Users involvement in the electronic health information systems development process in Uganda: what is missing in relation to requirements gathering and analysis

Abstract

User involvement in the electronic health information systems (eHIS) development process is crucial for gathering and analysing requirements that accurately reflect user needs. This is because their involvement is linked to the gathering and analysis of requirements that align with user needs. However, several studies reveal that there is still limited user involvement during these crucial phases, leading to the development of ineffective and inefficient systems that do not reflect user needs. Thus, this study explored how users were involved in the requirements gathering and analysis phases during eHIS development, with an aim of identifying the missing elements that hindered the design of more effective and effective eHIS. A cross-sectional survey, encompassing secondary and primary users, explored their involvement in the requirements gathering, analysis and design phases, using both open-ended and close ended questionnaires. Respondents (<i>n</i> = 140) were purposively selected from 20 organizations in northern and central Uganda. Data were cleaned and analysed using Microsoft Excel. The findings revealed a dominant use of a top-down approach, favouring the capture of high-level requirements at the Ministry of Health level, and among implementing partners. However, less attention was given to gathering and analysing requirements from facility-level users. Even when collected, primary users reported that their opinions and recommendations were often ignored/disregarded, resulting in eHIS designs with usability-related challenges. This study underscores the critical need for active user involvement in the early stages of eHIS development to ensure alignment with user needs and work practices.