PDF(Pubmed)
Abstract：
BACKGROUND: Monitoring childhood immunization programs is essential for health systems. Despite the introduction of an electronic immunization registry called e-Tracker in Rwanda, challenges such as lacking population denominators persist, leading to implausible reports of coverage rates of more than 100%.
OBJECTIVE: This study aimed to assess the extent to which the immunization e-Tracker responds to stakeholders\' needs and identify key areas for improvement.
METHODS: In-depth interviews were conducted with all levels of e-Tracker users including immunization nurses, data managers, and supervisors from health facilities in 5 districts of Rwanda. We used an interview guide based on the constructs of the Human, Organization, and Technology-Fit (HOT-Fit) framework, and we analyzed and summarized our findings using the framework.
RESULTS: Immunization nurses reported using the e-Tracker as a secondary data entry tool in addition to paper-based forms, which resulted in considerable dissatisfaction among nurses. While users acknowledged the potential of a digital tool compared to paper-based systems, they also reported the need for improvement of functionalities to support their work, such as digital client appointment lists, lists of defaulters, search and register functions, automated monthly reports, and linkages to birth notifications and the national identity system.
CONCLUSIONS: Reducing dual documentation for users can improve e-Tracker use and user satisfaction. Our findings can help identify additional digital health interventions to support and strengthen the health information system for the immunization program.
OBJECTIVE: This study aimed to assess the extent to which the immunization e-Tracker responds to stakeholders\' needs and identify key areas for improvement.
METHODS: In-depth interviews were conducted with all levels of e-Tracker users including immunization nurses, data managers, and supervisors from health facilities in 5 districts of Rwanda. We used an interview guide based on the constructs of the Human, Organization, and Technology-Fit (HOT-Fit) framework, and we analyzed and summarized our findings using the framework.
RESULTS: Immunization nurses reported using the e-Tracker as a secondary data entry tool in addition to paper-based forms, which resulted in considerable dissatisfaction among nurses. While users acknowledged the potential of a digital tool compared to paper-based systems, they also reported the need for improvement of functionalities to support their work, such as digital client appointment lists, lists of defaulters, search and register functions, automated monthly reports, and linkages to birth notifications and the national identity system.
CONCLUSIONS: Reducing dual documentation for users can improve e-Tracker use and user satisfaction. Our findings can help identify additional digital health interventions to support and strengthen the health information system for the immunization program.
摘要：
背景：监测儿童免疫计划对卫生系统至关重要。尽管卢旺达引入了名为e-Tracker的电子免疫登记处，缺乏人口分母等挑战依然存在，导致覆盖率超过100%的报告令人难以置信。
目的：本研究旨在评估免疫e-Tracker响应利益相关者需求的程度，并确定需要改进的关键领域。
方法：对包括免疫护士在内的各级e-Tracker用户进行了深入访谈，数据管理人员,卢旺达5个地区的卫生机构和监督员。我们使用了基于人类结构的采访指南，组织,和技术匹配(HOT-Fit)框架，我们使用该框架分析和总结了我们的发现。
结果：免疫护士报告说，除了纸质表格外，还使用e-Tracker作为辅助数据输入工具，这导致护士相当不满。虽然用户认识到与纸质系统相比，数字工具的潜力，他们还报告需要改进功能来支持他们的工作，例如数字客户预约列表，违约者列表，搜索和注册功能，自动每月报告，以及与出生通知和国家身份系统的联系。
结论：减少用户的双重文档可以提高e-Tracker的使用和用户满意度。我们的发现可以帮助确定其他数字健康干预措施，以支持和加强免疫计划的健康信息系统。
目的：本研究旨在评估免疫e-Tracker响应利益相关者需求的程度，并确定需要改进的关键领域。
方法：对包括免疫护士在内的各级e-Tracker用户进行了深入访谈，数据管理人员,卢旺达5个地区的卫生机构和监督员。我们使用了基于人类结构的采访指南，组织,和技术匹配(HOT-Fit)框架，我们使用该框架分析和总结了我们的发现。
结果：免疫护士报告说，除了纸质表格外，还使用e-Tracker作为辅助数据输入工具，这导致护士相当不满。虽然用户认识到与纸质系统相比，数字工具的潜力，他们还报告需要改进功能来支持他们的工作，例如数字客户预约列表，违约者列表，搜索和注册功能，自动每月报告，以及与出生通知和国家身份系统的联系。
结论：减少用户的双重文档可以提高e-Tracker的使用和用户满意度。我们的发现可以帮助确定其他数字健康干预措施，以支持和加强免疫计划的健康信息系统。
