Strengthening urban primary healthcare service delivery using electronic health technologies: A qualitative study in urban Nepal
Background Nepal is a South Asian country with a high burden of non-communicable diseases. Electronic health technologies are a promising strategy to mitigate the rising burden of non-communicable diseases by strengthening primary healthcare center service delivery. However, electronic health implem...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2022-07-01
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| Series: | Digital Health |
| Online Access: | https://doi.org/10.1177/20552076221114182 |
| _version_ | 1811288337472815104 |
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| author | Prayog Bhattarai Abha Shrestha Shangzhi Xiong Nicholas Peoples Chandrika Ramakrishnan Shrinkhala Shrestha Ruoyu Yin Biraj Karmacharya Lijing L. Yan Tazeen H. Jafar |
| author_facet | Prayog Bhattarai Abha Shrestha Shangzhi Xiong Nicholas Peoples Chandrika Ramakrishnan Shrinkhala Shrestha Ruoyu Yin Biraj Karmacharya Lijing L. Yan Tazeen H. Jafar |
| author_sort | Prayog Bhattarai |
| collection | DOAJ |
| description | Background Nepal is a South Asian country with a high burden of non-communicable diseases. Electronic health technologies are a promising strategy to mitigate the rising burden of non-communicable diseases by strengthening primary healthcare center service delivery. However, electronic health implementation in Nepal is limited. Furthermore, electronic health use at the primary healthcare center level is chronically understudied. This qualitative study seeks to understand the perceived awareness, benefits, and determinants of electronic health uptake in Nepal, focusing on primary healthcare center-level non-communicable disease management. Methods We conducted in-depth interviews with 27 participants including policymakers, health experts, facility administrators, providers, and non-communicable diseases patients in 2019. We selected six urban primary healthcare center facilities via cluster convenience sampling for recruiting facility administrators, providers, and patients, and used convenience sampling to recruit policymakers and experts. We conducted thematic data analysis inductively and deductively using the electronic health readiness assessment framework to understand perceived barriers and facilitators of electronic health implementation. Results While there was general awareness and acceptance of electronic health, multiple barriers impede readiness for implementation. These include policy making gaps, language barriers, low user technical literacy, concerns of overreliance on technology, and inadequate training for administrators and providers. Stakeholder suggestions include creating electronic health interfaces that meet the needs of end users (providers and patients), providing training to enable end users to effectively use electronic health technologies, and strong policy support at the national level. Conclusion We identify several determinants for effectively promoting the use of electronic health for non-communicable diseases service delivery at the primary healthcare center level in Nepal. |
| first_indexed | 2024-04-13T03:35:00Z |
| format | Article |
| id | doaj.art-7e3e266837384dca8986e6af12e881fe |
| institution | Directory Open Access Journal |
| issn | 2055-2076 |
| language | English |
| last_indexed | 2024-04-13T03:35:00Z |
| publishDate | 2022-07-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Digital Health |
| spelling | doaj.art-7e3e266837384dca8986e6af12e881fe2022-12-22T03:04:21ZengSAGE PublishingDigital Health2055-20762022-07-01810.1177/20552076221114182Strengthening urban primary healthcare service delivery using electronic health technologies: A qualitative study in urban NepalPrayog Bhattarai0Abha Shrestha1Shangzhi Xiong2Nicholas Peoples3Chandrika Ramakrishnan4Shrinkhala Shrestha5Ruoyu Yin6Biraj Karmacharya7Lijing L. Yan8Tazeen H. Jafar9 , Singapore , Nepal , ChinaThe George Institute for Global Health, University of New South Wales, Australia , USA , Singapore Kathmandu University School of Medical Sciences, Nepal Department of Family Medicine and Primary Care, , Singapore Department of Community Programs, Kathmandu University School of Medical Sciences (KUSMS), Nepal Global Health Research Center, , China , SingaporeBackground Nepal is a South Asian country with a high burden of non-communicable diseases. Electronic health technologies are a promising strategy to mitigate the rising burden of non-communicable diseases by strengthening primary healthcare center service delivery. However, electronic health implementation in Nepal is limited. Furthermore, electronic health use at the primary healthcare center level is chronically understudied. This qualitative study seeks to understand the perceived awareness, benefits, and determinants of electronic health uptake in Nepal, focusing on primary healthcare center-level non-communicable disease management. Methods We conducted in-depth interviews with 27 participants including policymakers, health experts, facility administrators, providers, and non-communicable diseases patients in 2019. We selected six urban primary healthcare center facilities via cluster convenience sampling for recruiting facility administrators, providers, and patients, and used convenience sampling to recruit policymakers and experts. We conducted thematic data analysis inductively and deductively using the electronic health readiness assessment framework to understand perceived barriers and facilitators of electronic health implementation. Results While there was general awareness and acceptance of electronic health, multiple barriers impede readiness for implementation. These include policy making gaps, language barriers, low user technical literacy, concerns of overreliance on technology, and inadequate training for administrators and providers. Stakeholder suggestions include creating electronic health interfaces that meet the needs of end users (providers and patients), providing training to enable end users to effectively use electronic health technologies, and strong policy support at the national level. Conclusion We identify several determinants for effectively promoting the use of electronic health for non-communicable diseases service delivery at the primary healthcare center level in Nepal.https://doi.org/10.1177/20552076221114182 |
| spellingShingle | Prayog Bhattarai Abha Shrestha Shangzhi Xiong Nicholas Peoples Chandrika Ramakrishnan Shrinkhala Shrestha Ruoyu Yin Biraj Karmacharya Lijing L. Yan Tazeen H. Jafar Strengthening urban primary healthcare service delivery using electronic health technologies: A qualitative study in urban Nepal Digital Health |
| title | Strengthening urban primary healthcare service delivery using electronic health technologies: A qualitative study in urban Nepal |
| title_full | Strengthening urban primary healthcare service delivery using electronic health technologies: A qualitative study in urban Nepal |
| title_fullStr | Strengthening urban primary healthcare service delivery using electronic health technologies: A qualitative study in urban Nepal |
| title_full_unstemmed | Strengthening urban primary healthcare service delivery using electronic health technologies: A qualitative study in urban Nepal |
| title_short | Strengthening urban primary healthcare service delivery using electronic health technologies: A qualitative study in urban Nepal |
| title_sort | strengthening urban primary healthcare service delivery using electronic health technologies a qualitative study in urban nepal |
| url | https://doi.org/10.1177/20552076221114182 |
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