Healthcare professionals' satisfaction toward the use of district health information system and its associated factors in southwest Ethiopia: using the information system success model.

Background: Ethiopia has the potential to use the district health information system, which is a building block of the health system. Thus, it needs to assess the performance level of the system by identifying the satisfaction of end users. There is little evidence about users' satisfaction with using this system. As a result, this study was conducted to fill this gap by evaluating user satisfaction and associated factors of district health information system among healthcare providers in Ethiopia, using the information system success model. Methods: An institutional-based cross-sectional study was conducted from November to December 2022 in the Oromia region of southwest Ethiopia. A total of 391 health professionals participated in the study. The study participants were selected using a census. Using a self-administered questionnaire, data were collected. Measurement and structural equation modeling analyses were used to evaluate reliability, the validity of model fit, and to test the relationship between the constructs, respectively, using analysis of moment structure (AMOS) V 26. Results: System quality had a positive direct effect on the respondent's system use (ß = 0.18, P-value < 0.001), and satisfaction (ß = 0.44, P-value < 0.001). Service quality had also a direct effect on the respondent's system use (ß = 0.37, P-value < 0.01), and satisfaction with using the district health information system (ß = 0.36, P-value < 0.01). Similarly, system use had also a direct effect on the respondent's satisfaction (ß = 0.53, P-value < 0.05). Moreover, computer literacy had a direct effect on the respondent's system use (ß = 0.63, P-value < 0.05), and satisfaction (ß = 0.51, P-value < 0.01). Concussions: The overall user satisfaction with using the district health information system in Ethiopia was low. System quality, service quality, and computer literacy had a direct positive effect on system use and user satisfaction. In addition, system use and information quality had a direct positive effect on healthcare professionals' satisfaction with using the district health information system. The most important factor for enhancing system use and user satisfaction was computer literacy. Accordingly, for the specific user training required for the success of the district health information system in Ethiopia, the manager should offer additional basic computer courses for better use of the system.

Exploring facilitators and barriers of the sustainable acceptance of e-health system solutions in Ethiopia: A systematic review.

BACKGROUND: eHealth is the use of information and communications technologies in support of health and health-related fields, including healthcare services, health surveillance, health literature, and health education knowledge and research, has the potential to improve the delivery and support of healthcare services by promoting information sharing and evidence-based health practice. Acceptance of e-health in Ethiopia using systematic review is uncertain. As a result, this study aimed to assess barriers and facilitators of the sustainable acceptance of e-health system adoption in Ethiopia through a systematic review of the literature. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist was used to conduct this study. Relevant articles have been searched in Google Scholar, Medline, PubMed, Embrace, Web of Science, Scopus, Cochrane Library, and empirical research done in Ethiopia is the main emphasis of the search strategy. The total number of studies that satisfied the criteria for inclusion was ten. In this research, empirical data related to e-health acceptance factors were retrieved, examined, and summarized by the authors. RESULTS: This systematic review identified a total of 25 predictors that have been found in the ten studies. The identified facilitators were effort expectancy, performance expectancy, facilitating conditions, social influences, attitude, computer literacy, participant age, perceived enjoyment, and educational status, duration of mobile device use, organizational culture, and habit. Moreover, technology anxiety was the most barrier to sustainable acceptance of e-health systems in Ethiopia. CONCLUSIONS: The most common facilitator identified from the predictors was effort expectancy, which played a major role in the adoption of the e-health system in Ethiopia. Therefore, eHealth implementers and managers in those settings should give users of the system priority in improving the technical infrastructure by regularly providing them with basic facilitating conditions. They should also pay attention to the system they want to implement because doing so will improve the users' perception of the system's value and attitude.

Willingness of diabetes mellitus patients to use mHealth applications and its associated factors for self-care management in a low-income country: an input for digital health implementation.

