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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 imple...

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Autores principales: Bhattarai, Prayog, Shrestha, Abha, Xiong, Shangzhi, Peoples, Nicholas, Ramakrishnan, Chandrika, Shrestha, Shrinkhala, Yin, Ruoyu, Karmacharya, Biraj, Yan, Lijing L., Jafar, Tazeen H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9309786/
https://www.ncbi.nlm.nih.gov/pubmed/35898291
http://dx.doi.org/10.1177/20552076221114182
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author Bhattarai, Prayog
Shrestha, Abha
Xiong, Shangzhi
Peoples, Nicholas
Ramakrishnan, Chandrika
Shrestha, Shrinkhala
Yin, Ruoyu
Karmacharya, Biraj
Yan, Lijing L.
Jafar, Tazeen H.
author_facet Bhattarai, Prayog
Shrestha, Abha
Xiong, Shangzhi
Peoples, Nicholas
Ramakrishnan, Chandrika
Shrestha, Shrinkhala
Yin, Ruoyu
Karmacharya, Biraj
Yan, Lijing L.
Jafar, Tazeen H.
author_sort Bhattarai, Prayog
collection PubMed
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.
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spelling pubmed-93097862022-07-26 Strengthening urban primary healthcare service delivery using electronic health technologies: A qualitative study in urban Nepal Bhattarai, Prayog Shrestha, Abha Xiong, Shangzhi Peoples, Nicholas Ramakrishnan, Chandrika Shrestha, Shrinkhala Yin, Ruoyu Karmacharya, Biraj Yan, Lijing L. Jafar, Tazeen H. Digit Health Qualitative Study 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. SAGE Publications 2022-07-21 /pmc/articles/PMC9309786/ /pubmed/35898291 http://dx.doi.org/10.1177/20552076221114182 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Qualitative Study
Bhattarai, Prayog
Shrestha, Abha
Xiong, Shangzhi
Peoples, Nicholas
Ramakrishnan, Chandrika
Shrestha, Shrinkhala
Yin, Ruoyu
Karmacharya, Biraj
Yan, Lijing L.
Jafar, Tazeen H.
Strengthening urban primary healthcare service delivery using electronic health technologies: A qualitative study in urban Nepal
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
topic Qualitative Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9309786/
https://www.ncbi.nlm.nih.gov/pubmed/35898291
http://dx.doi.org/10.1177/20552076221114182
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