Examining the Practices and Challenges of Information Technology in Health Supply Chain Management in Alsabah Children’s Hospital, Juba, South Sudan

Paulo Okech1*, Emmanuel Gore2 and Ogeno Charles Johnson3

Abbreviations: ICT: Information and Communication Technology; WHO: World Health Organization; HSCM: Health Supply Chain Management.

Introduction

Information and communication technology (ICT) is a very important tool in healthcare facilities and it plays a very crucial role in improving the quality of health services along with patient satisfaction. Some previously carried studies discovered the importance of the adoption of the new information communication technologies (ICT) into the health supply chain management system for additional support [1]. This support includes electronic medical records which could reduce the time of the treatment steps. The World Health Organization (WHO) also discussed the benefits of the adoption and the role of ICT in improving the health care system and improving the data exchange which could lead to better cost-effectiveness in the firms [2]. It can help the physicians and Nurses in performing their daily duties with ease. They could easily access the data of the patients on a single platform and prescribe medications to the patients and this prescription could also be transacted through these technologies.

Using health care technologies could help in reducing medical errors, decrease treatment time, manage health teams, patients, and enhance the service quality and safety [3]. It’s very important to provide high-quality health care services to the patients who need treatment or medical attention because this could affect the level of satisfaction. Health care services should be acceptable by the patients along with those who seek special medical attention, and should not affect the casual or regular behavioral choices. However the attitudinal of satisfaction in the health services depends on the presence of a strong, well structured, and oriented health management system [4]. A study conducted in Turkey observed that the level of satisfaction among the patients getting treatment at a private hospital was greater than those who got treated at the government hospitals. It was because the health staff or teams in private hospitals were well trained and up-to-date with the new health technologies [5]. Computer technology or software in hospitals could be utilized to examine the internal organs, complex surgeries, and transmit orders from other departments within or outside the hospital. It could also be used to order health commodities and view patients’ records and profiles. The benefits associated with the use of electronic software in the healthcare system have added positive value to the patient’s care. This is the reason that more and more healthcare centers are adopting the latest technology and taking steps to transform the way they operate [6]. This study assessed the practices of information technology adoption in the health supply chain management and also identified the major challenges associated with information technology in the Hospital.

Methods

An in-depth interview was conducted guided by the research questions to gather information from 8 individuals (staff) in Alsabah Children’s Hospital. The participants recruited for this study included hospital staff who were on daily duties. Participants were informed about the purpose of the research before the exercise along with the study information provided by the researcher and the hospital administrator. The educational background of the participants’ was Secondary and University leavers, Participants were personally approached for their acceptance to participate in the study. An adequate environment and time were allocated and they were allowed to speak freely about their ideas regarding the study. The main purpose was to get the real picture of practices and the challenges of information and communication technology in health supply chain management in the Alsabah children’s hospital. Interviews were successfully conducted and the estimated time for each participant was around 30 - 35 min. A topic guide was used to conduct the interviews. The hierarchy followed in the interview was that first, the researchers introduced themselves, and then the participants introduced themselves. Thereafter, they were immediately asked 6 questions one after the other and participants shared their ideas about the research questions. All the interviews were registered and written. All texts were anonymized. Field notes were also kept during the interviews. Substantive content analysis with some elements of grounded theory was used to analyze the data. Data collection, coding, and analysis were interconnected processes. The analysis of data was completed immediately after the interview. A modified version similar to the three-step coding and analysis approach (open coding, axial coding, and selective coding) introduced by Strauss and Corbin was used. Each transcript was read at least twice and core concepts were identified. Codes were assigned for the selected texts. This was further developed by adding sub-themes which were followed by the detailed coding. A preliminary coding scheme was developed after identifying the major themes. The relationships and differences between codes were identified. Coding was done and cross-checked twice, and detailed discussions were conducted where mismatch was found to achieve consensus Table 1.

Results

We carried out 8semi-structured interviews with a total of 8respondents of which one was a medical officer, one nurse, one Statistician, one lab technician, one logistician, one hospital administrator, one pharmacist, and one EPI vaccinator. The interviewed people were enthusiastic and concerned about the study and its outcomes. The main key areas identified were lack of ICT new technologies, training, and the severe shortage of qualified and trained human health personnel to fulfill these gaps in the hospital.

Discussion

On inspecting the health technologies available in the hospital, we found that only one hematology machine was available along with 3 microscopes and all these were functional. The main challenge was the non-availability of the essential basic health technologies in the hospital. Three desktop computers were available but were not in use due to the lack of internet connectivity and persons to operate them.

It was also found that there was a lack of knowledge regarding the role that new technologies could play. Only two participants of this study were able to respond adequately (Lab technician and the medical officer). On the other hand, most of the participants could not answer adequately about how these technologies improved the HSCM practices. Most of them answered that they did not know because they had never seen those technologies. Only the medical officer and the lab technician were able to respond adequately. Regarding the views about the major external challenges hindering the adoption of ICT in HSCM, only the hospital administrator and medical officer responded and the response was no direct funding from the national government to support the hospital and the support from the partners was insufficient to close the gaps. On the views about the major company- related internal challenges hindering the adoption of ICT in HSCM, the hospital and the medical officer mentioned the main challenge as green pasture and less number of the trained and qualified staff due to the lack of motivation and low payment. . Among the proposed solutions for how the above barriers to the adoption of ICT in HSCM can be removed, hospital staff suggested allocation of adequate resources including financial and new technologies, building additional children’s hospital, training and motivation, and regular supervision along with the implementation of good policies for staff retention.

Conclusion

The lack of adoption of new technologies in the hospital is the most key findings. Moreover, the absence of the knowledge on use of the new technologies and lack of staff motivation remains the main challenge. The benefits of adopting and using advanced new technologies were highly recognized by the health workers in the hospital. Among the key benefits, health technologies could reduce the working load, remove the huge burden, help in performing complex surgeries, and could also improve communication among the staff. In short, there is a great need to urgently support the hospital with the necessary essential new technologies to achieve the desired level of services and increase the efficiency and capacity of the hospital. However, World Health Organization (WHO) also discussed the benefits of the adoption and the role of ICT in improving the health care system and improving the data exchange which could lead to better cost-effectiveness in the firms [6]. This study will inform and guide the countrywide, and the stakeholders on the crucial need of the new technologies in the national hospitals, and their role in improving the health services delivery and health of the patients.