“web based healthcare system for comunnity information sharing

POLYTECHNIC OF NAMIBIA

SCHOOL OF COMPUTING AND INFORMATICS

DEPARTMENT OF INFORMATICS

PROJECT

“WEB BASED HEALTHCARE SYSTEM FOR COMUNNITY INFORMATION

SHARING”

Author: Nikodemus Angula

Supervisor: Tiko Iyamu

Submission: 06-13 October 2014

Project Period: March 2014 to October 2014

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Meta data

TITLE: Mr.

CREATOR: Nikodemus Angula

SUPERVISOR: Prof. Tiko Iyamu

INSTITUTION: Polytechnic of Namibia

DEPARTMENT: School of Computing and Informatics

COURSE / SUBJECT: Research Methodology (RIT811S)

TITLE OF THE PROJECT: Web Based Healthcare System for Community Information Sharing

MAIN KNOWLEDGE AREA: Health Information Systems

KEYWORDS: Information and Communication Technology, Health Systems, Mobile

Healthcare Systems, and Community Information Sharing System.

TYPE OF RESEARCH: Applied Research

METHODOLOGY: Qualitative Research Methods

STATUS: Research Project

SITE: Polytechnic of Namibia

DOCUMENT DATE: 06-13 October 2014

SPONSOR: None

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Declaration

I Nikodemus Angula, ID No 8606100278 born on 10 June 1986 in a village called Onakalunga in

Ohangwena region hereby declaring that this research thesis describes the work undertaken by me

as part of the Polytechnic of Namibia study programme. All views and opinions presented and

expressed therein remains the sole responsibility of my own original research work, and do not

necessarily represent that of the institute or anybody. Wherever other sources of information was

used, it has been indicated clearly with due references to the literatures.

Signature…………………………… Date…………………………………………………..

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Abstract

The main purpose of the study was to develop a web based healthcare system for community

information sharing. The system would allow members of the communities to access health related

information from anywhere, at any time, without physically visiting the hospitals.

The study has addressed the challenges faced by Ministry of Health and Social Service and health

service providers in Namibia on how community members access health related information and

how healthcare information are currently shared between the service providers and the

communities and also how information relating to healthcare can be distributed and accessed by

the sparsely populace of the country.

Web based healthcare systems are fast becoming the replacements for manual documentation

processing of healthcare information in both public and private health institutions. However,

online health based systems are very much flexible and provides easy access to the required

healthcare information anywhere and anytime online through various communication means.

Today’s online world is easily accessible through many channel of communication means which

are rapidly being developed such as wireless technologies, generation mobile communication

technologies and satellites technologies. Therefore, advancements through those communication

technologies make this online based application reachable by people in various part of the world.

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Table of Contents

Meta data ....................................................................................................................................................... 1

Declaration .................................................................................................................................................... 2

Abstract ......................................................................................................................................................... 3

Acknowledgement ........................................................................................................................................ 5

List of acronym ............................................................................................................................................. 6

Chapter 1 ....................................................................................................................................................... 7

1. Introduction ........................................................................................................................................... 7

1.1. Research problem Statement ............................................................................................................. 8

1.2. Research aim .................................................................................................................... 8

1.3. Research objectives .......................................................................................................... 9

1.3.1. Sub objectives ....................................................................................................................... 9

1.4. Research questions ........................................................................................................... 9

1.4.1. Sub questions ........................................................................................................................ 9

1.5. Limitation ......................................................................................................................... 9

1.6. Research significance ....................................................................................................... 9

1.7. Literature review ............................................................................................................ 10

1.8. Research methodology ................................................................................................... 10

1.9. Expected outcome .......................................................................................................... 11

1.10. Structure of the thesis ................................................................................................. 11

2.3 Healthcare Systems ......................................................................................................................... 13

2.4 Mobile Healthcare Systems ............................................................................................................. 14

2.5 Communities Information Sharing Systems .................................................................................... 15

3.4 Data collection ...................................................................................................................................... 18

3.5 Ethical consideration ...................................................................................................................... 20

