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Imperial Journal of Interdisciplinary Research (IJIR)
Vol-3, Issue-2, 2017
ISSN: 2454-1362, http://www.onlinejournal.in
Imperial Journal of Interdisciplinary Research (IJIR) Page 895
Assessing of Information Communication
Technology Development in Primary Health
Care for Health Promotion, a Study at the
Asante Akyem North District of Ghana
Kojo Osei Frimpong1, Prince Osei Akumiah2, Dorothy Oforiwah
Antwi-Asante3, Nomah Daniel Kwakye4
1-3Presby University College, Ghana
4Yaroslav-the-Wise Novgorod State University
Abstract: Primary Health Care (PHC) has been
singled out as the most suitable health care setting to
meet the increasing need for health promotion
interventions and to curb the rising number of
chronic diseases. Most people depend on health care
services for health information, yet PHC is poorly
equipped to provide this service. The health system
in Ghana has a fundamental aim of maintaining or
improving the health outcomes of people living in the
country. The study assessed the use of ICT in PHC
for health promotion. This study was carried out in
Primary Health Care facilities at the Asante Akyem
North District in Ghana and sample size of 55 nurses
was selected from the health centers within the
district to participate in this study. The study
revealed that the most common forms of ICT tools
available were radio, mobile phones, Televisions,
computer / laptop, digital projectors, digital
cameras, DVDs, internet access, and landline
telephones. ICT in PHC are used for sending reports,
receiving information, communication among staff,
for learning, report preparation, storage of data,
education of clients / patients, leisure, entertainment,
and analysis of data. Most the nurses had skills in
using ICT applications such as word processing,
spreadsheets, presentation tools, basic E-mailing,
and basic use of the internet. Among the challenges
confronting the usage of ICT in PHC were irregular
power supply, high cost of purchase and installation,
inadequate knowledge on ICT, lack of internet
access, lack of financial support on the use of ICT,
virus attack and high cost of training.
Key words: Health, Health Education, Health
promotion, Primary Health Care, Public Health.
1. Introduction
Primary Health Care (PHC) has been singled out
as the most suitable health care setting to meet the
increasing need for health promotion interventions
and to curb the rising number of chronic diseases [1].
Most people depend on health care services for
health information, yet PHC is poorly equipped to
provide this service [2]. Primary health care systems
are responsible for providing various outreach
facilities to the community. A variety of programs
fall under the ambit of primary health care requiring
routine reporting of information. In addition to
routine monthly information, the primary health care
sector needs to also deal with large amounts of
extraordinary data arising from, for example,
epidemics and deaths that require immediate
response and action [3].
Developing Information Communication
Technology (ICT) supported to health
communication in PHC could contribute to increased
health literacy and empowerment, which are
foundations of health promotion and the notion of
enabling people to increase control over their health
and its determinants, and thereby improve their
health [4].
The PHC sector in developing countries like
Ghana is often the key asset responsible for
providing health care services to the population,
especially within rural areas [5]. At the moment,
attempts are being made by states and local
governments to introduce various reforms into
primary health care, such as decentralization,
integration of different health programs,
strengthening of management practices, and the
introduction of Information and Communication
Technologies (ICTs) to strengthen the health
information systems [6]. Also, there are multiple
administrative levels (community, district, province
and national) involved in the health information
systems each with their own information needs. As
such trying to harmonize and cater to these different
needs is another difficult undertaking. Typically, the
PHC sector is significantly under-resourced both in
terms of materials and people, and staffs are
overburdened with work often making it difficult to
Imperial Journal of Interdisciplinary Research (IJIR)
Vol-3, Issue-2, 2017
ISSN: 2454-1362, http://www.onlinejournal.in
Imperial Journal of Interdisciplinary Research (IJIR) Page 896
motivate them to engage with new efforts such as the
introduction of ICTs.
Despite the efforts of governments in developing
countries to improve living conditions, including the
prioritization of health care services at the policy
level, the majority of their populations still face
obstinate development challenges [7]. The existing
inequality of living conditions especially in the
health status of the people and the distribution of
basic services between, as well as within countries,
adversely shape the social development processes
[8].
The recent Human Development Report (HDR)
2004 describes that the majority of the population in
developing countries are still living in hunger and
poverty, are facing high disease burdens, and have
limited access to sanitation and health care services.
