Addressing challenges in the development of health information systems in The Gambia

Background: The Gambia, like many other developing countries, has encountered numerous challenges in terms of developing effective and efficient health information systems (HISs). The country's health sector is characterized by a human resource base lacking in numbers and specialized skills, coupled with poor information management and ineffective referral systems. These factors have rendered the development and implementation of effective and efficient HISs more complex. Methods: We conducted a quantitative study designed to evaluate the level of IT expertise in the Gambia's health care sector, availability of electronic health record (EHR) systems, database management and record-keeping methods, constraints on improving HISs, and willingness to implement an HIS. Furthermore, we investigated the factors and fundamental challenges associated with improving HISs in health institutions in the Gambia, and we determined the willingness of clinicians to implement effective and efficient HISs. Results: A total of 280 clinicians responded to the survey (response rate: 97.5%). In most hospitals or clinics, the lack of the availability of EHR systems (60%) and database management systems (66%) significantly influenced clinicians' willingness to implement an HIS (87%) to have significant positive weights. Considering to implement a HIS will improve the performance and quality delivery of clinicians. Conclusion: Our results reveal that availability of EHR systems, database management or record-keeping methods, and constraints on improving HISs had significant effects and can serve as a baseline for policymakers to draft appropriate policies for managing and enhancing the interoperability of the Gambia's HIS before and after implementation.