Cargando…
Factors Affecting the Successful Implementation of a Digital Intervention for Health Financing in a Low-Resource Setting at Scale: Semistructured Interview Study With Health Care Workers and Management Staff
BACKGROUND: Digital interventions for health financing, if implemented at scale, have the potential to improve health system performance by reducing transaction costs and improving data-driven decision-making. However, many interventions never reach sustainability, and evidence on success factors fo...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
JMIR Publications
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9862332/ https://www.ncbi.nlm.nih.gov/pubmed/36607708 http://dx.doi.org/10.2196/38818 |
_version_ | 1784875066084818944 |
---|---|
author | Schuetze, Leon Srivastava, Siddharth Missenye, Abdallah Mtiba Rwezaula, Elizeus Josephat Stoermer, Manfred De Allegri, Manuela |
author_facet | Schuetze, Leon Srivastava, Siddharth Missenye, Abdallah Mtiba Rwezaula, Elizeus Josephat Stoermer, Manfred De Allegri, Manuela |
author_sort | Schuetze, Leon |
collection | PubMed |
description | BACKGROUND: Digital interventions for health financing, if implemented at scale, have the potential to improve health system performance by reducing transaction costs and improving data-driven decision-making. However, many interventions never reach sustainability, and evidence on success factors for scale is scarce. The Insurance Management Information System (IMIS) is a digital intervention for health financing, designed to manage an insurance scheme and already implemented on a national scale in Tanzania. A previous study found that the IMIS claim function was poorly adopted by health care workers (HCWs), questioning its potential to enable strategic purchasing and succeed at scale. OBJECTIVE: This study aimed to understand why the adoption of the IMIS claim function by HCWs remained low in Tanzania and to assess implications for use at scale. METHODS: We conducted 21 semistructured interviews with HCWs and management staff in 4 districts where IMIS was first implemented. We sampled respondents by using a maximum variation strategy. We used the framework method for data analysis, applying a combination of inductive and deductive coding to organize codes in a socioecological model. Finally, we related emerging themes to a framework for digital health interventions for scale. RESULTS: Respondents appreciated IMIS’s intrinsic software characteristics and technical factors and acknowledged IMIS as a valuable tool to simplify claim management. Human factors, extrinsic ecosystem, and health care ecosystem were considered as barriers to widespread adoption. CONCLUSIONS: Digital interventions for health financing, such as IMIS, may have the potential for scale if careful consideration is given to the environment in which they are placed. Without a sustainable health financing environment, sufficient infrastructure, and human capacity, they cannot unfold their full potential to improve health financing functions and ultimately contribute to universal health coverage. |
format | Online Article Text |
id | pubmed-9862332 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | JMIR Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-98623322023-01-22 Factors Affecting the Successful Implementation of a Digital Intervention for Health Financing in a Low-Resource Setting at Scale: Semistructured Interview Study With Health Care Workers and Management Staff Schuetze, Leon Srivastava, Siddharth Missenye, Abdallah Mtiba Rwezaula, Elizeus Josephat Stoermer, Manfred De Allegri, Manuela J Med Internet Res Original Paper BACKGROUND: Digital interventions for health financing, if implemented at scale, have the potential to improve health system performance by reducing transaction costs and improving data-driven decision-making. However, many interventions never reach sustainability, and evidence on success factors for scale is scarce. The Insurance Management Information System (IMIS) is a digital intervention for health financing, designed to manage an insurance scheme and already implemented on a national scale in Tanzania. A previous study found that the IMIS claim function was poorly adopted by health care workers (HCWs), questioning its potential to enable strategic purchasing and succeed at scale. OBJECTIVE: This study aimed to understand why the adoption of the IMIS claim function by HCWs remained low in Tanzania and to assess implications for use at scale. METHODS: We conducted 21 