BACKGROUND: Although mHealth applications are becoming more widely available and used, there is no evidence about why people are willing to use them. Therefore, this study aimed to assess the willingness of patients with diabetes to use mHealth applications and associated factors for self-care management in Ethiopia. METHODS: An institutional cross-sectional study was conducted among 422 patients with diabetes. Data were collected using pretested interviewer-administered questionnaire. Epi Data V.4.6 for entering the data and STATA V.14 for analysing the data were used. A multivariable logistic regression analysis was carried out to identify factors associated with patient's willingness to use mobile health applications. RESULTS: A total of 398 study participants were included in the study. About 284 (71.4%) 95% CI (66.8% to 75.9%)). Of participants were willing to use mobile health applications. Patients below 30 years of age (adjusted OR, AOR 2.21; 95% CI (1.22 to 4.10)), urban residents (AOR 2.12; 95% CI (1.12 to 3.98)), internet access (AOR 3.91; 95% CI (1.31 to 11.5)), favourable attitude (AOR 5.20; 95% CI (2.60 to 10.40)), perceived ease of use (AOR 2.57; 95% CI (1.34 to 4.85)) and perceived usefulness (AOR 4.67; 95% CI (1.95 to 5.77)) were significantly associated with patients' willingness to use mobile health applications. CONCLUSIONS: Overall, diabetes patients' willingness to use mobile health applications was high. Patients' age, place of residence, internet access, attitude, perceived ease of use and perceived usefulness were significant factors concerning their willingness to use mobile health applications. Considering these factors could provide insight for developing and adopting diabetes management applications on mobile devices in Ethiopia.

Healthcare professionals' knowledge, attitude and its associated factors toward electronic personal health record system in a resource-limited setting: A cross-sectional study.

Introduction: Electronic personal health record (e-PHR) system enables individuals to access their health information and manage it themselves. It helps patient engagement management of health information that is accessed and shared with their healthcare providers using the platform. This improves individual healthcare through the exchange of health information between patients and healthcare providers. However, less is known about e-PHRs among healthcare professionals. Objective: Therefore, this study aimed to assess Health professionals' Knowledge and attitude and its associated factors toward e-PHR at the teaching hospital in northwest Ethiopia. Methods: An institution-based cross-sectional study design was used to determine healthcare professionals' knowledge and attitude and their associated factors toward e-PHR systems in teaching hospitals of Amhara regional state, Ethiopia, from 20 July to 20 August 2022. Pretested structured self-administered questionnaires were used to collect the data. Descriptive statistic was computed based on sociodemographic and other variables presented in the form of table graphs and texts. Bivariable and multivariable logistic analyses were performed with an adjusted odds ratio (AOR) and 95% CI to identify predictor variables. Result: Of the total study participants, 57% were males and nearly half of the respondents had a bachelor's degree. Out of 402 participants, ~65.7% [61-70%] and 55.5% [50-60%] had good knowledge and favorable attitude toward e-PHR systems, respectively. Having a social media account 4.3 [AOR = 4.3, 95% CI (2.3-7.9)], having a smartphone 4.4 [AOR = 4.4, 95% CI (2.2-8.6)], digital literacy 8.8 [(AOR = 8.8, 95% CI (4.6-15.9)], being male 2.7 [AOR = 2.7, 95% CI (1.4-5.0)], and perceived usefulness 4.5 [(AOR = 4.5, 95% CI (2.5-8.5)] were positively associated with knowledge toward e-PHR systems. Similarly, having a personal computer 1.9 [AOR = 1.9, 95% CI (1.1-3.5)], computer training 3.9 [AOR = 3.9, 95% CI (1.8-8.3)], computer skill 19.8 [AOR = 19.8, 95% CI (10.7-36.9)], and Internet access 6.0 [AOR = 6.0, 95% CI (3.0-12.0)] were predictors for attitude toward e-PHR systems. Conclusion: The findings from the study showed that healthcare professionals have good knowledge and a favorable attitude toward e-PHRs. Providing comprehensive basic computer training to improve healthcare professionals' expectation on the usefulness of e-PHR systems has a paramount contribution to the advancement of their knowledge and attitude toward successfully implementing e-PHRs.

Predicting healthcare professionals' acceptance towards electronic personal health record systems in a resource-limited setting: using modified technology acceptance model.