Poor health status is an important dimension of
deprivation and adversely influences social
development [9]. This needs to be strengthen, health
information systems has also been emphasized by the
recent World Health Report (WHR) 2004, which
states that health information systems are needed to
better support health interventions and improve
access to health services. For example, the problem
of maternal mortality often results from patients
living in rural areas not being able to reach the clinic
on time when needed due to distance and lack of
transportation. If information about the geographical
spread of pregnant women and of existing clinics can
be provided more effectively, authorities can take
steps, for example, to improve transportation or
strengthen outreach support, to try to deal with the
problem of poor access, and with it at least to some
extent, the maternal mortality problem.
Therefore, the responsibility to provide health
care to the broader community and to serve as the
hub for the health information systems rests with the
PHC structure. Other aspects of history, geography,
culture, infrastructure, inadequate skill levels and
pressures of everyday work heighten the complexity
of the primary health care sector. The culture of
information and communication, whether supported
by ICT or not, typically reflects the practice of
collecting data and sending it upwards to satisfy the
needs of the bureaucracy, rather than to support
action at the local level of the sub-district where
information is needed most [10].
2. Materials and Methods
2.1. Study Setting
The study was conducted at the Asante Akyem
North District in the Ashanti Region of Ghana. It has
Agogo as its capital. Agogo is approximately 80
kilometers east of Kumasi, the second capital of
Ghana.
During the year 2000, Ghana census recorded a
population of 28,271 in Agogo. The population
estimate in 2010 population and housing census
stands at 140,694 with 67,673 males and 73,021
females [11].
The district has one hospital namely Agogo
Presbyterian Hospital and three community health
centers and eighteen community-based health
planning and services (CHPS) centers.
2.2 Study Population
The target population for this study was primary
or public health care nurses working in the Health
Care Centers of the district under Ministry of Health
in the Asante Akyem North District. The Primary
Health Directorate of the Ministry of Health has staff
population of 150 primary health care nurses in the
district of the four public health facilities at Agogo
Presbyterian Hospital, Juansa, Amanteman and
Ananekrom. Per the four public health facilities the
staff strength for Agogo Presbyterian Hospital,
Juansa, Amanteman and Ananekrom are 62, 43, 15
and 30 staffs respectively (District health
Directorate).
2.3. Sample Size
Fifty-five (55) public health nurses working
within three health centers of the district were
sampled as subjects for this study. List of all primary
health care nurses working within the health centers
was obtained from the Health Directorate in the
district. Three of the public health centers were
selected which were Juansa, Amanteman and
Ananekrom. Per the three health centers selected the
total staff strength made up a total of 88 public health
nurses.
From the three centers Juansa, Amanteman and
Ananekrom 30, 10 and 15 public health nurses were
selected respectively.
2.4. Method of Data Collection
Questionnaires were administered to respondents
who were assisted to fill. The main instrument for
data collection were in the form of open and close
ended questions. The questionnaire made up of five
(5) sections. First section is on bio data of
respondents. Second section contains items on
availability and level of ease of using ICT in health
promotion. Third section asks questions on
usefulness and level of skills of ICT respectively.
The last part asks questions on the challenges
associated with the usage of ICT in health care for
health promotion.
2.5. Method of Data Analysis
Imperial Journal of Interdisciplinary Research (IJIR)
Vol-3, Issue-2, 2017
ISSN: 2454-1362, http://www.onlinejournal.in
Imperial Journal of Interdisciplinary Research (IJIR) Page 897
Data collected was edited and coded for analysis.
Statistical Package for Social Sciences (SPSS version
16) computer software was used to analyze data.
3. Results and Discussions
3.1. The Demographic Characteristics
Majority of the nurses , 50.9% were within the
ages of 25-29, followed by 20 -24 age group with
21.8.7%, 30 – 34 years with 10.9%, 35 -39 years
with 7.3%, 40 – 44 years with 5.0% and above 44
years with 3.6%.
20 of the respondents (36.3%) had Diploma in
community health whereas 19 (34.5%) had
Certificate in community health. The remaining 16,
representing 29.2%, had gone through varied level of
education notable among them were Diploma in
General Nursing, BSc Nursing, and Post Diploma in
Nursing.
Majority of the nurses that is 31 out of the 55
nurses were single, representing 56.4%. 41.8% were
married, 1.8% divorced.
With regards to number of years in service,
collectively, 94.5% of the nurses have had at least
one (1) year of experience in nursing whilst the
remaining 5.5% have had less than one (1) year
experience.
