Facilitators and barriers in the use of the electronic consultation register for Integrated Management of Childhood Illness in the health district of Toma, Burkina Faso: Perspectives of health care providers

Abstract

Background: In collaboration with the Ministry of Health and Public Hygiene (MHPH) of Burkina Faso (BF), the Foundation Terre des Hommes (Tdh) has developed the Integrated e-Diagnostic Approach (IeDA) project in BF since 2010 to strengthen the health system by digitalizing medical protocols, improving the quality of services and using data. We sought to identify and analyze the barriers and facilitators of using the electronic clinic registry (ECR) for the integrated management of childhood illness (IMCI) by healthcare providers (HCPs) in the health district of Toma, BF. Methods: We conducted a descriptive and exploratory qualitative study. In-depth individual interviews were conducted with thirty-five (35) HCPs in the health district of Toma, BF, from the 1st to the 30th of December 2021. Thematic analysis of qualitative data according to the Braun & Clarke model was performed using NVivo 12 software and arranged along a social-ecological model. Results: Our findings revealed that HCPs play an essential role in using ECR for IMCI. Many key facilitating factors have emerged regarding the use of IMCIs in primary health care (PHC) facilities, such as positive perceptions of the ECR, firm commitment and the involvement of HCPs, stakeholder support, collaborative networks with implementing partners, convenience, privacy, confidentiality and client trust, experience and confidence in using the system, and the satisfaction, motivation and competency of staff. In addition, the easy diagnosis offered by the ECR and the training of HCPs increased the acceptance and use of the ECR. Regarding barriers, HCPs complained about the tablet's slowness, recurrent breakdowns, and increased workload. Conclusion This study revealed that ECR has excellent potential to improve the quality of care and, in turn, reduce maternal and infant mortality. Although the satisfaction of the HCPs with the tool is positive, the actors of the Foundation Tdh, in collaboration with the MHPH, must work to optimize the application's performance and reduce breakdowns and delays during consultations. This will allow the deployment of ECR in all BF health districts. Keywords: Integrated e-Diagnostic approach, integrated management of childhood illness, electronic consultation register, perceptions, healthcare providers, Burkina Faso.