AUTHOR=Bogale Tariku Nigatu , Teklehaimanot Selamawit Meressa , Fufa Debela Tilahun , Enyew Daniel Berhanie , Nigusse Bedada Abebe , Dufera Kebebew Segni , Nigusie Weldeab Adane , Wolde Daka Dawit , Willems Herman Jozef , Bekele Tadesse Alemu 

TITLE=Barriers, facilitators and motivators of electronic community health information system use among health workers in Ethiopia

JOURNAL=Frontiers in Digital Health

VOLUME=Volume 5 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/digital-health/articles/10.3389/fdgth.2023.1162239

DOI=10.3389/fdgth.2023.1162239

ISSN=2673-253X

ABSTRACT=Abstract
Background: The electronic community health information system (eCHIS) has been implemented in Ethiopia to support health services delivered by community health workers. Despite the many benefits of digitizing community health information systems, the implementation of the eCHIS is challenged by many barriers resulting in low uptake. This study assessed the barriers, facilitators, and motivators of eCHIS use among health workers with focus on health extension workers (HEWs) in Ethiopia.  
Methods: Phenomenological approach was used to assess the barriers, facilitators and motivators of eCHIS use in Amhara, Harari, Oromia, Sidama, South West Ethiopia and Southern Nation Nationalities and People’s regions of Ethiopia. Data were collected from May 15 – 29, 2022. A total of 54 face-to-face in-depth interviews were conducted among HEWs, HEW supervisors, health information technicians and managers. The interviews were audiotaped using Open Data Kit, transcribed verbatim and translated into English. OpenCode 4.03 software was used for coding and categorizing the data. Thematic analysis was used to analyze the data. 
Results: The HEWs and other eCHIS users reported lack of infrastructure and resources; poor quality of training, follow-up, and supervision; parallel recording using the manual and electronic system; and HEWs’ workload as barriers hindering eCHIS use. Data quality, retrievability, and traceability; tablet portability; encouragement from supervisors; and positive image in the community resulting from HEWs using tablets in their routine activities were the main facilitators of eCHIS use. 
Conclusion: The study identified various barriers that adversely affect the use of eCHIS. An integrated and coordinated approach to eCHIS implementation that encompasses removing the barriers, and reinforcing facilitators is required.
Keywords: barriers; facilitators; motivators; electronic community health information system; health workers