Chapter 4 ..................................................................................................................................................... 21

4.1. Introduction .......................................................................................................................................... 21

References ................................................................................................................................................... 26

Appendix 2 .................................................................................................................................................. 30

Time Schedule and Work plan .................................................................................................................... 30

Appendix 3……………………………………………………………………………………….31

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Acknowledgement

I would like to thank Prof. Tiko Iyamu my supervisor, my research group members as well as the

contributions of all the entities involved, my family members, friends and co-workers. I wish I

could name each and every one of you who contributed directly or indirectly. All your efforts, hard

work and commitment that made this thesis as possible are highly appreciated. Indeed, you were

a great source of motivation and strength. Your ideas were solid bricks that helped to carry out this

work successfully on solid foundations that will stand the test of time.

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List of acronym

ICT Information and Communication Technology

MH Mobile Health

MHC Mobile Healthcare

MOHSS Ministry of Health and Social services

MR Medical Registration

NDP4 National Development Plan4

NIPMA Namibian Institute for Public Administration and Management

HIE Health Information Exchange

PoN Polytechnic of Namibia

RUPRI rural policy research institute

3G Third Generation Mobile Telephony

4G Fourth Generation Mobile Telephony

WHO World Health Organization

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Chapter 1

1. Introduction

Web based application is becoming almost ubiquitous worldwide in providing healthcare services

to the communities (Annapurna,2012).The increasing penetration of smartphones as well as the

3G and 4G networks provide a significant boost to the use of the web application for providing

healthcare services to the societies in order to improve the process of health information

dissemination to the societies as a result; it will benefit the societies since they will not travel long

distance to access health related information (Aarts,1999). They can use their mobile technologies

to access health information. The health service providers will also benefit due to the fact that

transport costs will be reduced when health information is disseminated to the regions via web

based technologies.

The web based health application initiated can help caregivers, communities and societies to reach

each other through a web based healthcare application platform by accessing health information

and services wherever they happen to be (Boland, 2007). The web based application will allow

communities, to login and access health information; this will hinder the Ministry of health and

Social Services (MoHSS) or health service providers sending its health officials to the regions in

Namibia to disseminate health information. Web based healthcare applications are important,

because they provide better access to health information to the communities and as a result the

involved parties will benefit greatly.

The web based healthcare application will support and enable Ministry of Health and Social

Services (MoHSS) or healthcare service providers to disseminate healthcare information to the

communities and the societies at large (Ackerknecht, 1982). The use of web based healthcare

application will enable healthcare service providers to achieve effective and efficient health

services delivery to the community in general and the societies (Rafael, 2007). This study led to

the development of a web based application because the world is moving faster and most of the

Namibian youth uses mobile technologies instead of listening to radio that broadcast health related

information, in other words radio program has group age in most cases only elders that listen to

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radio nowadays while majority of the youth uses mobile technologies to access information (Bates,

2003).

The main reason of developing a web based healthcare system is to simplify and automate current

manual way of distributing healthcare information to the communities. Currently, process of

accessing health information and distributing healthcare information are done in manual way

which is time consuming. Therefore, by developing this web based system, it will benefit all

involved parties greatly.

1.1.Research problem Statement

The Ministry of Health and Social Services (MoHSS) is the focal (main) actor in the provision of

healthcare services to the communities and societies, in Namibia (Smith, 2011). The healthcare

services are also provided by private organizations. Both public and private organization

experiences the same challenges in providing their services. One of the main challenges is the

communities’ access to healthcare information, and dissemination of health information to the

societies. The Namibian government is aware of this problem, hence it is recognized in the

National development Plan 4 (NDP4). The challenge can only get worse if it is not addressed. The

implication affects and impacts how healthcare services are provided to the general public,

specifically to the communities. This study aimed to provide a solution by addressing this

challenge, through the development of a web based application.

The challenge faced by the Namibian government and societies is that of access to health services.

