A model for the adoption of ICT by health workers in Africa

PurposeTo investigate the potential of information and communication technology (ICT) adoption among maternal and child health workers in rural Nigeria.MethodsA prospective, quantitative survey design was used to collect data from quasi-randomly selected clusters of 25 rural health facilities in 5 of the 36 states in Nigeria over a 2-month period from June to July 2010. A total of 200 maternal and child health workers were included in the survey, and the data were analyzed using a modified theory of acceptance model (TAM).ResultsThere was no significant difference between ICT knowledge and attitude scores across states. There were significant differences in perceived ease of use (P < .001) and perceived usefulness scores (P = .001) across states. Midwives reported higher scores on all the constructs but a lower score on endemic barriers (which is a more positive outcome). However, the differences were only statistically significant for perceived usefulness (P = .05) and endemic barriers (P < .001). Regression analysis revealed that there was no interaction between worker group and age. Older workers were likely to have lower scores on knowledge and attitude but higher scores on perceived ease of use and perceived usefulness. Lastly, we found that worker preference for ICT application in health varied across worker groups and conflicted with government/employer priorities.ConclusionsAlthough the objective of this study was exploratory, the results provide insight into the intricacies involved in the deployment of ICT in low-resource settings. Use of an expanded TAM should be considered as a mandatory part of any pre-implementation study of ICT among health workers in sub-Saharan Africa.

► Knowledge and attitude were not predictive of perceived usefulness or perceived ease of use among health workers in Nigeria.
► Endemic barriers to technology are an important addition to the TAM in low-resource settings.
► End-user preference should be considered in ICT implementation strategies in developing countries.