JMIR Publications

ABSTRACT

Background:

Botswana has made significant investments in its healthcare information infrastructure, including vertical programs for child health and nutrition, HIV care, and Tuberculosis (TB). However, effectively integrating the more than 18 systems in place for data collection and reporting has proved to be challenging. The Botswana Health Data Collaborative Roadmap Strategy (2020-24) states that “there exists parallel reporting systems and data is not integrated into the mainstream reports at the national level,”seconded by the Botswana National eLearning strategy (2020) stating that “there is inadequate information flow at all levels, proliferation of systems, reporting tools are not synthesized; hence too many systems are not communicating.”

Objective:

1. Create a visual representation of how data is processed and the inputs and outputs through each healthcare system level. 2. Understand how front-line workers perceive healthcare data sharing across existing platforms and the impact of data on healthcare service delivery.

Methods:

The approach engaged participants from the start, allowing input about all aspects of the study. Ethical clearance was obtained from all necessary stakeholders, and over 30 institutions were sensitized. The Rapid Assessment Process (RAP) and Technology Assessment Model for Resource Limited Settings (TAM-RLS) informed the design of survey questionnaires.

Results:

The steps taken to perform our study so far have broader value and applicability. These steps should be adopted by most research studies in the healthcare sector and are especially important in environments where it may be difficult to secure buy-in regarding participation. During this process, local healthcare centers commented that they required further data science education. To this end, we created a free data science workshop to teach basic skills to those working in the healthcare sector. As part of this workshop, we invited the participants to help us collect further data about Botswana’s data healthcare infrastructure as phase two of our project to try and broaden and deepen our understanding.

Conclusions:

We believe the steps we have detailed and implemented for our study should be considered heavily when designing global health informatics studies. Even more broadly, global health research in general would benefit from including much of our approach, especially in environments where it may be difficult for buy-in regarding participation.