Access is difficult due to the sparsely distributed population of Namibia, which makes it difficult

to not only provide health service, but also adds additional transport costs to those who want to

access services. Accessibility to healthcare information could be attributed to the fact that the

Namibian population is sparsely distributed, this making distribution of information to be difficult.

1.2.Research aim

The aim of the study was to develop a web based healthcare system for community information

sharing. The systems would allow members of the communities to access health related


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1.3.Research objectives

The objectives of the study were divided into main and sub.

The main objective is to develop a web based healthcare system for community information

sharing. The systems would allow members of the communities to access health related


1.3.1. Sub objectives

i. To understand how healthcare information are currently shared between the service

providers and the communities.

ii. To examine how information relating to healthcare can be distributed and accessed

through mobile technologies.

1.4.Research questions

The main research question of the study; How can a web based healthcare system, which allows

the communities and service providers to disseminate information, be developed?

1.4.1. Sub questions

i. How are healthcare information currently shared between the service providers and

the communities?

ii. How can information relating to healthcare be distributed and accessed by the sparsely

populace of the country?

1.5.Limitation

The study covered Katutura State Hospital and Windhoek Central Hospital as a unity of

Analysis. The sparsely populace of the country put a hinder of this research study. This is

because the researcher was not able to visit all the hospitals and healthcare centres country wide

for data gathering and capturing purposes due to financial constraints.

1.6.Research significance

This research study significantly aimed to develop web based application, an interaction channel

through which information is disseminated between communities and health service providers.

The outputs from the research would address the challenge facing the government and the

communities of access to health services. However, the study provided nurses, doctors and

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community members with the relevant health related information on the distribution of health

information to the societies. This health information would be very helpful to the health

Practitioners, Ministry of Health and Social Services, Policy makers, Health administrators as well

as Private and Public Hospitals in Namibia.

1.7.Literature review

The literature was conducted by looking at related materials similar to the research study, hence

a collection of published information and data relevant to the research questions and objective of

the study were conducted during the research study. The broad, comprehensive, in-depth,

systematic and critical review of scholarly publications, unpublished scholarly print materials,

audio-visual materials, and personal communications were looked at during the research study.

During the research study the researcher identified the importance of literature review because it

generate ideas, helps form significant research questions, helps in the process of research design

and also helps to test the research questions against what already known about your study or your

subject. The keywords were identified for the study such as Information and communication

technology (ICT), Health systems, Mobile healthcare system, Community information sharing

systems. Literature review are presented in chapter 2 for further clarification and in-depth

explanations.

1.8.Research methodology

The qualitative research method was selected as a strategy. Meaning that, qualitative data was

collected and analyzed using interpretive technique. This is mainly because qualitative type of data

are expressive, and opinion from involving actors. This type of data helped to understand the

interaction which takes place between, human-to-human, human-to-technology, and technology-

to-technology, in the delivering of healthcare services (Baden et al., 2013). The qualitative

methods was selected primarily because it allows research to gather data of subjective views and

opinions from individuals and groups. The interpretive technique was used to interpret qualitative

data collected during the research study in this case Windhoek Central Hospital, Katutura State

Hospital and Ministry of Health and Social Services. Research methodology are presented in

chapter 3 for further clarification and in-depth explanations.

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1.9.Expected outcome

The outcome of this study was to develop a web based healthcare system for community

information sharing the systems would allow members of the communities to access health related

information from anywhere, at any time, and without physically visiting the hospitals as well as a

thesis was documented. Skills and knowledge on health information distribution to the

communities was acquired during the research study. The thesis was documented as a course

program requirement.

1.10. Structure of the thesis

Below are the chapters included in this research study, however each chapter describes the research

study in details and give more clarification on the research that was conducted.

Chapter 1: Introduction

Chapter 2: literature review

Chapter 3: Research methodology

Chapter 4: Case study overview

Chapter 5: Data Analysis and findings

Chapter 6: Conclusion and recommendation

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Chapter 2

2. Literature Review

2.1Introduction

This section discusses the scientific and general overview of Mobile Healthcare Systems,

Information and Communication Technology (ICT), Healthcare Systems and Community

Information Sharing Systems. The keywords were identified of existing work or related materials

similar to the research study and they are described in details below.

