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International Journal of Informatics and Communication Technology (IJ-ICT)
Vol.10, No.3, December 2021, pp. 171~181
ISSN: 2252-8776, DOI: 10.11591/ijict.v10i3.pp171-181 171
Journal homepage: http://ijict.iaescore.com
Knowledge and utilization of health informatics among medical
doctors in Ahmadu Bello University Teaching Hospital, Shika-
Zaria
Jamila Mohammed Dahiru
Department of Mass Communication, Ahmadu Bello University, Zaria, Nigeria
Article Info
ABSTRACT
Article history:
Received Dec 20, 2020
Revised Sep 2, 2021
Accepted Oct 11, 2021
The strategic vision in the health care system now underpins application of
information communication technology for effective health care delivery.
Recognising the potentials of Information and communications technology
(ICT) for health, the Nigerian government as part of its policy derive towards
achieving effective health care delivery by the year 2020, adopted use of
ICT. This study assessed the level of knowledge and utilization of health
informatics among medical doctors in Ahmadu Bello University
Teaching Hospital (ABUTH), Shika-Zaria. This study adopted descriptive
survey method and structured questionnaire as its instrument of data
collection. Findings revealed that 68% (n=150) of the 220 sampled medical
doctors in ABUTH are aware of health informatics and that 68.2% (n=120)
have knowledge of how to use it. The most prominent areas of health
informatics among the medical doctors are ‘management information
system’, ‘electronic health record system’ and ‘electronic medical record’.
However, only 58.6% (n=120) of the medical doctors in BUTH Shika-Zaria
are utilizing health informatics. Internet (n=120, 60.5%) and interpersonal
sources (n= 71, 32.3%) were found to be the major sources of information of
knowledge and utilization of health informatics among the medical doctors.
The study therefore recommends that ABUTH, Shika-Zaria should put in
place more mechanisms for creating awareness on use of health informatics
varieties and a strong need for time-series research to examine future
development in respect to knowledge and utilization of health informatics in
Nigerian health institutions.
Keywords:
Health care system
Health informatics
Healthcare delivery
ICT
Knowledge and utilization
Sources of information
This is an open access article under the CC BY-SA license.
Corresponding Author:
Jamila Mohammed Dahiru
Department of Mass Communication, Ahmadu Bello University
Samaru Campus, Community Market, 810211, Zaria, Nigeria
Email: jamiladahiru@yahoo.com
1. INTRODUCTION
Information is a generic term which has been described as the livewire of any enterprise.
information and communication technology (ICT) has become a tool in service delivery and has a
revolutionary impact on how people live and perceive the world [1]. Scholars [2] state that ICT has
touched every aspect of life, giving birth to the contemporary “Es”: e-learning, e-commerce, e-
governance, e-banking, e-shopping and e-health. The healthcare environment is increasingly adopting the
use of technology for its everyday delivery. Technological transformation is now among the major hitch
and one of the measures used in rating the advancements of health care delivery across the globe [3].
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Health informatics involve the use of information and communication technology in support of
health and health-related fields including, healthcare services, health surveillance, health literature, and
health education, knowledge, and research [4]. In practical term, it entails a means of ensuring that correct
health information is provided in a timely and secure manner via electronic devices for the purpose of
improving the quality and efficiency of healthcare delivery, prevention programmes in healthcare
delivery, solving critical data management and clinical communication challenges especially in
developing countries given the high burden of diseases and low number of skilled medical personnel [5].
A health system that utilises health informatics therefore, enjoys benefits such as, a transformed
health care delivery, access to well-defined health strategies, reduced healthcare cost, improved disease
management, improved patient safety and decision support for practitioners, reduced clerical works
required of professionals, reduced printed forms to minimize redundancy, centralized patient care data to
aid delivery of health research and teaching, and fostered communication for effective service delivery. It
is applied in the areas of nursing, clinical care, dentistry, pharmacy, public health, occupational therapy,
and (bio) health research [6]-[8].
Review of ICT for health tools for frontline health workers as part of the United Nations
Commodities Commission indicates that governments in sub-Saharan Africa, such as South Africa,
Ethiopia, Ghana, Uganda, Kenya, and Nigeria, are interested in developing an enabling environment for
such tools and their implementation. These developing countries have invested immensely in equipping
their health workforce with the right ICT for health tools, skills and knowledge and mechanisms in place
for standards and interoperability through setting up national health information systems.
