. Springer, Cham (2022). https://doi.org/10.1007/978-3-031-06374-9_15

    Chapter  Google Scholar 

  35. UBOS Statistical Abstract, Uganda bureau of statistics 2017 statistical abstract. Uganda Bur. Stat., pp. 1–341 (2019)

    Google Scholar 

  36. Uganda Bureau of Statistics, National Population and Housing Census 2014 (2014)

    Google Scholar 

  37. Ministry of Health, National Health Facility Master List 2018, pp. 1–164 (2018). http://library.health.go.ug/sites/default/files/resources/National Health Facility Master List 2018_0.pdf

  38. 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

    Article  Google Scholar 

  39. Kiberu, V.M., Scott, R.E., Mars, M.: Assessment of health provider readiness for telemedicine services in Uganda. Heal. Inf. Manag. J. 48(1), 33–41 (2019). https://doi.org/10.1177/1833358317749369

    Article  Google Scholar 

  40. 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

    Article  Google Scholar 

  41. 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

    Article  Google Scholar 

  42. 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. BMC Public Health 15(1), 1–13 (2015). https://doi.org/10.1186/s12889-015-1939-3

    Article  Google Scholar 

  43. 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

    Article  Google Scholar 

  44. Adam, A.M.: Sample size determination in survey research. J. Sci. Res. Rep. 26(5), 90–97 (2020). https://doi.org/10.9734/jsrr/2020/v26i530263

    Article  Google Scholar 

  45. Muhaise, H., Muwanga-zake, J.W.F., Kareeyo, M.: Assessment model for electronic health management information systems success in a developing country context : a case of the greater Bushenyi districts in Uganda. Am. Sci. Res. J. Eng. Technol. Sci. 61(1), 167–185 (2019)

    Google Scholar 

  46. Kushniruk, A.W., Myers, K., Borycki, E.M., Kannry, J.: Exploring the relationship between training and usability: A study of the impact of usability testing on improving training and system deployment. Stud. Health Technol. Inform. 143, 277–283 (2009). https://doi.org/10.3233/978-1-58603-979-0-277

    Article  Google Scholar 

  47. He, Z.: ScholarWorks @ UMass Amherst Design , Implementation, and Evaluation of a User Training Program for Integrating Health Information Technology into Clinical Processes (2016)

    Google Scholar 

  48. Ajami, S., Mohammadi-Bertiani, Z.J.J.I.T.S.E.: Training and its impact on hospital information system (HIS) success. J. Inf. Technol. Softw. Eng. 2(05) (2012). https://doi.org/10.4172/2165-7866.1000112

  49. Ross, J.: Its not a training Issue. Practical Usability. Moving Towards a more Usable World (2010). https://www.uxmatters.com/mt/archives/2010/12/its-not-a-training-issue.php. Accessed 29 June 2021

  50. Ross, J., Stevenson, F., Lau, R., Murray, E.: Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update). Implementation Sci. 11(1), 1–12 (2016)

    Article  Google Scholar 

  51. Patel, V., et al.: The Lancet commission on global mental health and sustainable development. Lancet 392(10157), 1553–1598 (2018). https://doi.org/10.1016/S0140-6736(18)31612-X

    Article  Google Scholar 

  52. Archer, N., Fevrier-Thomas, U., Lokker, C., McKibbon, K.A., Straus, S.E.: Personal health records: a scoping review. J. Am. Med. Inf. Assoc. 18(4), 515–522 (2011). https://doi.org/10.1136/amiajnl-2011-000105

    Article  Google Scholar 

  53. Mcginn, C.A., et al.: Comparison of user groups ‘ perspectives of barriers and facilitators to implementing electronic health records : a systematic review. BMC Med. 9(1), 1–10 (2011)

    Article  Google Scholar 

  54. Mapesa, N.M.: Health Information Technology Implementation Strategies in Zimbabwe (2016)

    Google Scholar 

  55. 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

    Article  Google Scholar 

  56. Kassim, E.S., Jailani, S.F.A.K., Hairuddin, H., Zamzuri, N.H.: Information system acceptance and user satisfaction: the mediating role of trust. Procedia-Soc. Behav. Sci. 57, 412–418 (2012). https://doi.org/10.1016/j.sbspro.2012.09.1205

    Article  Google Scholar 

  57. Kesse-Tachi, A., Asmah, A.E., Agbozo, E.: Factors influencing adoption of eHealth technologies in Ghana. Digit. Heal. 5, 1–13 (2019). https://doi.org/10.1177/2055207619871425

    Article  Google Scholar 

  58. Riana, D., Hidayanto, A.N., Hadianti, S.: Integrative Factors of E-Health Laboratory Adoption : A Case of Indonesia, pp. 1–27 (2021)

    Google Scholar 

  59. Nikou, S., Aavakare, M.: An assessment of the interplay between literacy and digital technology in higher education. Educ. Inf. Technol. 26(4), 3893–3915 (2021)