67.3% were affiliated to Christianity, 29.1% were
Muslims and 3.6% African traditional believers.
3.2. Availability and Rate of Ease in Using
ICT Tools
49 (89.1%) of the nurses indicated that the
television as ICT tool is available to them however,
63.6%, 9.1% and 16.4% of the nurse indicated their
level of ease of using TV in PHC delivery as very
high, high and medium respectively. In contrast, 6
(10.9%) indicated their level of ease of using as very
low.
In response to availability of mobile phone for
PHC, 47 (96.4%) of the nurses indicated that mobile
phone is available. With their levels of ease of using
ICT tool – mobile phone, 34 (61.9%), 7 (12.7%),
6(10.9%), 2(3.6%) and 4 (7.3%) were very high,
high, medium, low and very low respectively. In
contrast, 2 (3.6%) said mobile phone is not available
for PHC delivery but their level of ease of using such
tool is medium.
All respondents indicated that the radio is
available for PHC delivery in Asante Akyem North
District. 39 (70.9%) of mentioned that they have very
high skills in using radio, 6 (10.9%) said high level,
5 (9.1%) indicated medium, 2 (3.6%) of them said
they have low skills in using radio whereas 3 (5.5%)
said they have very low skills in using radio for
PHC.
41 (74.5%) of the nurses indicated that computer /
laptop as ICT tool is available to them however, 32
(58.2%), 2 (3.6%), 5 (9.1%) and 2 (3.6%) of the
nurses indicated their level of ease of using computer
/ laptop in PHC delivery as very high, high, medium
and low respectively. In contrast, 14 (25.5%) of
them reported not having computer / laptop available
to them for PHC delivery.
With regards to internet availability for PHC
delivery, 29(52.7%) of the nurses indicated that they
have internet available which consisted of
24(43.6%), 3(5.5%) and 2(3.6%) of very high, high
and medium level of ease of using respectively.
26(47.3%) of the nurses said that they do not have
internet available for PHC.
In response to availability of digital camera for
PHC, 30(54.6%) of the nurses indicated that digital
camera is available. With their levels of ease of using
digital camera as an ICT tool; 20(36.4%), 4(7.3%)
and 6(10.9%) were very high, high and low
respectively. However, 25(45.4%) said digital
camera is not available for PHC delivery.
With regards to digital projector availability for
PHC delivery, 32(58.2%) of the nurses indicated that
they do not have digital projector available which
consisted of 3 (5.5%), 6(10.9%) and 23(41.8%) of
medium, low and very low respectively level of ease
of using digital projector. 23(41.8%) of the nurses
reported to have digital projector for PHC.
Majority of the nurses indicated that printers and
landline telephones are available for PHC with
varied level of ease of using these tools for health
delivery and promotion. However, nurses mentioned
that scanners are not available.
The findings of this study are in consonance to
several studies reported on ICT use among
Reproductive Health Workers (RHWs) [12]. Idowu,
Ogunbodede and Idowu, 2003 reported that while
ICT capabilities (personal computers, mobile phones,
Internet) were available in Nigerian teaching
hospitals, mobile phones were spreading fastest.
Their findings also revealed that computers and
mobile phones were in use in all the teaching
hospitals but not much Internet connectivity was
available, meaning that most of the medical experts
used external (non-hospital) Internet services, such
as cybercafés, for even rudimentary Internet access,
such as e-mail. They further explained that while just
1.4% of the medical staff did not use the Internet in
any fashion, the vast majority (70.7%) of those using
the Internet did so only for e-mail.
3.3. Usefulness of ICT in PHC
The results showed that at least 50% (53) of the
nurses indicated ICT is useful in sending reports,
receiving information, communication among staff,
for learning, for report preparation, for storage of
data/ information and for analysis of data.
Imperial Journal of Interdisciplinary Research (IJIR)
Vol-3, Issue-2, 2017
ISSN: 2454-1362, http://www.onlinejournal.in
Imperial Journal of Interdisciplinary Research (IJIR) Page 898
Furthermore the result shows that least 70% (44)
indicated that ICT is useful for education of clients /
patients, for leisure and for entertainment.
The findings are in concordance to the findings of
the United Nations Development Programme in 2003
[13]. ICTs contribute to health education, knowledge
sharing, health monitoring, statistics gathering and
analysis, the delivery of care and in meeting
internationally agreed upon health targets with
respect to a number of diseases. ICTs’ impact on
health care have been particularly significant in
developing countries and in rural settings, where
long distances and the quality of the infrastructure
hinder the movement of physicians and patients [14],
reducing the quality of the health services delivered.