The Nigerian government in its effort to harness those benefits holds that ICTs are important
enablers and key drivers in achieving strategic goals and vision for a healthy nation. This is portrayed in
its ‘Vision 2020’ drive to meet the then ‘Millennium Development Goals (MDG’s)’, the ‘national health
strategic development plan (NHSDP)’, and the push for ‘Universal Health Coverage (UHC)’ in the
country. All these strategic visions in the health system underpin application of ICTs for healthcare
delivery hence, Health information management system units were established in Nigerian teaching
hospitals for an improved healthcare delivery.
Ahmadu Bello University Teaching Hospital (ABUTH) Shika-Zaria is one of the university
teaching hospitals in the country equipped with the Health Information Management unit was established
towards enhancing use of IT for health. It started as Institute of Health in 1967 in accordance with statute
15 of the University ABU Law (Amendment Act, Schedule, 16) by the then interim common services
agency to provide broad range of tertiary services to meet the healthcare needs of people from the
catchment area and the country at large; provide technical support to primary and secondary health
facilities within its area of operation, provide facilities for the training of different cadre of health workers
and conduct relevant research on prevalent health related problems. [9].
The information management unit (IMU) in the hospital underscores use of health information
technologies in the hospital. The unit was introduced in 2014 under the federal government’s policy for e-
health strategy and is responsible for advising, managing, and maintaining all information and
communication technology related issues in the hospital. It is also the responsibility of the unit to ensure
and enhance connectivity of computers and internet in the hospital as well as handling of all the necessary
information record and communication in the computers within the hospital.
In essence, Ahmadu Bello University Teaching Hospital Shika-Zaria is equipped with an ICT
unit that handles all health-related information record and manages it for effective delivery. Observations
however show that despite these efforts, medical records and other clinical services are still conveyed in
paper files in the hospital. Could it be that the health personnel are not aware of the potential uses of the
technology or that there is lack of knowledge of its utilization? Or could there be other factors that are
limiting effective use of health informatics in the teaching hospital?
Existing literatures on health informatics such as [10]-[13] have also been largely prescriptive of
the technology, focusing on ICT for health policies and benefits, but leaving little empirical studies
available on knowledge and utilization of health informatics. Most studies focused on other parts of the
country such as Ile-Ife, Niger, Ibadan, and Lagos; or other healthcare personnel such as nurses and health
information record officers but leaving the Northern part of the country and medical doctors who are also
part of the workforce in the utilization of health informatics. It is in recognition of these therefore that the
study concerned to fill these gaps by examining the knowledge and utilization of health informatics
among medical doctors of Ahmadu Bello University Teaching Hospital, Shika-Zaria. The study is guided
by the following research objectives: a) To assess knowledge of health informatics among medical
doctors in ABUTH Shika-Zaria, b) To determine the level of utilization of health informatics among
medical doctors in the study area, c) To examine the sources of information of knowledge and utilization
of health informatics among the medical doctors in the study area.
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2. CONCEPTUALIZING AND LITERATURE REVIEW
The word health informatics is used interchangeably with e-Health, nursing informatics, medical
informatics, and bioinformatics. It was coined in 1957 to correct the view of some health officers that it had
to do with physicians only [14]. Health informatics is broadly defined as the intersection of information and
communication management in medicine and healthcare dealing with resources, devices and methods
required to optimize acquisition, storage, retrieval and use of information and communication in health and
biomedicine [4].
It is also defined as the use of information and communication technology (ICT) in support of health
and health-related fields, including health care services; health surveillance; health literature; and health
education, knowledge, and research [15]. Health informatics is the science that deals with the use of
computers and communication technology to acquire, store, analyze, communicate, and display health
information and knowledge to facilitate understanding and improve the accuracy, timeliness, and reliability
of decision making [16]. Although his definition is more inclined to computerization, the communication
aspect is also spelled out.
The Nigerian government implemented a national strategic health development plan (NSHDP)
2010- 2015 towards transforming its health sector into an efficient one, ensure sustainability and achieve the
country’s target of universal health coverage by 2020 as well as to complement the universal world health
organization’s guideline on e-Health strategy development plan. The priority areas include national health
management information system (NHIMS) of which Health Informatics is a part [10]-[13]. The recent
economic policy also stated under section seven (7), the aim to strategies e-Health to effectively link
specialized hospitals with the rural health care units via telemedicine and mobile health. The national
information technology development agency (NITDA) where in its ICT policy for development called
ICT4D Strategic Action Plan include ICT for health towards achieving national development via adoption
and use of technologies in the country.