OBJECTIVES: Personal health record systems allow users to manage their health information in a confidential manner. However, there is little evidence about healthcare providers' intentions to use such technologies in resource-limited settings. Therefore, this study aimed to assess predicting healthcare providers' acceptance of electronic personal health record systems. METHODS: An institutional-based cross-sectional study was conducted from 19 July to 23 August 2022 at teaching hospitals in the Amhara regional state of Ethiopia. A total of 638 health professionals participated in the study. Simple random sampling techniques were used to select the study participants. Structural equation modelling analysis was employed using AMOS V.26 software. RESULT: Perceived ease of use had a significant effect on the intention to use electronic personal health records (ß=0. 377, p<0.01), perceived usefulness (ß=0.104, p<0.05) and attitude (ß=0.204, p<0.01); perceived ease of use and information technology experience had a significant effect on perceived usefulness (ß=0.077, p<0.05); and digital literacy (ß=0.087, p<0.05) and attitude had also a strong effect on intention to use electronic personal health records (ß=0.361, p<0.01). The relationship between perceived ease of use and the intention to use was mediated by attitude (ß=0.076, p<0.01). CONCLUSION: Perceived ease of use, attitude and digital literacy had a significant effect on the intention to use electronic personal health records. The perceived ease of use had a greater influence on the intention to use electronic personal health record systems. Thus, capacity building and technical support could enhance health providers' acceptance of using electronic personal health records in Ethiopia.

Prevalence and associated factors of early sexual initiation among youth female in sub-Saharan Africa: a multilevel analysis of recent demographic and health surveys.

BACKGROUND: Early sexual initiation is a major public health concern globally, specifically in Sub-Saharan African (SSA) countries where reproductive health care services are limited. It is strongly related to increased risk of HIV/AIDS, sexually transmitted diseases, unwanted pregnancy, adverse birth outcomes, and psychosocial problems. However, there is limited evidence on the prevalence and associated factors of early sexual initiation among youth females in SSA. METHODS: A secondary data analysis was employed based on the recent DHSs of sub-Saharan African countries. A total weighted sample of 184,942 youth females was considered for analysis. Given the hierarchical nature of DHS data, a multilevel binary logistic regression model was fitted. The Intra-class Correlation Coefficient (ICC), Median Odds Ratio (MOR), and Likelihood Ratio (LR) test were used to assess the presence of clustering. Four nested models were fitted and the model with the lowest deviance (-2LLR0 was selected as the best-fitted model. Variables with p-value < 0.2 in the bivariable multilevel binary logistic regression analysis were considered for the multivariable analysis. In the multivariable multilevel binary logistic regression analysis, the Adjusted Odds Ratio (AOR) with the 95% Confidence Interval (CI) was reported to declare the strength and statistical significance of the association. RESULTS: The prevalence of early sexual initiation among youth females in sub-Saharan Africa was 46.39% [95%CI: 41.23%, 51.5%] ranging from 16.66% in Rwanda to 71.70% in Liberia. In the final model, having primary level education [AOR = 0.82, 95% CI; 0.79, 0.85], and [AOR = 0.50, 95%CI; 0.48, 0.52], being rural [AOR = 1.05, 95%CI: 1.03, 1.07], having media exposure [AOR = 0.91, 95%CI: 0.89, 0.94], and belonged to a community with high media exposure [AOR = 0.92, 95%CI: 0.89,0.96] were found significantly associated with early sexual initiation. CONCLUSION: The prevalence of early sexual initiation among youth females in SSA was high. Educational status, wealth index, residence, media exposure, and community media exposure have a significant association with early sexual initiation. These findings highlight those policymakers and other stakeholders had better give prior attention to empowering women, enhancing household wealth status, and media exposure to increase early sexual in the region.

Pooled prevalence and determinants of antenatal care visits in countries with high maternal mortality: A multi-country analysis.