semistructured interviews with HCWs and management staff in 4 districts where IMIS was first implemented. We sampled respondents by using a maximum variation strategy. We used the framework method for data analysis, applying a combination of inductive and deductive coding to organize codes in a socioecological model. Finally, we related emerging themes to a framework for digital health interventions for scale. RESULTS: Respondents appreciated IMIS’s intrinsic software characteristics and technical factors and acknowledged IMIS as a valuable tool to simplify claim management. Human factors, extrinsic ecosystem, and health care ecosystem were considered as barriers to widespread adoption. CONCLUSIONS: Digital interventions for health financing, such as IMIS, may have the potential for scale if careful consideration is given to the environment in which they are placed. Without a sustainable health financing environment, sufficient infrastructure, and human capacity, they cannot unfold their full potential to improve health financing functions and ultimately contribute to universal health coverage. JMIR Publications 2023-01-06 /pmc/articles/PMC9862332/ /pubmed/36607708 http://dx.doi.org/10.2196/38818 Text en ©Leon Schuetze, Siddharth Srivastava, Abdallah Mtiba Missenye, Elizeus Josephat Rwezaula, Manfred Stoermer, Manuela De Allegri. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 06.01.2023. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included. |
spellingShingle | Original Paper Schuetze, Leon Srivastava, Siddharth Missenye, Abdallah Mtiba Rwezaula, Elizeus Josephat Stoermer, Manfred De Allegri, Manuela Factors Affecting the Successful Implementation of a Digital Intervention for Health Financing in a Low-Resource Setting at Scale: Semistructured Interview Study With Health Care Workers and Management Staff |
title | Factors Affecting the Successful Implementation of a Digital Intervention for Health Financing in a Low-Resource Setting at Scale: Semistructured Interview Study With Health Care Workers and Management Staff |
title_full | Factors Affecting the Successful Implementation of a Digital Intervention for Health Financing in a Low-Resource Setting at Scale: Semistructured Interview Study With Health Care Workers and Management Staff |
title_fullStr | Factors Affecting the Successful Implementation of a Digital Intervention for Health Financing in a Low-Resource Setting at Scale: Semistructured Interview Study With Health Care Workers and Management Staff |
title_full_unstemmed | Factors Affecting the Successful Implementation of a Digital Intervention for Health Financing in a Low-Resource Setting at Scale: Semistructured Interview Study With Health Care Workers and Management Staff |
title_short | Factors Affecting the Successful Implementation of a Digital Intervention for Health Financing in a Low-Resource Setting at Scale: Semistructured Interview Study With Health Care Workers and Management Staff |
title_sort | factors affecting the successful implementation of a digital intervention for health financing in a low-resource setting at scale: semistructured interview study with health care workers and management staff |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9862332/ https://www.ncbi.nlm.nih.gov/pubmed/36607708 http://dx.doi.org/10.2196/38818 |
work_keys_str_mv | AT schuetzeleon factorsaffectingthesuccessfulimplementationofadigitalinterventionforhealthfinancinginalowresourcesettingatscalesemistructuredinterviewstudywithhealthcareworkersandmanagementstaff AT srivastavasiddharth factorsaffectingthesuccessfulimplementationofadigitalinterventionforhealthfinancinginalowresourcesettingatscalesemistructuredinterviewstudywithhealthcareworkersandmanagementstaff AT missenyeabdallahmtiba factorsaffectingthesuccessfulimplementationofadigitalinterventionforhealthfinancinginalowresourcesettingatscalesemistructuredinterviewstudywithhealthcareworkersandmanagementstaff AT rwezaulaelizeusjosephat factorsaffectingthesuccessfulimplementationofadigitalinterventionforhealthfinancinginalowresourcesettingatscalesemistructuredinterviewstudywithhealthcareworkersandmanagementstaff AT stoermermanfred factorsaffectingthesuccessfulimplementationofadigitalinterventionforhealthfinancinginalowresourcesettingatscalesemistructuredinterviewstudywithhealthcareworkersandmanagementstaff AT deallegrimanuela factorsaffectingthesuccessfulimplementationofadigitalinterventionforhealthfinancinginalowresourcesettingatscalesemistructuredinterviewstudywithhealthcareworkersandmanagementstaff |