Knowing how to use computerized health records, retrieving patient data at a distant and accessing
health journals and literatures electronically is vital towards improving access to health facilities for effective
healthcare delivery [17]. Hence, acquiring basic knowledge of computer and understanding the basics of the
internet among physicians was found to be crucial for health care delivery. A baseline survey was conducted [18]
to assess the overall computer literacy among health professionals in Ethiopia. The study found 39% computer
literacy among the respondents with no visible differences between Addis Ababa and regional towns. Personal
effort (67%) was found to be the main method of acquiring ICT skill followed by short-term computer training
(33%). Formal college or university ICT training was reported by only 2% of the respondents as the sources of
acquiring computer skills. The baseline study adopts similar method of research (survey) but a cross sectional
rather than a baseline study, and where the study focused on computer literacy only, this study went further to
include health information technology usage for health purposes.
Another study survey study [7] conducted in India found that all the nurses had a positive attitude
towards computer with the majority (75%) of them having good computer knowledge and 21% having average
computer knowledge in a clinical care setting. The survey study [7] focused on attitude and nurses while this
study shift focusses to knowledge and medical doctors use of health information technologies for health care.
In another survey study among health students in Ile-Ife [11], it was found that only 19% and 40% of the
health students and health workers demonstrated good knowledge of computers and positive attitude towards IT
respectively. The gap between those study and that of Bello et al., is based on location (Southern Nigeria) and the
focus of their research (computer knowledge and attitude).
Similarly, a survey study [19] conducted on knowledge and utilization of Information Technology
among 180 health care professionals and students of University Teaching Hospital Ile-Ife Nigeria, found that 80
respondents (54%) reportedly had received some form of computer training and 77.7% of the respondents
demonstrated knowledge of computers even though majority of them revealed that they do not own a computer.
There was also good attitude (39.9%) and utilization of computers (33.8%) among the respondents. The study
[19] also found variation in the knowledge and attitude of computers among different departments with doctors
being better than record officers. In contrary, this study focused on Northern part of Nigeria, medical doctors as
the study population and more specific to health informatics.
Furthermore, a survey research [20] on knowledge and perception of health workers towards
telemedicine application in a Lagos teaching hospital found that majority of the respondents (60.9%) were
familiar with the new emerging concepts of telemedicine/telehealth. Identified factors weighing down usage of
telemedicine in the study area were lack of knowledge of application (28.1%) and perception of telehealth
benefits (14.1%). The findings [20] also revealed that most respondents believed telehealth can enhance access to
health care services (23.4%) and can improve quality of care (14.1%).
Also a quantitative cross-sectional study [21] was conducted in Addis Ababa to test the health workers
knowledge and utilization of computers for health care delivery. The study [21] found that computer knowledge
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and utilization habit of health workers is very low and access to computers and delivering training on the use of
computers for workers to facilitate the rate of diffusion of the technology to the health sector is necessary.
Significant predictor variables were average monthly income, job satisfaction index and computer possession.
The study also [21] indicated an association between computer knowledge/skill and health care delivery
competence. In line with [21], this study also tests knowledge and utilization though theirs is to ICT in general.
Like their method this study used cross sectional design stratified sampling technique. Although the location of
[21] study differs from Nigeria in terms of technology advancement, its findings are a strong indication of the
potential benefits of using technologies for health care delivery in terms of communication and information and
that knowledge and utilization of those technologies are significant for effective work delivery.
Similarly, a cross-sectional study on knowledge and utilization of computers in Ethiopia [5] was
conducted among 554 health professionals working in 7 hospitals, 19 primary health centers, and 10 private
clinics to determine the level of knowledge and identify determinants of utilization of information
communication technology. The findings of the study [5] revealed that, out of 482 (87.0%) of the response rate,
90 (18.7%) demonstrated good knowledge of computers while 142 (29.5%) demonstrated good utilization habits.
Health professionals who work in the primary health centers were found to have lower knowledge (3.4%) and
utilization (18.4%). Age, field of study, level of education and previous computer training participation were
found to be significantly associated with computer utilization habits of health professionals. Thus, the study [5]
identifies that computer knowledge and utilization habits of health professionals, especially those who work in
primary health centers are low, thus the need for training and continuous follow-up as necessary measures to
increase the likelihood of the success of implemented e-Health systems in those settings. What is interesting in
this finding is the demographic aspect signifying that they have an impact on knowledge and utilization habits of
medical workers towards the use of computers in support of this study.
