2 research outputs found
Electricity, computing hardware, and internet infrastructures in health facilities in Sierra Leone : field mapping study
Background: Years of health information system investment in many countries have facilitated service delivery, surveillance,
reporting, and monitoring. Electricity, computing hardware, and internet networks are vital for health facility–based information
systems. Availability of these infrastructures at health facilities is crucial for achieving national digital health visions.Objective: The aim of this study was to gain insight into the state of computing hardware, electricity, and connectivity
infrastructure at health facilities in Sierra Leone using a representative sample.Methods: Stratified sampling of 72 (out of 1284) health facilities distributed in all districts of Sierra Leone was performed,
factoring in the rural-urban divide, digital health activity, health facility type, and health facility ownership. Enumerators visited
each health facility over a 2-week period.Results: Among the 72 surveyed health facilities, 59 (82%) do not have institutionally provided internet. Among the 15 Maternal
and Child Health Posts, as a type of primary health care unit (PHU), 9 (60%) use solar energy as their only electricity source and
the other 6 (40%) have no electricity source. Similarly, among the 13 hospitals, 5 (38%) use a generator as a primary electricity
source. All hospitals have at least one functional computer, although only 7 of the 13 hospitals have four or more functional
computers. Similarly, only 2 of the 59 (3%) PHUs have one computer each, and 37 (63%) of the PHUs have one tablet device
each. We consider this health care computing infrastructure mapping to be representative with a 95% confidence level within an
11% margin of error. Two-thirds of the PHUs have only alternate solar electricity, only 10 of the 72 surveyed health facilities
have functional official internet, and most use suboptimal computing hardware. Overall, 43% of the surveyed health facilities
believe that inadequate electricity is the biggest threat to digitization. Similarly, 16 (22%) of the 72 respondents stated that device
theft is a primary hindrance to digitization.Conclusions: Electricity provision for off-electricity-grid health facilities using alternative and renewable energy sources is
emerging. The current trend where GSM (Global System for Mobile Communication) service providers provide the internet to
all health facilities may change to other promising alternatives. This study provides evidence of the critical infrastructure gaps
in health facilities in Sierra Leone.peer-reviewe