2.2 Information and Communication Technology (ICT)

According to Healy (2011) information and communication technology can allows health care

providers to collect, store, retrieve and transfer information electronically. However, more specific

discussion of information and communication technology in health care is challenging due to the

lack of detailed definitions, the volume of applications, and a rapid pace of change in technology.

The increase penetration of smartphones enabled mobile health to play an important role in

healthcare to deliver relevant health services to the societies. Information and communication

technology has the potential to improve the quality, safety, and efficiency of health care.

Information and communication technology in health care is generally low (varying, however,

with the application and setting) but surveys indicate that providers plan to increase their

investments. Information and communication technology includes the capacity of quality and

efficiency gains in health sector (WHO, 2002). A barrier of ICT includes the cost and complexity

of information and communication technology implementation, which often necessitates

significant work process and cultural changes. Certain characteristics of the healthcare market-

including payment policies that reward volume rather than quality, and an uneven delivery system-

can also position barriers to information and communication technology adoption.

Because of its potential, policymakers need to better understand how information technology is

diffusing across providers, whether action to branch further adoption is needed, and if so, what

steps might be taken (Walsham,1995). Any policy to stimulate further investment must be

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carefully considered because of possible unintended consequences-such as implementation

failures due to organizations’ inability to make the necessary cultural changes Immigrant (Jameton,

1984). The use of Information and Communication Technology (ICT) in healthcare has improved

the well-being of people around the world. ICT can improve the quality of healthcare as well as

shift behavior to strengthen mobile health technologies, all of which can improve health outcomes

over the long term.

2.3 Healthcare Systems

According to Bruno (2003), healthcare system is the organization of people, institutions, and

resources to deliver healthcare services to meet the health needs of target populations. The use of

healthcare system is important; because it can help societies to access health information. World

health organization report further articulate that health systems are defined as comprising all the

organizations, institutions and resources that are devoted to producing health actions. A health

action is defined as any effort, whether in personal health care, public health services or through

intersectional initiatives, whose primary purpose is to improve health.

The use of healthcare systems will allow health service providers to promote, restore or maintain

health through healthcare systems technologies. Bruno (2003) further argued that, healthcare

systems encompass all organizations, people and actions whose primary intent is to promote,

restore or maintain health.

According to Hanson & Berman (1998) health service providers are the one that have the major

responsibilities for community health service. It is stated that, healthcare system can help in the

administrative process in healthcare sector. Health promotion is defined as an ongoing “process of

enabling people to increase control over, and to improve, their health through health system

technologies”, emphasizing the need to close the gaps of health inequities within and between

communities and to advocate social justice (Robert, 2008). Five action areas proposed by the

Ottawa Charter include building healthy public policy, creating supportive environments,

strengthening community actions, developing personal skills, and reorienting health services. The

three overarching strategies of health promotion are to advocate favourable conditions, enable all

people to achieve their fullest health potential, and mediate between the different interests of

society to attain health for all .With these principles in mind, it is important for policy makers and

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health practitioners to consider the social ecological context within which each health issue is

embedded. Mobile technologies is helping with chronic disease management, empowering the

elderly and expectant mothers, and reminding people to take medication at the proper time,

extending service to underserved areas, and improving health outcomes and medical system

efficiency. Mobile devices are saving money in the health care system.

To achieve improved health outcomes for both individual patients and populations, the future rural

health system will require that primary care providers and their patients connect to community

health resources, services, and initiatives that can improve individual health (especially for those

with chronic conditions) and “go upstream” to address environmental, policy, and other factors

that influence community and population health (Yakushko, 2005). Improved rural patient health,

improved rural community health, and improved rural quality of life are the prizes of the rural

health care system’s transformational journey. In concert with clinical quality and efficiency

metrics, rural communities should employ metrics that assess these more global outcomes. Both

rural providers, and the community injunction large, should be active participants in actualizing

the RUPRI (rural policy research institute) Health Panel’s vision for a high performance rural

health care system.