3.4. Level of Skills in the Use of ICT
Applications
The results points out that all of the nurses
(100%) had fair to excellent knowledge on word
processing application software. On spreadsheet
software, 50(90.9%) of the nurses had capabilities.
On the use of ICT presentation tools, 53(96.4%) of
the nurses had capabilities ranging from excellent to
fair. On communication via the e-mail, 54(98.2%) of
the nurses said they had fair to excellent skills in
basic e-mailing. Also with regards to basic internet
browsing, most of the nurses 51(92.7%) said they
had fair to excellent knowledge in internet browsing.
39(70.8%) of the nurses had fair to excellent skills in
using graphics. On both the issue of designing
webpage and graphics, most (not more 72.7%) the
nurses had some capabilities ranging from fair to
excellent skills.
A survey involving four general hospitals, 10
primary health-care centers, and six private hospitals
in Nigeria [15], reported that none of the institutions
had e-mail access or a Web site, only 5% of the
workers possessed personal computers, only 7% of
the health-care workers were computer literate, only
2% had any measurable computer skills, and just
65% had access to a mobile phone, but not
necessarily their own. This was in spite of the fact
that the state of Lagos has the largest concentration
of Internet service providers, telecom operators, and
cybercafés, intended to create a reasonable platform
for ICT use.
3.5. Challenges Associated with the Use of
ICT in PHC
Among the challenges confronting the usage of
ICT in PHC delivery in Asante Akyem North District
in the Ashanti Region of Ghana are presented in
Figure 4.1 are: inadequate knowledge in ICT (12%)
(17), high cost of purchase and installation (17%)
(24), irregular power supply (26%) (35), lack of
financial support on the use of ICT (12%) (16), lack
of internet access (17%) (23), high cost of training
(7%) (9) and virus attack (9%) (13).
The above challenges are not different from report
of Chandrasekhar and Ghosh, (2001) [16] that some
of the more obvious constraints common to
developing countries in using ICT in health delivery
include the limits of physical access to ICTs, the high
cost of providing access for nations trying to balance
multiple financial priorities, and the exclusion from
access of large segments of the population due to
inadequate infrastructure.
4. Summary
The study sought to assess ICT development in
PHC for health promotion in the Asante Akyem. The
major findings of the study include the following:
Most of the community nurses were below 30
years more than 70% and having between 1 to 3
years working experience.
The most common forms of ICT tools available
were radio (100%), mobile phone (96.4%), TV
(89.1%), computer / laptop (74.5%), digital projector
(58.2%), digital camera (54.6%), DVD (54.5%),
internet (52.7%), and landline telephones. The nurses
indicated varied levels of ease of usage ranging from
very high to very low.
The usefulness of ICT in PHC were for sending
reports, receiving information, communication
among staff, for learning, report preparation, storage
of data / information, education of clients / patients,
leisure, entertainment and analysis of data. Most the
nurses had skills in using ICT applications such as
word processing, spreadsheets / excel, presentation
tools, basic E-mailing and basic Internet browsing.
Among the challenges confronting the usage of
ICT in PHC were irregular power supply (26%), high
cost of purchase and installation (17%), inadequate
knowledge on ICT (12%), lack of internet access
(17%), lack of financial support on the use of ICT
(12%), virus attack (9%) and high cost of training
(7%).
5. Conclusions
Based on the findings of the study, the following
conclusions could be made from the study:
ICT based solutions offer a modern measure to
meet both current and future challenges of exploding
health expenditures of the population. However as
concerns have been raised regarding data security
and safety issues as well as acceptance by public
health nurses, stakeholders have to appreciate their
societal duty to minimize risks and optimize benefits
of technical innovations. The presented data found
evidence that public health nurses were highly aware
of the ongoing trends towards digitalization and
surveillance society. The rapid progress in the future
demands of health care requires for intensified co-
Imperial Journal of Interdisciplinary Research (IJIR)
Vol-3, Issue-2, 2017
ISSN: 2454-1362, http://www.onlinejournal.in
Imperial Journal of Interdisciplinary Research (IJIR) Page 899
operation and networking of stakeholders at a quite
early stage of planning of public health strategies and
implementation of health promotion related ICT
tools.
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