Effectiveness of e-Tracker System in Strengthening Health Information System in Volta and Eastern Regions, Ghana: Findings from the Pre- and Post-Surveys (Preprint)
Authors: Lee Young-Ji , Kim Sun-Young , Lee Seohyun , Kim SeYeon , Choi Wonil , Jeong Yoojin , Rhim Nina Jin Joo , Seo Ilwon 
Published: December 2020

BACKGROUND

Despite the increasing attention to electronic health record (EHR) system in the field of global health, most African countries still depend on inconvenient and inaccurate paper-based system. Good Neighbors International and Evaluate 4 Health have recently supported Ghana Health Service (GHS) rollout its EHR system called e-Tracker in three Regions in Ghana -- Upper East, Volta (recently renamed to Oti and Volta Regions), and Eastern Regions. The e-Tracker is an Android-based tracker capture app to collect maternal and child health (MCH) data electronically and transmit the data into the District Health Information Management System (DHIMS)-2 managed by District Health Offices in Ghana. This mHealth program has been implemented in the Community Health Planning and Services (CHPS) in the three Regions.

OBJECTIVE

The aim of this study is to evaluate whether the use of the e-Tracker system has been effective in improving the quality of MCH data management in Ghana. Specifically, this study assesses changes in the knowledge, attitude and practice (KAP) of the health workers regarding MCH data management by comparing the pre- and post-survey results.

METHODS

To assess the effectiveness of the e-Tracker system, KAP of frontline health workers were measured through self-administered surveys before and after the implementation of the e-Tracker system. The surveys were conducted among participants of the e-Tracker system training sessions, with a purposive sampling scheme. A total of 1,124 health workers from Volta and Eastern Regions participated in both pre- and post-surveys. McNemar’s Chi-Square test, Wilcoxon signed-rank test were used for a pre-post comparison analysis. Also conducted were random-effects ordered logistic regression and random effects panel analysis.

RESULTS

The results of the pre-post comparison analysis showed significant improvement in the Knowledge and Practice levels. However, the level of Attitude towards electronic data management has worsened compared to the pre-survey when they hadn’t start to use the e-tracker system. The results of the regression analyses showed that demographic and environmental factors had impact on Attitude and Practice. These findings imply that using a tablet PC-based e-Tracker system could enhance the health data management system in Ghana but external support would be needed to improve Attitude towards the emergent system.

CONCLUSIONS

In Ghana, the e-Tracker system is to be scaled up nationally, increasing the need to evaluate its capability and sustainability more comprehensively and rigorously. This study provides empirical evidence for the effectiveness of the e-Tracker system and some policy implications for a nation-wide scale-up of the mHealth system. This study may also provide insights for other African countries regarding strengthening health data management and health information system.

CLINICALTRIAL

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