An mHealth-Based Health Management Information System Among Health Workers in Volta and Eastern Regions of Ghana: Pre-Post Comparison Analysis

BackgroundDespite the increasing attention to electronic health management information systems (HMISs) in global health, most African countries still depend on inefficient paper-based systems. Good Neighbors International and Evaluate 4 Health have recently supported the Ghan...

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Main Authors: Young-ji Lee, Seohyun Lee, SeYeon Kim, Wonil Choi, Yoojin Jeong, Nina Jin Joo Rhim, Ilwon Seo, Sun-Young Kim
Format: Article
Language:English
Published: JMIR Publications 2022-08-01
Series:JMIR Medical Informatics
Online Access:https://medinform.jmir.org/2022/8/e29431
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author Young-ji Lee
Seohyun Lee
SeYeon Kim
Wonil Choi
Yoojin Jeong
Nina Jin Joo Rhim
Ilwon Seo
Sun-Young Kim
author_facet Young-ji Lee
Seohyun Lee
SeYeon Kim
Wonil Choi
Yoojin Jeong
Nina Jin Joo Rhim
Ilwon Seo
Sun-Young Kim
author_sort Young-ji Lee
collection DOAJ
description BackgroundDespite the increasing attention to electronic health management information systems (HMISs) in global health, most African countries still depend on inefficient paper-based systems. Good Neighbors International and Evaluate 4 Health have recently supported the Ghana Health Service on the rollout of a mobile health–based HMIS called the e-Tracker system in 2 regions in Ghana. The e-Tracker is an Android-based tracker capture app that electronically manages maternal and child health (MCH) data. The Ghana Health Service has implemented this new system in Community Health Planning and Services in the 2 regions (Volta and Eastern). ObjectiveThis study aims to evaluate changes in health workers’ capacity and behavior after using the e-Tracker to deliver MCH services. Specifically, the study assesses the changes in knowledge, attitude, and practice (KAP) of the health workers toward the e-Tracker system by comparing the pre- and postsurvey results. MethodsThe KAP of frontline health workers was measured through self-administered surveys before and after using the e-Tracker system to assess their capacity and behavioral change toward the system. A total of 1124 health workers from the Volta and Eastern regions responded to the pre-post surveys. This study conducted the McNemar chi-square test and Wilcoxon signed-rank test for a pre-post comparison analysis. In addition, random-effects ordered logistic regression analysis and random-effects panel analysis were conducted to identify factors associated with KAP level. ResultsThe pre-post comparison analysis showed significant improvement in health workers’ capacity, with higher knowledge and practice levels after using the e-Tracker system. As for knowledge, there was a 9.9%-point increase (from 559/1109, 50.41% to 669/1109, 60.32%) in the proportion of the respondents who were able to generate basic statistics on the number of children born in a random month within 30 minutes. In the practice section, the percentage of respondents who had scheduled clientencounters increased from 91.41% (968/1059) to 97.83% (1036/1059). By contrast, responses to the attitude (acceptability) became less favorable after experiencing the actual system. For instance, 48.53% (544/1121) initially expressed their preferences for an electronic system; however, the proportion decreased to 33.45% (375/1121) after the intervention. Random-effects ordered logistic regression showed that days of overwork were significantly associated with health workers’ attitudes toward the e-Tracker system. ConclusionsThis study provides empirical evidence that the e-Tracker system is conducive to enhancing capacity in MCH data management for providing necessary MCH services. However, the change in attitude implies that the users appear to feel less comfortable using the new system. As Ghana plans to scale up the electronic HMIS system using the e-Tracker to the national level, strategies to enhance health workers’ attitudes are necessary to sustain this new system.
