Factors that Predict the Adoption and Sustained Use of the Electronic Community Health Information System Over Time in Nyatike and Awendo Sub-Counties, Migori County, Kenya using TAM Framework
Abstract:
Electronic Community Health Information System (e-CHIS) are increasingly adopted, However, evidence explaining the factors driving their initial uptake compared to those sustaining long-term use continues to be inadequate and neglects contextual nuances. This study explored the predictors of initial adoption and sustained use of e-CHIS among healthcare providers in Migori, with a focus on temporal variations in influencing factors and sub-county disparities, guided by the Technology Acceptance Mode (TAM). Cross-sectional design was employed. Quantitative data were obtained from 357 healthcare providers, complemented by qualitative insights from 14 key informant interviews and 25 focus group discussions. Binary logistic regression identified predictors of initial adoption, linear regression examined determinants of sustained use intention. The adoption rate was remarkably high (94.7%). A distinct temporal pattern was observed: Perceived Usefulness was the only significant psychological predictor of initial adoption (OR = 5.631, p = 0.008), though its internal consistency was modest (α = 0.552). In contrast, Perceived Ease of Use (B = 0.541, p < 0.001) was the strongest determinant of sustained use intention, explaining 71.9% of the variance. Social Influence predicted sustained use (p < 0.001) but not initial adoption (p = 0.089). Geographical disparities were the most powerful overall predictor, with providers in Nyatike over 14 times more likely to adopt e-CHIS (OR = 13.880, p = 0.019) than those in Awendo. Demographic characteristics (age, gender, education, and experience) were not significant predictors. The study calls for enhanced training, further research, and policy integration to strengthen e-CHIS adoption and sustainability in Migori.References:
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