Impact of GOTHOMIS on healthcare transformation in Tanzania: Insights from digital health stakeholders

Abstract

Many low- and middle-income countries have invested in digital health information systems to improve service delivery, reporting, and decision-making. However, evidence on whether such systems translate into meaningful improvements in routine clinical workflows, data use, and health system coordination remains limited, particularly in decentralised public health systems. In Tanzania, multiple digital health initiatives have been implemented over time, yet systematic assessments of their practical contributions to healthcare transformation at facility and district levels are scarce. This study examined the perceived impact of the Government of Tanzania Hospital Management Information System (GOTHOMIS) on healthcare transformation. A qualitative content analysis was conducted using 106 publicly available LinkedIn posts authored by key digital health stakeholders from January 2020 to March 2025. Thematic analysis following Braun and Clarke’s framework was applied to identify recurrent patterns related to system implementation, benefits, innovations, and challenges. Findings were validated through triangulation with official government publications and peer-reviewed literature. By March 2025, GOTHOMIS had achieved adoption in 70.64 % of healthcare facilities, resulting in measurable improvements in clinical workflow efficiency, patient record accuracy, and real-time data availability. Notable innovations included integrating national databases and offline functionalities that ensured continuity during connectivity disruptions. However, persistent challenges were identified, including unreliable electricity supply, weak internet infrastructure, insufficient technical support, and resistance from some healthcare workers due to increased workloads and perceived impacts on professional autonomy. The system significantly enhanced data-driven decision-making and operational coordination across health facilities. Interpretation GOTHOMIS has emerged as a transformative tool in Tanzania’s healthcare digitalisation efforts. Its successful implementation underscores the need for sustained infrastructure investment, continuous user training, and multi-stakeholder engagement to ensure long-term sustainability. The use of professional social media platforms for data collection provided real-time, contextually rich insights into digital health adoption, offering a valuable methodological approach for similar settings. Future research should pursue longitudinal evaluations and cross-country comparisons to further assess scalability and long-term outcomes. • GOTHOMIS has achieved 70.64 % adoption in Tanzania, improving healthcare operations. • Integration with national databases (NIDA, NHIF, GePG) and offline functionality ensures system reliability. • Infrastructure limitations and technical support gaps remain key challenges. • Government and international partnerships (UNICEF, GIZ) drive implementation success. • Leverage LinkedIn posts as a novel qualitative data source for digital health research.