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spelling doaj.art-84549e4158cb449193d7d58cfa14d1902023-08-28T22:59:14ZengJMIR PublicationsJMIR Medical Informatics2291-96942022-08-01108e2943110.2196/29431An mHealth-Based Health Management Information System Among Health Workers in Volta and Eastern Regions of Ghana: Pre-Post Comparison AnalysisYoung-ji Leehttps://orcid.org/0000-0002-7915-2415Seohyun Leehttps://orcid.org/0000-0003-3240-8126SeYeon Kimhttps://orcid.org/0000-0001-7119-4269Wonil Choihttps://orcid.org/0000-0003-0136-4474Yoojin Jeonghttps://orcid.org/0000-0003-3439-0935Nina Jin Joo Rhimhttps://orcid.org/0000-0002-7500-3834Ilwon Seohttps://orcid.org/0000-0001-9196-4945Sun-Young Kimhttps://orcid.org/0000-0002-5419-4424 BackgroundDespite the increasing attention to electronic health management information systems (HMISs) in global health, most African countries still depend on inefficient paper-based systems. Good Neighbors International and Evaluate 4 Health have recently supported the Ghana Health Service on the rollout of a mobile health–based HMIS called the e-Tracker system in 2 regions in Ghana. The e-Tracker is an Android-based tracker capture app that electronically manages maternal and child health (MCH) data. The Ghana Health Service has implemented this new system in Community Health Planning and Services in the 2 regions (Volta and Eastern). ObjectiveThis study aims to evaluate changes in health workers’ capacity and behavior after using the e-Tracker to deliver MCH services. Specifically, the study assesses the changes in knowledge, attitude, and practice (KAP) of the health workers toward the e-Tracker system by comparing the pre- and postsurvey results. MethodsThe KAP of frontline health workers was measured through self-administered surveys before and after using the e-Tracker system to assess their capacity and behavioral change toward the system. A total of 1124 health workers from the Volta and Eastern regions responded to the pre-post surveys. This study conducted the McNemar chi-square test and Wilcoxon signed-rank test for a pre-post comparison analysis. In addition, random-effects ordered logistic regression analysis and random-effects panel analysis were conducted to identify factors associated with KAP level. ResultsThe pre-post comparison analysis showed significant improvement in health workers’ capacity, with higher knowledge and practice levels after using the e-Tracker system. As for knowledge, there was a 9.9%-point increase (from 559/1109, 50.41% to 669/1109, 60.32%) in the proportion of the respondents who were able to generate basic statistics on the number of children born in a random month within 30 minutes. In the practice section, the percentage of respondents who had scheduled clientencounters increased from 91.41% (968/1059) to 97.83% (1036/1059). By contrast, responses to the attitude (acceptability) became less favorable after experiencing the actual system. For instance, 48.53% (544/1121) initially expressed their preferences for an electronic system; however, the proportion decreased to 33.45% (375/1121) after the intervention. Random-effects ordered logistic regression showed that days of overwork were significantly associated with health workers’ attitudes toward the e-Tracker system. ConclusionsThis study provides empirical evidence that the e-Tracker system is conducive to enhancing capacity in MCH data management for providing necessary MCH services. However, the change in attitude implies that the users appear to feel less comfortable using the new system. As Ghana plans to scale up the electronic HMIS system using the e-Tracker to the national level, strategies to enhance health workers’ attitudes are necessary to sustain this new system.https://medinform.jmir.org/2022/8/e29431
spellingShingle Young-ji Lee
Seohyun Lee
SeYeon Kim
Wonil Choi
Yoojin Jeong
Nina Jin Joo Rhim
Ilwon Seo
Sun-Young Kim
An mHealth-Based Health Management Information System Among Health Workers in Volta and Eastern Regions of Ghana: Pre-Post Comparison Analysis
JMIR Medical Informatics
title An mHealth-Based Health Management Information System Among Health Workers in Volta and Eastern Regions of Ghana: Pre-Post Comparison Analysis
title_full An mHealth-Based Health Management Information System Among Health Workers in Volta and Eastern Regions of Ghana: Pre-Post Comparison Analysis
title_fullStr An mHealth-Based Health Management Information System Among Health Workers in Volta and Eastern Regions of Ghana: Pre-Post Comparison Analysis
title_full_unstemmed An mHealth-Based Health Management Information System Among Health Workers in Volta and Eastern Regions of Ghana: Pre-Post Comparison Analysis
title_short An mHealth-Based Health Management Information System Among Health Workers in Volta and Eastern Regions of Ghana: Pre-Post Comparison Analysis
title_sort mhealth based health management information system among health workers in volta and eastern regions of ghana pre post comparison analysis
url https://medinform.jmir.org/2022/8/e29431
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