Constraints to and enablers for contextualizing digital health terminology standards in Uganda’s health services: a qualitative case study

Abstract

ABSTRACTThis study investigated the constraints to and enablers for contextualizing digital health terminology standards using a case study approach of Uganda HIV services. Qualitative methods were used. The study was conducted at both the national and subnational levels of Uganda’s health system. Primary data were collected through key informant interviews, whereas secondary data were collected through document review. Twenty-one interviews were held at subnational levels among officers or their assistants including medical recorders, clinicians, nurses, laboratory technologists, pharmacists and administrators at health facilities and districts. Twelve interviews were held at the national level involving research institutions, academia, health development partners, health implementing partners, Ministry of Health and government agencies. The respondents were sampled purposively. Data were analysed using thematic analysis. The constraints to contextualizing digital health terminology standards were limited digital health terminology expertise, human resources deficits and inadequate information communication technology training. The enablers identified included presence of an installed base of established systems, digital health capacity-building endeavours and technical support at the health facilities. The study recommends that governments should invest in building capacities for digital health particularly training in terminology standards, with the vision of using uniform terminologies in health services across all levels of the health system. Constraints and enablers identified in this study informed our work of requirements generation and design of a framework for contextualizing digital health terminology standards for low- and middle-income countries like Uganda.