Furthermore, a cross sectional survey [22] was conducted to assess physician’s use of internet for health
information for patients care in Ibadan Nigeria, using anonymous standardized questionnaire. The study [22] found
that 98% of the respondents had used internet, 76% access it on cyber cape. Email was the most used (64%) and
that 90% of the respondent’s obtained information from the internet for patients care while 76.2 % of them had
searched database for health information. Medline/PubMed was found to be the most searched database among
99% of the respondents, while only 7% of the respondents had ever searched for Cochrane library. Also, the study
[22] found that 58.1% of the respondents perceived that they had no confidence to download full text articles from
online sources such as health internet access to research initiative (HINARI). Barriers to use of internet among the
respondents were poor availability of broadband internet access, lack of information for search skills, costs of
access and information overload. The study [22] was more on use of IT in relations to patient care whereas this
study was on general use of IT for an effective health service delivery.
Similarly, a survey [23] was conducted to assess the use of electronic health records among medical
practice in Massachusetts in 2005. The study [23] was aimed at determining the rate of health electronic record
(HER) adoption, perceived barriers to adoption and satisfaction with HER systems. Findings of the study [23]
revealed more than 40% black or Hispanic physicians had comparable level of HER adoption than other
physicians (27.9%) and that 21.8% physicians from minority practices identified financial and other barriers to
implement HER systems such as privacy and securing of HER. The study [23] also found that the physicians from
high minority practices had similar perceptions about the positive impact of EHR’s on quality (73.7% vs 96.69%,
P = 0.43) and cost of care (46.9% vs 51.5%, P =0.17). This study adopted a similar method of sampling [23] and
similarly checked on perception but in terms of usefulness and ease of use of health informatics.
A similar survey research [24] on the use of internet-based and mobile e-health tools to increase
information access among cervical cancer patients in Kenya, found low-level use of the internet by cervical
cancer clients attending public referral facilities. The low-level use of the internet was attributed to lack of
knowledge on how to use computers and lack of access to a computer. However, a high level of access to mobile
phones was reported in the findings and thus the study [24] concluded that there is a greater potential for internet
use through web access via mobile phones. Unlike the other research reviewed in this study where majority
studied the service providers such as the health personnel, the study [24] assessed patient’s knowledge.
In the same vein, [25] assessed the knowledge and usage pattern of health internet access to research
initiative (HINARI), specifically information on demographics profile pattern of usage and constraints to use of
HINARI in 12 tertiary institutions in South-western Nigeria using a descriptive cross - sectional survey among
1150 clinicians and researchers that had access to it. The findings of the study [25] show that majority of the
respondents (72.05) are aware of it however, only 35.1%had formal training on how to use it. 68.05 had used it and
the most frequently used are Medlin, Pub Med (53.2%), full text journal articles (55.5%), and reference materials
(28.5%). Previous users encountered problems in accessing HINARI and lack of password. The study [25]
recommends for learner – centred training among the clinicians and researchers and its wide distribution of its
username and password within the library. By focusing on a local IT platform (HINARI), the study [25] indicates
is a strong access, use and acceptance, of health informatics in the country for health care delivery.
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The literatures reviewed therefore revealed that use of health communication technologies for effective
healthcare delivery among health students as well as healthcare providers especially in Africa is gaining grounds,
though there is room for improvement. These findings also predispose the need to ascertain if the same scenario
or otherwise can be found in the northern Nigerian university teaching hospitals which this study filled the gap.
3. THEORETICAL FRAMEWORK AND RESEARCH METHOD
The study is premised on unified theory of acceptance and use of technology (UTAUT) which
relates to technology acceptance and use. UTAUT has also been proven to be a theoretical framework widely
used to explain and predict user behavior, acceptance and use of information technology [26]. UTAUT posits
that there are variables related to the behavioral intention to use information technology or to the actual use
of information technology. These variables could be grouped into four categories: performance expectancy,
effort expectancy, social influence and facilitating condition. Performance expectancy is from an individual
context, represents the extent to which using a technology will enable users to improve their job performance.
Effort expectancy, which is from the system context, represents the degree
of ease associated with the individual's use of the system/technology. This is regarded to be of great
concern to users during their initial use of the system. Social influence has to do with the level of influence
exerted by the individual's social settings which could influence his/her intention towards using the
technology; and facilitating condition is about organizational context which emphasizes any organization’s
influence or support on one’s information technology use. Further, the theory posits variables including
gender, age, experience, and voluntariness can moderate the impact of the four key constructs on usage
intention and behavior. These additional demographics are said to also have impact in the way a user accepts
and use a new technology [27]-[29].
