Factors affecting the successful implementation of a digital intervention for health financing in a low-resource setting at scale: semistructured interview study with health care workers and management staff
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 fo...
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| Main Authors: | , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
6.1.2023
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| In: |
Journal of medical internet research
Year: 2023, Volume: 25, Issue: 1, Pages: 1-14 |
| ISSN: | 1438-8871 |
| DOI: | 10.2196/38818 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.2196/38818 Verlag, kostenfrei, Volltext: https://www.jmir.org/2023/1/e38818 
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| Author Notes: | Leon Schuetze, Siddharth Srivastava, Abdallah Mtiba Missenye, Elizeus Josephat Rwezaula, Manfred Stoermer, Manuela De Allegri |
| Summary: | 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. |
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| Item Description: | Zuerst veröffentlicht: 01. Mai 2022 Gesehen am 04.07.2023 |
| Physical Description: | Online Resource |
| ISSN: | 1438-8871 |
| DOI: | 10.2196/38818 |