Background: Complications during pregnancy and childbirth are the leading causes of maternal and child deaths and disabilities, particularly in low- and middle-income countries. Timely and frequent antenatal care prevents these burdens by promoting existing disease treatments, vaccination, iron supplementation, and HIV counseling and testing during pregnancy. Many factors could contribute to optimal ANC utilization remaining below targets in countries with high maternal mortality. This study aimed to assess the prevalence and determinants of optimal ANC utilization by using nationally representative surveys of countries with high maternal mortality. Methods: Secondary data analysis was done using recent Demographic and Health Surveys (DHS) data of 27 countries with high maternal mortality. The multilevel binary logistic regression model was fitted to identify significantly associated factors. Variables were extracted from the individual record (IR) files of from each of the 27 countries. Adjusted odds ratios (AOR) with a 95% confidence interval (CI) and p-value of ≤0.05 in the multivariable model were used to declare significant factors associated with optimal ANC utilization. Result: The pooled prevalence of optimal ANC utilization in countries with high maternal mortality was 55.66% (95% CI: 47.48-63.85). Several determinants at the individual and community level were significantly associated with optimal ANC utilization. Mothers aged 25-34 years, mothers aged 35-49 years, mothers who had formal education, working mothers, women who are married, had media access, households of middle-wealth quintile, richest household, history of pregnancy termination, female household head, and high community education were positively associated with optimal ANC visits in countries with high maternal mortality, whereas being rural residents, unwanted pregnancy, having birth order 2-5, and birth order >5 were negatively associated. Conclusion and recommendations: Optimal ANC utilization in countries with high maternal mortality was relatively low. Both individual-level factors and community-level factors were significantly associated with ANC utilization. Policymakers, stakeholders, and health professionals should give special attention and intervene by targeting rural residents, uneducated mothers, economically poor women, and other significant factors this study revealed.

Exploring the spatial variation and associated factors of childhood febrile illness among under-five children in Ethiopia: Geographically weighted regression analysis.

BACKGROUND: The global burden of febrile illness and the contribution of many fever inducing pathogens have been difficult to quantify and characterize. However, in sub-Saharan Africa it is clear that febrile illness is a common cause of hospital admission, illness and death including in Ethiopia. Therefore the major aim of this study is to explore the spatial variation and associated factors of childhood febrile illness among under-five children in Ethiopia. METHODS: This study were based on the 2016 Ethiopian Demographic health survey data. A total weighted sample of 10,127 under- five children was included. Data management was done using Stata version-14, Arc-GIS version-10.8 and SatsScan version- 9.6 statistical software. Multi-level log binomial model was fitted to identify factors associated with childhood febrile illness. Variables with a p-value < 0.2 in the bi-variable analysis were considered for the multivariable analysis. In the multivariable multilevel log binomial regression analysis p-value< 0.05, the APR with the 95% CI was reported. Global spatial autocorrelation was done to assess the spatial pattern of childhood febrile illness. Spatial regression was done to identify factors associated with the spatial variations of childhood febrile illness and model comparison was based on adjusted R2 and AICc. RESULT: The prevalence of febrile illness among under-five children was 13.6% (95% CI: 12.6%, 14 .7%) with significant spatial variation across regions of Ethiopia with Moran's I value of 0.148. The significant hotspot areas of childhood febrile illness were identified in the Tigray, Southeast of Amhara, and North SNPPR. In the GWR analysis, the proportion of PNC, children who had diarrhea, ARI, being 1st birth order, were significant explanatory variables. In the multilevel log binomial regression age of children 7-24 months(APR = 1.33, 95% CI: (1.03, 1.72)), maternal age 30-39 years (APR = 1.36 95% CI: 1.02, 1.80)), number of children (APR = 1.78, 95% CI: 0.96, 3.3), diarrhea(APR = 5.3% 95% CI: (4.09, 6.06)), ARI (APR = 11.5, 95% CI: (9.2, 14.2)) and stunting(APR = 1.21; 95% CI: (0.98, 1.49) were significantly associated with childhood febrile illness. CONCLUSION: Childhood febrile illness remains public health problem in Ethiopia. On spatial regression analysis proportion of women who had PNC, proportion of children who had diarrhea, proportion of children who had ARI, and proportion of children who had being 1st birth order were associated factors. The detailed map of childhood febrile illness and its predictors could assist health program planners and policy makers to design targeted public health interventions for febrile illness.