The UTAUT is adopted for this research being it relevant in explaining the reasons of the increasing
adoption and integration of technology into all sectors such as business, education, and health. Despite efforts
by the government to ensure availability and implementation of health informatics in the health sector, it was
observed that it has not been effectively utilized. This research, therefore, will try to establish whether
constructs such as performance expectancy, effort expectancy, social influence and facilitating conditions are
related to lack of or otherwise of knowledge and utilization of health informatics among the medical doctors
in ABUTH.
Other variables such as age, gender, working experience, and specialization will also be explored to
see if they have any bearing on the way medical doctors in ABUTH accepts and use Health Informatics.In
order words, the research will try to grasp if individual, system, organizational and social factors play a role
in the knowledge and utilization of health informatics and whether demographics such as age, gender,
working experience, area of specialization and voluntariness play a role in knowledge and utilization of
health informatics among the medical doctors.
According to this research, performance expectancy is the extent to which medical doctors in
ABUTH believe that using health informatics will boost their work performance. While Effort Expectancy is
the extent to which medical doctors in ABUTH believe that using health informatics will be free of cognitive
effort (is easy to use). Social influence and Facilitating Conditions here refer to the level of influence and
support (health informatics infrastructures present in the hospitals) exerted by the important stakeholders
such as the management of the hospital to the medical doctors’ knowledge and usage of health informatics.
Specifically, the study adopted descriptive survey method to picture the condition of knowledge and
usage of health informatics among medical doctors in the study area. 246 medical doctors from a population
of 624 medical in ABUTH constituted the sample size of this research. Multi-stage sampling procedure was
employed in determining the respondents. Stratified random sampling technique was used in the first stage to
group the research population into subgroups (strata) according to their specializations/departments.
Proportion of each subgroup was calculated to arrive at the sample size required for the research. The
proportional distribution of the research sample presented in Table 1.
In the second stage of sampling, the study employed simple random sampling technique. The
samples were randomly picked using raffle draw across the stratified specializations going by the number
arrived at from the calculated. Structured questionnaire was used as the instrument for data collection and the
data gathered were analyzed using descriptive method of data analysis such as frequency distribution tables
and percentages.
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Table 1. Proportional distribution of respondents
Specialization/Departments
No of Doctors
Proportion
%
Orthopaedic
25
9
3.7
Paediatrics
83
30
12
Dentistry
25
9
3.7
Gynaecology
85
31
12.6
Surgery
90
32
13
Ophthalmology
29
10
4.1
Psychiatry
15
5
2.1
Haematology
26
9
3.7
Community/family/internal medicine
173
62
25
Chemical pathology
15
5
2.1
Anesthesiology
24
9
3.7
Pathology
21
8
3.3
Radiology
55
20
8.1
Microbiology
15
5
2.1
Otorhinolaryngology
5
2
0.8
Total
686
246
100
4. RESULTS AND DISCUSSION
The result of this study is analyzed according to the research objectives as sub-headings. The study
also retrieved 220 (89.4%) out of the 246 copies of questionnaires administered, hence 220 were used in the
analysis.
4.1. Level of knowledge of health informatics among medical doctors in ABUTH
With regards to level of knowledge of health informatics among the respondents, the analysis begins
with a test of their awareness. This is presented in Table 2.
Table 2. Distribution of respondents’ awareness of health informatics
Response
N
%
Aware of health informatics
150
68.2
Not aware of health informatics
59
26.8
No response
11
5
Total
220
100
Table 2 reveals that majority (n=150, 68.2%) of the medical doctors are aware of health informatics,
while 59 (26.8%) reported that they are unaware of it. The medical doctors that are not aware of health
informatics gave reasons as ‘not relevant to their specialty or that is unavailable in their hospital/department
(14 = 6.4%) while others didn’t specify.
Data was also sought for the specific areas of health informatics that the respondents have
knowledge of. This is presented in Table 3 and only considered only the doctors that reported to be aware of
health informatics. The question is also a multiple choice which the respondents choose many that they
know. Table 3 reveals that “management information system (MIS)” is the most known area of health
informatics among the respondents with 135 (90%). This is closely followed by “Telemedicine” with 134
(89.3%). This may be because they are also the available health informatics areas provided by the hospital
management.