2.4 Mobile Healthcare Systems

Mobile health systems is defined by Mechael (2006) as a term used for the practice of medicine

and public health supported by mobile devices. The term is most commonly used in reference to

using mobile communication device, such as mobile phones, tablet computers and PDAs, for

health services and information. However, the use of this technologies improves health services

delivery to the communities.

Africa had the lowest rate of mHealth adoption while North America, South America, and

Southeast Asia showed the highest adoption levels. A number of countries have initiatives in the

pilot stage or have informal activities that are underway (WHO, 2011).

Member states reported their biggest mHealth obstacles were competing priorities, budgetary

restrictions, and staff shortages. Concerns over privacy and data security also were cited as barriers

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to effective implementation. Most countries are implementing mHealth through various types of

public-private partnerships (Hao & Jing, 2009).

According to WHO (1986) mobile health can be defined as the application of emerging mobile

communications and network technologies for health care systems. (It involves the use of mobile

computing medical sensors, and communication technologies for health care. However, successful

implementation of mobile health makes the right information available at the right place, at the

right time, and in the correct form.

Web based technologies has promised to transform healthcare organization by bringing

information to the point of care. Mobile technology has expanded dramatically around the world

(Bartholomew, 2006). According to Phil (2008) global mobile data traffic has doubled for the

fourth year in a row. And looking toward the future, the report estimates that “global mobile data

traffic will increase 18-fold between 2011 and 2016”. By the end of that time period, it is projected

that there will be 10 billion mobile devices in use around the world. Along with 3G and 4G, these

advances have had a huge impact on many walks of life. The utilization of smart phones and tablets

has transformed communications, commerce, and entertainment, among other fields. Their

emergence has improved service delivery, empowered consumers, businesses, and entrepreneurs,

and changed the way in which people access information and make transactions (WHO, 1978).

Now this technology is poised to alter how health care is delivered, the quality of the patient

experience, and the cost of health care. Mobile technology is helping with chronic disease

management, empowering the elderly and expectant mothers, reminding people to take medication

at the proper time, extending service to underserved areas, and improving health outcomes and

medical system efficiency.

2.5 Communities Information Sharing Systems

According to Lokuge (2006) community information sharing systems are defined as an ongoing

“process of enabling people to increase control over and to improve health information to the

societies”. Lokuge (2006) further argued that the need to close the gaps of health inequities within

and between communities and to advocate social justice remains a main concern in many

developing countries. It is important for policy makers and health practitioners to consider the

social ecological context within which each health issue is embedded. The social ecological

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approach views health as “a function of individuals and of the environments in which individuals

live, including family, social networks, organizations, communities and societies.

The use of community health sharing systems is used to disseminate health information to the

communities in order to improve healthcare by addressing fragmented personal health information.

However, these policies adoption will allow health information to be utilized to its full potential

to support effective and efficient care due to fragmented information creation and storage.

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Chapter 3

3. Research Methodology

3.1 Introduction

This section explains the methods and techniques that were employed in the study, to collect data,

the type of data that was collected, and how the data was analyzed. The selection of the methods

and techniques were influenced by the goal of the study, which was to develop a web based

healthcare system for community information sharing. The systems would allow members of the

communities to access health related information from anywhere, at any time, and without

physically visiting the hospitals.

3.2Research strategy

The qualitative research method was selected as a strategy. Meaning that, qualitative data was

collected. This is mainly because qualitative type of data are expressive, and opinion from

involving actors (Lindlof & Taylor,2002) .This type of data helped to understand the interaction

which takes place between, human-to-human, human-to-technology, and technology-to-

technology, in the delivering of healthcare services. The qualitative methods was selected

primarily because it allows research to gather data of subjective views and opinions from

individuals and groups (Savin-Baden & Major, 2013).

3.3 Research design

In this study, case studies were adopted as the main approach which the investigation was

conducted. According to Mouton (2001), a case study is defined; “as an intensive/ in-depth

investigation of a single unit. In this case Windhoek Central Hospital and Katutura State Hospital

which was selected as case studies.