    Article  Google Scholar 

  60. Naher, A.: Fear of Computers among People and How to Overcome it (2020). https://www.linkedin.com/pulse/fear-computers-among-people-how-overcome-assrafun-naher/

  61. U. Bureau of Statistics and I. International, “Demographic Health Survey,” Uganda Bur. Stat. Kampala, Uganda, p. 461 (2011). https://dhsprogram.com/pubs/pdf/FR264/FR264.pdf

  62. 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. Telec. 21(1), 14–17 (2015). https://doi.org/10.1177/1357633X14545433

    Article  Google Scholar 

  63. 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

    Article  Google Scholar 

  64. Pfeiffer, E.: How maternal depression and behaviours impact child health and development

    Google Scholar 

  65. Dahleez, K.A., Bader, I., Aboramadan, M.: E-health system characteristics, medical performance and healthcare quality at UNRWA-Palestine health centers. J. Enterp. Inf. Manage. 34(4), 1004–1036 (2021). https://doi.org/10.1108/JEIM-01-2019-0023

    Article  Google Scholar 

  66. Zhang, X., Guo, X., Lai, K.H., Guo, F., Li, C.: Understanding gender differences in m-Health adoption: a modified theory of reasoned action model. Telemed. e-Health 20(1), 39–46 (2014). https://doi.org/10.1089/tmj.2013.0092

    Article  Google Scholar 

  67. Khan, I., Xitong, G., Ahmad, Z., Shahzad, F.: Investigating factors impelling the adoption of e-health: a perspective of African expats in China. SAGE Open 9(3), 2158244019865803 (2019). https://doi.org/10.1177/2158244019865803

    Article  Google Scholar 

  68. 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

    Article  Google Scholar 

  69. Viola, S.B., Coleman, S.L., Glennon, S., Pastorek, M.E.: Use of parent education to improve self-efficacy in parents of students with emotional and behavioral disorders. Eval. Program Plann. 82, 101830 (2020). https://doi.org/10.1016/j.evalprogplan.2020.101830

    Article  Google Scholar 

  70. Margolis H., Mccabe, P.P.: Self-Efficacy a key to improving the motivation of struggling learners. 77(6), 241–249 (2004)

    Google Scholar 

  71. Forman, C., Goldfarb, A., Greenstein, S.: How did location affect adoption of the commercial Internet? Global village vs. urban leadership. J. Urban Econ. 58(3), 389–420 (2005)

    Article  Google Scholar 

  72. Melesse, B.: A review on factors affecting adoption of agricultural new technologies in Ethiopia. J. Agric. Sci. Food Res. 9(3), 1–4 (2018)

    Google Scholar 

Download references

Acknowledgments

We thank the management of the health facilities for the support rendered especially during COVID-19 pandemic. Similarly, we appreciate the participants whose involvement in this study was very pivotal. Lastly, I would like to extend sincere gratification to the Government of Uganda, through the Makerere University, Research and Innovations Fund for funding this research.

Funding

The Government of Uganda through the Makerere research and innovations fund funded this research. The grant number is MAK-RIF/IND-RD2/1205 and the same funded the APC.

Author information

Authors and Affiliations

  1. Makerere University, Kampala, Uganda

    Hasifah Kasujja Namatovu & Mark Abraham Magumba

Authors
  1. Hasifah Kasujja Namatovu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mark Abraham Magumba
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

The authors’ contribution towards this study were as follows; Conceptualization, Hasifah K. Namatovu; methodology, both authors; data collection, both authors; validation, both authors; formal analysis, Hasifah K. Namatovu; investigation, both authors; resources, Hasifah K. Namatovu; data curation, both authors; writing—original draft preparation, Hasifah K. Namatovu; writing—review and editing, both authors; supervision, both authors; project administration, both authors; funding acquisition, Hasifah K. Namatovu. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Hasifah Kasujja Namatovu .

Editor information

Editors and Affiliations

  1. Taif University, Ta'if, Saudi Arabia

    Rashid A. Saeed

  2. State University of Zanzibar, Zanzibar, Tanzania

    Abubakar D. Bakari

  3. State University of Zanzibar, Zanzibar, Tanzania

    Yahya Hamad Sheikh

Ethics declarations

The authors declare a no conflict of interest.

Rights and permissions

Reprints and permissions

Copyright information

© 2023 ICST Institute for Computer Sciences, Social Informatics and Telecommunications Engineering

About this paper

Check for updates. Verify currency and authenticity via CrossMark

Cite this paper

Namatovu, H.K., Magumba, M.A. (2023). Barriers and Facilitators of eHealth Adoption Among Patients in Uganda – A Quantitative Study. 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_15

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-34896-9_15

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-34895-2

  • Online ISBN: 978-3-031-34896-9

  • eBook Packages: Computer ScienceComputer Science (R0)

Publish with us

Policies and ethics

Search

Navigation