Diffusion of e-health innovations in ‘post-conflict’ settings: a qualitative study on the personal experiences of health workers

Abstract

BackgroundTechnological innovations have the potential to strengthen human resources for health and improve access and quality of care in challenging ‘post-conflict’ contexts. However, analyses on the adoption of technology for health (that is, ‘e-health’) and whether and how e-health can strengthen a health workforce in these settings have been limited so far. This study explores the personal experiences of health workers using e-health innovations in selected post-conflict situations.MethodsThis study had a cross-sectional qualitative design. Telephone interviews were conducted with 12 health workers, from a variety of cadres and stages in their careers, from four post-conflict settings (Liberia, West Bank and Gaza, Sierra Leone and Somaliland) in 2012. Everett Roger’s diffusion of innovation-decision model (that is, knowledge, persuasion, decision, implementation, contemplation) guided the thematic analysis.ResultsAll health workers interviewed held positive perceptions of e-health, related to their beliefs that e-health can help them to access information and communicate with other health workers. However, understanding of the scope of e-health was generally limited, and often based on innovations that health workers have been introduced through by their international partners. Health workers reported a range of engagement with e-health innovations, mostly for communication (for example, email) and educational purposes (for example, online learning platforms). Poor, unreliable and unaffordable Internet was a commonly mentioned barrier to e-health use. Scaling-up existing e-health partnerships and innovations were suggested starting points to increase e-health innovation dissemination.ConclusionsResults from this study showed ICT based e-health innovations can relieve information and communication needs of health workers in post-conflict settings. However, more efforts and investments, preferably driven by healthcare workers within the post-conflict context, are needed to make e-health more widespread and sustainable. Increased awareness is necessary among health professionals, even among current e-health users, and physical and financial access barriers need to be addressed. Future e-health initiatives are likely to increase their impact if based on perceived health information needs of intended users.

Healthcare workers’ perceptions and experience on using mHealth technologies to deliver primary healthcare services: qualitative evidence synthesis

“…For example, the Diffusion of Innovation model (Woodward 2014) emphasises the importance of the socio-cultural context in which technology is used, such as social networks and cultural values, to understand the perceptions and experiences of those who use the technology. Likewise does the Health IT Usability Evaluation model (Brown 2013) offer nine concepts, including the flexibility of the technology to be used for more than one task, that shape users’ experiences and perceptions of the technology.…”

Use of information and communication technology and retention of health workers in rural post-war conflict Northern Uganda: findings from a qualitative study

“…Information and communication technologies (ICTs) have become a vital infrastructural asset for potential use in the retention of health care providers in remote rural areas [1–5]. Though there have been substantial studies on other factors that influence retention of health workers in rural areas such as pay rise, good housing and others [6], little attention has been put to explore the influence of ICT use on retention of health workers in rural and remote areas [3, 5].…”

“…Though there have been substantial studies on other factors that influence retention of health workers in rural areas such as pay rise, good housing and others [6], little attention has been put to explore the influence of ICT use on retention of health workers in rural and remote areas [3, 5]. Just as the case in favour of ICT use in promoting the retention of health care providers in rural areas has been made, it is also reasonable to explore the perceptions of health workers on whether ICT facilities and infrastructural development might contribute to retention in rural post-war conflict northern Uganda.…”

UNRWA’s innovative e-Health for 5 million Palestine refugees in the Near East

“…A study by Woodward and others in 2014 which included a sample from West Bank and Gaza showed that ICT-based e-Health innovations can relieve information and communication needs of health workers in postconflict settings. [17][18][19] Another study by Hassan and others in 2017 described the implementation of a registration tool for obstetric interventions and childbirth events using e-Health in a prospective birth cohort study in six Palestinian governmental hospitals. Their study indicated that e-Health provides opportunities for quality improvement of healthcare, although its implementation in low-income and middle-income countries is still limited.…”