This study adopted a case study as an approach because it has enabled the researcher to have an

in-depth investigation. It was suitable because the researcher got a chance to be involved with the

participants purposely and personally sit with them/talk with them face to face (Kothari, 1985).

The case study was selected in this study because it focuses on collecting information about a

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specific object, event or activity such a particular business unit or organization in this case Katutura

State Hospital and Central Hospital.

However, the researcher selected a case study mainly because the idea behind a case study clearly

give the researcher a picture of a problem one must examine the real-life situation from various

angles and perspectives. The case study was used because it is a research strategy that involves an

empirical investigation of a particular contemporary phenomenon within its real-life context

during data collection (Kumar, 2005).

3.4 Data collection

Semi-structured interview was conducted to gather health related information at Windhoek Central

Hospital and Katutura State Hospital. The two case studies were selected to represent other health

service providers that distribute health information to the communities in Namibia. The semi-

structured interview selected has enabled the study to gather concrete data, through insightful view

and opinion from the participants. The semi-structured interview technique conducted has allowed

flexibility during data collection, this included instant probing of participants answers that was

obtained as this was done face to face.The semi- structured interview used has allowed the

flexibility to rephrase and restructure the questions during the interviews.

Thus a total of eleven (11) nurses, four (4) doctors and three (3) administrators (secretaries) were

interviewed individually at the two hospitals. Eight (8) nurses were interviewed at Central Hospital

and three (3) nurses at Katutura State Hospital. Doctor’s interviewed were two (2) from Windhoek

Central Hospital and two (2) from Katutura State Hospital. There were two (2) group interviews

conducted with nurses, which ranged from two to three nurses at a time. All group interviews with

nurses were conducted at Central Hospital. Additionally, two (2) administrative staff referred to

as secretaries at both hospitals were interviewed at the Central Hospital and one (1) at Katutura

State Hospital. Below is a Bar graph indicating the total number of interviews conducted for each

population group.

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Furthermore, nurses were first interviewed and then doctors. This order was followed simply to

determine or separate what nurses said from doctors and because nurses are the first contact point

of patients in reference to patient care. The researcher conducted group interviews with nurses

only because the researcher experienced that it was unlikely to get doctors or secretaries in one

room for a group interview, or even if they were in one room the researcher could only interview

them one at a time. One interview with a nurse was conducted by appointment and the rest without

prior appointments.

In addition, the selection criterion was that each member of the population groups to be interviewed

had to be employed and based at these public hospitals for over one year.

The interviews were conducted at the premises of the hospitals. Each interview took an average of

11 minutes, with interview durations ranging from 2.39 minutes (a situation where the interviewee

only had time for one or two questions) to 22.51 minutes. The interviews were conducted in the

English language. These interviews were recorded using an audio recording device and the

recorded interviews were transcribed.

0

1

2

3

4

5

6

7

8

9

Central Hospital Katutura Hospital

Interviewees

Public Hospitals

Population group interviews

Nurses

Doctors

Administrators (secretaries)

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3.5 Ethical consideration

As stated in the research objectives, and indicated in the research methods section, the research

was carried out, using healthcare facilities for both Katutura State Hospital and Windhoek Central

Hospital. Due to the sensitive nature of healthcare data, the ethics of the two institutions were

highly considered. The study abided to the ethics of the Ministry of Health and Social Services

(MoHSS), and the specific healthcare facilities that were used. Also, the research ethics of the

Polytechnic of Namibia, under which this study was conducted, was strictly adhered to throughout

the course of this research study.

According to Bless (1995) research ethics are moral codes that should be abided by the researcher

when conducting researches”. What this basically means is that it governs the researcher in order

to be able to distinguish between right and wrong when conducting a research. The study ensured

that no person’s rights was violated in any manner during the research study. Explanation about

the nature of the study highlighted to the participant prior participation was ensured during the

study. Anonymity and confidentiality was highly considered during the research study.