Still on knowledge of health informatics, the study sought to know if the respondents that know
about health informatics know how to use it and which of the health informatics they know how to use. This
is presented on Table 4 and Table 5 and it also only focus on 150 respondents that are aware of the health
informatics. Table 4 reveals that only 120 (68.2%) out of the 150 medical doctors that are aware of health
informatics know how to use it. This means that 30 (20 %) of the total respondents reported that they don’t
know how to use health informatics even though they are aware of it. Reasons for not knowing how to use
health informatics as given by those respondents were “not relevant to specialization” “not available in the
department”, and “other reasons”. The specific areas of health informatics that the respondents know how to
use are presented in Table 5. This was also given in a multiple response question.
Table 5 shows that majority (n=78, 52%) of the medical doctors know how to use both
“Management Information System” and “Electronic Health Record System”. This is closely followed by
“Electronic Medical Record” 74 (49.3%). m-health (n=19, 12.7%) was found to be the least area of health
informatics that the medical doctors in ABUTH Shika –Zaria know how to use.
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Table 3. Areas of health informatics the respondents are aware of
Areas of Health Informatics
Σn=150 (100%)
Percentage (%)
Telemedicine
134
89.3
Management information system
135
90
m-health
33
22
e-health
94
62.7
Health Information Transfer
91
60.6
Electronic health record
125
83.3
Electronic medical record
125
83.3
Others
3
2
Table 4. Respondents’ knowledge of how to use health informatics
Response
N
%
Know how to use
120
80
Do not know how to use
20
13.3
No response
10
6.7
Total
150
100
Table 5. Areas of health informatics the respondents know how to use
Areas of health informatics
N
Σn=150 (100%)
Telemedicine
68
45.3
Management information system
78
52
m-health
19
12.7
e-health
46
30.7
Health information transfer
47
31.3
Electronic health record
78
52.0
Electronic medical record
74
49.3
Others
3
2.0
4.2. Utilization of health informatics among medical doctors in ABUTH Shika-Zaria
With regards to testing the level of utilization of health informatics in ABUTH, the study asked the
respondents that said they know about health informatics (Σn=150) if they are using health informatics. This
is presented in Table 6. Table 6 distributes actual utilization of health informatics by the medical doctors in
ABUTH Shika-Zaria. Majority (n=120, 80%) out of the 150 medical doctors that are aware of health
informatics are using it while about 30 (20%) respondents reported that they don’t utilize or there is no
response as to if they use health informatics even though they are aware of it. Reasons for not utilizing health
informatics given by the respondents include “not relevant to specialty”, “not available in the hospital”, and
“difficult to use”. Furthermore, the areas of health informatics that the respondents utilize are represented in
Table 7.
Table 6. Distribution of respondents’ actual utilization of health informatics
Response
N
%
Use health informatics
120
80
Do not use health informatics
20
13.3
No response
10
7.7
Total
150
100
Table 7. Areas of health informatics utilized by the respondents
Areas of health informatics
N
%
Telemedicine
52
34.6
Management information system
48
32
m-health
15
10
e-health
41
27.3
Health information transfer
40
26.7
Electronic health record
57
38
Electronic medical record
50
33.3
Others
1
0.7
Table 7 shows that “Electronic Health Record” is mostly utilized among 57 (38%) respondents
followed by “Electronic Medical Record” (n=50, 33.3%), unlike the result on awareness of health informatics
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which reveals that health information management system is the area that most of the respondents know
about and know how to use. This may be because there are computers and internet access in virtually all the
departments in the hospital. Even though use of mobile internet is becoming widespread and is part of the
Economic policy plan by the govt. m-health was found to be the least (n=15, 10%) area of health informatics
that is being utilized among the medical doctors in ABUTH.
The reasons for m-health’s underutilization may also be because mobile phones are mostly used for
personal dealings such as socialization than for official us. It can also be because the health informatics
packages are heavy and thus are commonly found on computers which have more memory and capacity than
mobile phones. To further determine the level of utilization of health informatics, data was sought for, to
know the areas of health care service that the medical doctors in ABUTH Shika- Zaria use Health informatics
for. This only considered the respondents that reported actual use of health informatics (Σn=120). This is
presented on Table 8.
Table 8. Services the respondents use health informatics for
Usage
N
%
Patient information/data record
120
100
Consultation with patients
108
14.7
Consultation with colleagues
115
15.6
Hospital management
109
14.8
Research and training
120
100
Seeking for information on diagnosis/treatment
112
15.2
Others
3
0.4
Table 8 shows that all the respondents that said they use health informatics are using for “patients’
information/data record” and “research and training”. Majority also used informatics for “consultation with
colleagues (n=115, 15.6%)” and “treatment/diagnosing patients (n=112, 15.2%)”. This finding compliments
with the usage of “electronic health record and electronic medical record” which are mostly for patients used.
