Factors promoting eRegister and data use for evidence-based midwifery practice in Lesotho: a qualitative study

Area of Science:

• Digital health interventions in sub-Saharan Africa.
• Health information systems for maternal and child health.
• Midwifery practice and evidence-based care.

Background:

• Electronic registers (eRegisters) are increasingly adopted in Africa for real-time patient data capture.
• Poor maternal and child health outcomes in Lesotho highlight the need for innovative health solutions.
• eRegisters offer a promising tool for enhancing maternal and newborn care services and informing midwifery practice.

Purpose of the Study:

• To explore factors promoting the adoption and utilization of eRegisters for midwifery practice in Lesotho.
• To understand the facilitators of eRegister and data use in a resource-limited setting.
• To inform strategies for effective implementation of digital health tools in maternal healthcare.

Main Methods:

• A descriptive qualitative approach was employed.
• Data were collected through interviews and focus group discussions at three piloting facilities in Lesotho.
• Descriptive content analysis was used to analyze the collected data.

Main Results:

• Five key categories emerged as promoting eRegister and data use: system readiness, organizational environment, data value and utility, human resource competency and digital literacy, and governance and stakeholder engagement.
• Successful implementation is linked to the interplay of technological, human, and organizational factors.
• Healthcare worker competency and digital literacy were identified as crucial for effective data utilization.

Conclusions:

• Critical factors promoting eRegister and data use in Lesotho have been identified.
• While external support has been vital, long-term sustainability necessitates national ownership, domestic investment, and robust digital health governance.
• Future research should focus on the impact of eRegisters on clinical outcomes and strategies for scaling digital health interventions in similar settings.