Factors affecting the successful implementation of a digital intervention for health financing in a low-resource setting at scale

• Verfasst von: Schütze, Leon [VerfasserIn]
• Verfasst von: Srivastava, Siddharth [VerfasserIn]
• Verfasst von: Missenye, Abdallah Mtiba [VerfasserIn]
• Verfasst von: Rwezaula, Elizeus Josephat [VerfasserIn]
• Verfasst von: Stoermer, Manfred [VerfasserIn]
• Verfasst von: De Allegri, Manuela [VerfasserIn]
• Titel: Factors affecting the successful implementation of a digital intervention for health financing in a low-resource setting at scale
• Titelzusatz: semistructured interview study with health care workers and management staff
• Verf.angabe: Leon Schuetze, Siddharth Srivastava, Abdallah Mtiba Missenye, Elizeus Josephat Rwezaula, Manfred Stoermer, Manuela De Allegri
• E-Jahr: 2023
• Jahr: 6.1.2023
• Umfang: 14 S.
• Fussnoten: Zuerst veröffentlicht: 01. Mai 2022 ; Gesehen am 04.07.2023
• Titel Quelle: Enthalten in: Journal of medical internet research
• Ort Quelle: Richmond, Va. : Healthcare World, 1999
• Jahr Quelle: 2023
• Band/Heft Quelle: 25(2023), 1 vom: Jan., Artikel-ID e38818, Seite 1-14
• ISSN Quelle: 1438-8871
• DOI: doi:10.2196/38818
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1851564772
• K10plus-PPN:
  Universitätsbibliothek
• Lokale URL UB: Zum Volltext

Abstract

Background: Digital interventions for health financing, if implemented at scale, have the potential to improve health system performance by reducing transaction costs and improving data-driven decision-making. However, many interventions never reach sustainability, and evidence on success factors for scale is scarce. The Insurance Management Information System (IMIS) is a digital intervention for health financing, designed to manage an insurance scheme and already implemented on a national scale in Tanzania. A previous study found that the IMIS claim function was poorly adopted by health care workers (HCWs), questioning its potential to enable strategic purchasing and succeed at scale. - Objective: This study aimed to understand why the adoption of the IMIS claim function by HCWs remained low in Tanzania and to assess implications for use at scale. - Methods: We conducted 21 semistructured interviews with HCWs and management staff in 4 districts where IMIS was first implemented. We sampled respondents by using a maximum variation strategy. We used the framework method for data analysis, applying a combination of inductive and deductive coding to organize codes in a socioecological model. Finally, we related emerging themes to a framework for digital health interventions for scale. - Results: Respondents appreciated IMIS’s intrinsic software characteristics and technical factors and acknowledged IMIS as a valuable tool to simplify claim management. Human factors, extrinsic ecosystem, and health care ecosystem were considered as barriers to widespread adoption. - Conclusions: Digital interventions for health financing, such as IMIS, may have the potential for scale if careful consideration is given to the environment in which they are placed. Without a sustainable health financing environment, sufficient infrastructure, and human capacity, they cannot unfold their full potential to improve health financing functions and ultimately contribute to universal health coverage.