The result also implies that the doctors use health informatics to also develop themselves on new ways of
treatment.
4.3. Sources of information on knowledge and utilization of health informatics
Data was sought for on the respondents’ sources of information of health informatics and how to use
it. This also only consider the respondents that said they know how to use health informatics (Σn=120) and is
presented on Table 9. Table 9 shows that the major sources of knowledge about Health Informatics among
the medical doctors in ABUTH Shika-Zaria is “internet (n=120, 100%), However the respondents also get
informed about how to use health informatics through “Interpersonal sources (n=71, 52.5%)”. As the data
also reveals, the source of knowledge with the lowest selection is “Health Advocacy Program”. This implies
that there is low level of knowledge creation on health informatics through health advocacy plan which was
part of governments’ health policy plan. Workshops and seminars, though very common in the hospital (as
witnessed during the research by the researcher) were among the least sources of information on the use of
health informatics among the respondents. Only 53 and 48 respondents mentioned ‘school’ and ‘workplace’
as sources of information on how to use health informatics.
Table 9. Respondents’ sources of information on knowledge of health informatics
Sources
N
%
Health advocacy program
5
4.2
National strategic health development plan
21
17.5
International health development plan
9
7.5
Workplace
36
30
Research
48
40
School
53
44.2
Workshop
51
42.5
Seminar
63
52.5
Interpersonal communication
71
59.2
Media
17
14.2
Radio
10
8.3
Television
45
37.5
Internet
120
100
Hospital
63
52.5
Others
5
4.16
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179
This study found that majority of the doctors in ABUTH Shika- Zaria that are aware of health
informatics, have knowledge of health it (n=150, 68.2%) and that they are mostly aware of management
information system (MIS) and telemedicine as Table 2 than the other areas of health informatics.
Furthermore, the knowledge of how to use health informatics among the medical doctors was too good. This
study found that majority of the medical doctors in the study area know how to use health informatics (n=
120, 80%). The specific areas of health informatics that the doctors in ABUTH Shika-Zaria know how to use
are “Management Information System”, “Electronic Health Record System” and “Electronic Medical
Record” which is slightly different from what was found on awareness of health informatics. On both
awareness and knowledge of how to use health informatics, the study found that only few medical doctors in
ABUTH Shika-Zaria are aware of and know how to use “m-health” as an area of health informatics as Table
5. These findings are similar to what was found in a survey study [20] in Lagos Teaching Hospital that
majority of the respondents (60.9%) are familiar with the new emerging concepts of telemedicine/telehealth.
The findings are also consistent with the theory used in this research (UTAUT) that social demographics can
have impact on user behavior towards technology acceptance and use. In the context of ABUTH this was
found to be true when age and specialization was taken into consideration. Also, utilization of health
informatics among the medical doctors in ABUTH was found to be fair as a good number of medical doctors
in ABUTH, Shika-Zaria are utilizing health informatics (n=120, 80%). The reasons given for not using health
informatics by those that reported not using were that it is not relevance to their specialization and that it is
difficult to use. Electronic health record and electronic medical record were found to be the most utilized
areas of health informatics among the medical doctors as Table 7.
The finding on utilization of health informatics among the medical doctors in ABUTH is in line with
what was found in a study [5] where majority of the respondents demonstrated good knowledge of computers
but with variation in utilization habits (n=142, 29.5%). Furthermore, this finding corroborates with the a
study [20] in Ile-Ife University Teaching Hospital, Nigeria where health care professionals and students have
good knowledge, attitude and utilization habit of computers. A similar studies [29] and [11] also found
factors weighing down utilization of telemedicine/telehealth among their respondents to be; lack of
knowledge of application, perception of telehealth benefits, perceived ease of use and usefulness, non -
availability, average monthly income, job satisfaction index and computer possession. These findings are
consistent with the findings of this research on the reasons why some medical doctors in ABUTH Shika-
Zaria do not utilize health informatics. However, the study found that the major sources of information of
health informatics among the medical doctors in ABUTH get information on health informatics are internet
(n = 120, 100%) and interpersonal sources (n= 71, 59.2%), while advocacy, seminars, workshop, and media
were the least sources of information on health informatics among the respondents (See Table 9). Availability
of internet facilities in all the departments in ABUTH Shika-Zaria and use of smart phones can be the reasons
why internet was mostly chosen as a source of information among all the medical doctors that know and use
health informatics. The study also found that even though internet was the major source of information of
health informatics and that it is used by most of the medical doctors, only a few of the medical doctors use it
for research. This finding is in line with what was found in the study in Nigeria [30] that computer and
internet use by first year clinical and final year nursing students though fair, is frequently used for computer
games than for health purposes or research.
