ICT applications as e-health solutions in rural healthcare in the Eastern Cape Province of South Africa

This paper describes a study which focused on factors perceived to influence the uptake and use of Information and Communication Technology solutions (ICTs) as e-health solutions in selected rural Eastern Cape healthcare centres (South Africa), and on structural variables relating to these facilities and processes. Attention was also given to two psychological variables that may underlie an individual’s acceptance and use of ICTs: usefulness and ease of use.

The aim of the study was to better understand how ICTs can be used more effectively to improve the health system in these selected number of rural Eastern Cape healthcare centres (St. Lucy’s Hospital, Nessie Knight Hospital, the Tsilitwa Clinic, the Madzikane Ka-Zulu Memorial Hospital and the Nelson Mandela General Hospital) and to make recommendations for their implementation.

Results of the present study indicate the following:

• a majority of participating staff perceived their level of ICT-related skills to be a problem that could hamper application of e-health solutions.
  

• all staff believed that lack of information (i.e. lack of relevant content for ICT applications) was a barrier to e-health solutions.
  

• in spite of some positive e-health policies that have resulted in ICT-related applications (e.g. computerised patient administration system) at some centres, there were also several indications of e-health policies perceived as inappropriate (e.g. policies that distributed ICTs to only certain selected departments and inadequate technical support and maintenance policies).
  

 Conclusions and recommendations:

• all structural and psychological factors investigated were seen to impinge to some extent on effective use of ICT applications as e-health solutions in the rural healthcare centres involved in the study.
• there was a distinct interplay between the various variables, with perceived ICT related shortcomings having a negative impact on perceived usefulness and ease-of-use variables and thus decreasing the likelihood of effective e-health solutions.
  
• this means that to increase effective use of ICTs that form part of e-health initiatives in the healthcare centres, a vital first step is to address reported perceived shortcomings.