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Chapter 4

4. Case Study

4.1. Introduction

Two organisations, Windhoek Central Hospital and Katutura State Hospital were used as cases

in the study. Windhoek Central hospital is located at Harvey Street Windhoek, Namibia.

Windhoek Central Hospital is a public hospital in Windhoek, Namibia. It is one of the two

state hospitals in the city. Katutura State Hospital is a hospital in Katutura, the black township

of Windhoek, Namibia. It is one of the two state hospitals in the Windhoek area. These two

hospitals are given a mandate to provide healthcare services to the communities in Namibia.

4.2 Kututura State Hospital

At Katutura State Hospital health information is accessed and distributed in a manual way.

Furthermore, the hospital has two sections. The outpatients that is where people come from home,

they go at the reception where they can get assistance. However, the reception is where the

patient’s information is kept in a book or causality side. Normally what happens when Katutura

State Hospital receive a patient, nurses admit the patient, and hence the patient information or

details are kept in the book and the health passport, therefore if the patient losses the health passport

information is lost forever. The way nurses communicate is through reading what doctors wrote

manually in the health passport and have access, the information. Namibian Institute for Public

Administration and Management (NIPAM), could offer computer typing courses for the public

staffs to be equipped with computer typing skills.

The challenge of e-health system is that the process is a bit slow due to low typing abilities as well

as insufficient training received by the staffs.

4.3 Windhoek Central Hospital

Windhoek Central State Hospital case study was selected to represent other health centers in

Namibia. However, Windhoek Central State Hospital is divided into (two sections) private patient

section and state patients section, which include civil patients. At public patients section civil

patients have to go through reception for the counter to capture their faces. They provide personal

identification documents and other details such as residential addresses and telephone number. The

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health passport have a (Medical registration) MR number, that can be used to track the patient

health records and if the patient had been at the hospital before. The Windhoek Central Hospital

has a human resources system that is used in the public service all the ministries makes use of such

a system. The circulars in the public sectors are presented in the system and also internal posts are

being advertised on the system. The Windhoek Central Hospital currently do not have a technology

platform used as an interaction channel between the health service providers and the communities

to share healthcare information to the communities.

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Chapter 5

5. Data Analysis and findings

5.1 Introduction

The qualitative data collected was analyzed using interpretive technique whereby the data was

examined, categorized, summarized, in order to establish meaning and maintain evidence. The

qualitative data was collected from both healthcare professionals of Windhoek Central Hospital

and Katutura State hospital. Among them nurses, doctors and other healthcare administrators.

Health information obtained from the two case studies namely Windhoek Central Hospital, and

Katutura State Hospital were categorized based on the sequence of the interviews conducted

below.

5.2 First category: Windhoek Central Hospital

Windhoek Central Hospital does not have a technology platform that act as an interaction channel

to distribute health information to the communities. In addition, the hospital does not have a

mechanism in place that can allow communities to access health information anytime, anywhere

without physically visiting the hospitals. The health professionals normally communicate with

each other through a switch board and manual writing on health passports. However, the Windhoek

Central Hospital patient information is stored on the system called e-health system, when the

patient comes to the hospital for the second time nurses and doctors can use medical registration

number to retrieve the patient’s details. Windhoek Central Hospital healthcare professionals when

sharing health information to the communities they normally use manual posters to distribute

health information whereby, drivers have to drive long distance to distribute health related

information across all the health centres country wide. Windhoek Central Hospital at the moment

still uses parallel systems, the manual one of physical files and the computerized one is also up

running.

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5.3 Second category: Katutura State Hospital

The administrative staff, doctors and nurses at Katutura State Hospital do not have a system in

place that distribute health related information to the communities, however they only

communicate among themselves through record keeping. The doctors normally read what nurses

wrote on manual health passports based file. The other method of communication in terms of

emergencies is a switch board in the hospital, switch board is responsible for connecting health

professionals and any other person who is needed on call or to come and attend to any emergencies.

The system in place currently is the e-health system which enable operations to run smoothly and

bring about less work. The e-health system is used by doctors at the admission office enters (patient

data) using their laptop then that information is immediately available on the system for access.