Still on sources of information about health informatics, the study also found that the medical
doctors in ABUTH get information about health informatics through training and workshops. However,
‘seminar’ was found to be among the least sources of information about health informatics among the
medical doctors in ABUTH. This confirms the observation by the researcher that though there were many
seminars conducted in the hospital as witnessed during the study, none of those were found to relate to
informatics. This finding also suggested why ‘workplace’ was also only mentioned among very few of
respondents as a source of information on health informatics. Overall, the findings on sources of information
about health informatics revealed that there is little awareness creation on health informatics in ABUTH. This
may portray inadequacy in the aspect of awareness creation by the system (ABUTH or The Federal
Government through the Federal Ministry of Health) which according to the theory (UTAUT) adopted for
this research can facilitate individual’s adoption and use of technology.
The study also found that only few (n=52, 13.2%) medical doctors in ABUTH have school as their
source of information on how to use health informatics. Interestingly, a cross tabulation revealed that
majority of the medical doctors with higher qualification have knowledge of health informatics and are using
it. The fact that majority of the respondents didn’t attribute their source of information about health
informatics to school also confirms the claim that there is low level of training about health information
technologies or computers at college. The preceding finding confirms the findings of a baseline survey [31]
in Ethiopia who found personal effort (67%) and short-term computer training (33%) as the major sources of
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180
knowledge of computers for health. Formal college or university ICT training as sources of information is
reported by only 2% of their respondents.
National strategic health development plan (NSHDP) which is a Nigerian health policy document or
the International health development policy document such as that by world health organization (WHO) and
united nation development program (UNDP) or International health organization website such as
radiology.com were also supposed to be official documents and sites about information on health informatics,
but this study found that very few of the medical doctors in ABUTH actually get information on health
informatics through those documents. National health development plan specifically National strategic health
development plan (NSHDP) which is a Nigerian health policy document was mentioned as a source of
information among only few medical doctors while the international health development policy document
such as that by world health organization (WHO) and united nation development program (UNDP) as well as
international health organization website such as radiology.com. were only mentioned by very few of the
medical doctors as source of information for health informatics. The medical doctors mentioned advocacy
group/organizations such as NMA, MDCAN and MEDS, CAPE as sources of information on health
informatics as Table 9. In addition, only few (n=17, 14.2%) of the medical doctors accorded media
(Television, Radio, Newspaper, Magazine, and social media) as their source of information about health
informatics. Interestingly, none of the research reviewed in this study attributed media as a source of
information of health information technology.
5. CONCLUSION AND RECOMMENDATIONS
This study concludes that majority of medical doctors in ABUTH Shika- Zaria are aware of health
informatics as they have knowledge of how to use health information management system and health medical
record. That the medical doctors in ABUTH, Shika-Zaria are utilizing health informatics for research,
consultation, diagnosis, and treatment, mostly among themselves and patients than with the hospital
management. It also concluded that the medical doctors get informed about health informatics through
personal effort (internet or inter-personal sources). The study therefore recommends: 1). The need to address
the issues of awareness of health informatics varieties in the national ICT for health framework. A new
strategy should be designed to help strengthen awareness and use of health informatics among medical
doctors for greater impact. This should be informed of in-house training and workshops as well as provision
of self-study modules for the staff and students to learn health informatics and upgrade their health care
delivery. 2). There is also need for awareness creation on health informatics varieties among the medical
doctors in the study area. This owes to the finding that most of the doctors do not utilize mhealth, ehealth
which can be easily used via mobile phones which is almost available to all the medical doctors. The
management of ABUTH, Shika-Zaria should not just provide training but provide the medicals with the
gadgets for actual use. 3). The federal government should strengthen effort to ensuring that the health
informatics centers established in all the teaching hospitals are well equipped and are provided the necessary
attention for sustainability. Health informatics training should be provided to all the health personnel of the
hospitals as mandatory to encourage use of it for healthcare delivery. 4). Finally, there is a need for further
research on health informatics in the study area using qualitative method of research to assess more in-depth,
the situation of health in formatics in the study area. This would help get more information on the solving the
situation of utilization of health informatics in the hospital and designing best strategies to adopt in enhancing
utilization of health informatics for health care delivery.
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