The state hospital uses health passport to keep patient’s details. The health passport has a medical

registration, this can be used to check if the patient was at the hospital before. Katutura State

Hospital logistic department staff are still transporting health information to the communities by

car, hence this is time consuming and paper distributed might get spoiled by natural disasters.

5.2 Findings

The study found out that two case studies that were selected for the study do not have a web based

application to distribute health related information to the communities. The Ministry of Health and

Social Services, Windhoek Central Hospital and Katutura State Hospital do not have a system in

place that disseminate health information. This study identified that both Windhoek Central and

Katutura state hospitals have (e-health system) a system used to keep patients details. Katutura

State Hospital also uses a switch board. Windhoek Central Hospital has a system in place called

human resources system which is a system used in the public service, hence all the ministries

makes use of such a system.

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Chapter 6

6. Conclusion and Recommendation

6.1 Conclusion

The use of Information and Communication Technologies (ICT) by healthcare service providers

is often driven by the need to achieve effective and efficient services delivery to the community in

general. The interaction channel through which information is shared between the community and

health service providers, exchange, and distribution of information within the environment and

significantly address the challenge of access to health services highlighted in the National

development plan 4 (NDP4). Ministry of Health and Social Services MoHSS have been challenged

in the way they carry out their operations, processes and how information is distributed to the

communities. The challenge include distribution and information flow between the communities

and the healthcare service providers. Unfortunately, these challenges and gaps hampers and

negatively impact healthcare service delivery specifically to the communities and societies.

Development of web based Healthcare System for community Information sharing would allow

members of the communities to access health related information from anywhere, without visiting

the hospitals.

6.2 Recommendation

It is evident that, the accessibility and distribution of health related information remain the main

concern in Namibia. From the Namibian point of view, there are major challenges and constrains

facing the Ministry of Health and Social Services, Windhoek Central Hospital and Katutura State

Hospital of disseminating health information to the communities. Therefore the study is

recommending policymakers to better understand how health information is accessed and

distributed to the communities without physically visiting the hospitals in a form of technology

platform. Furthermore, policymakers should formulate policies to further stimulate investment in

the accessibility of health information to the communities and training must be provide to the

communities in the usage of technology initiated by students at higher/tertiary institutions and

projects done at academic level must be implemented.

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Appendix 1: Data collection tool

Interview questions

(a) How do you distribute health information to the communities?

a. Why do you distribute the information in that way?

(b) What type of health information do you distribute to the communities?

a. How do you know what types of information to distribute?

b. Do you think that all members of the communities need the same type of

information?

(c) What platform do you use to distribute health information to the communities?

a. Why do you make use of that platform?

b. What other platform can you possibly make use of?

(d) How long does it take for health information to reach to the communities?

a. Why do you think it takes that long?

(e) What is the process of distributing health information to the communities within the

ministry?

a. What are some of the implications of the process?

(f) What are some of the challenges that you normally encounter with the current system

that distribute health information to the communities?

a. Why do you think that those challenges exist?

b. How do you think that those challenges can be addressed?

(g) What system are you currently using for distributing health information to the

communities

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Appendix 2

Time Schedule and Work plan

The gannt chart was used for the study to illustrate the start and finish dates of the research

activities, proposed days, start, end, month and year. According to Wilson (2003) a gannt chart is

defined as a graphical aid that helps viewers/researcher quickly see the order and duration of

project research tasks.

GANTT CHART

Research

Activities

jan feb mar apl may June July Aug sep Oct nov dec

Planning

Writing a

research

proposal

System design

Development &

testing

System

implementation

Evaluation

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Appendix 3

Below are screen shot of Web Based System for Community Information Sharing

This is the login form for web based system for community information sharing. The end user

can login by providing their user name and password.

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This screen shot indicate that if the end user username and password is wrong or the field are not

filled than the system will not allow you to login.

This screen shot shows the whole lay out of web based system for community information

sharing.

This screen shot can allow the user to upload image.

“web based healthcare system for comunnity information sharing

Documents