Project Kamogano: A Mixed-Methods Approach for Evaluating Healthcare Data Collection, Sharing and Use in Botswana (Preprint)

BACKGROUND Botswana has made significant investments in its healthcare information infrastructure, including vertical programs for child health and nutrition, HIV care, and Tuberculosis (TB). However, effectively integrating the more than 18 systems in place for data collection and reporting has proved to be challenging. The Botswana Health Data Collaborative Roadmap Strategy (2020-24) states that “there exists parallel reporting systems and data is not integrated into the mainstream reports at the national level,” seconded by the Botswana National eLearning strategy (2020) stating that “there is inadequate information flow at all levels, proliferation of systems, reporting tools are not synthesized; hence too many systems are not communicating.” OBJECTIVE 1. Create a visual representation of how data is processed and the inputs and outputs through each healthcare system level. 2. Understand how front-line workers perceive healthcare data sharing across existing platforms and the impact of data on healthcare service delivery. METHODS A mixed-methods approach was adopted, combining quantitative surveys with semi-structured interviews among healthcare professionals across Botswana. This comprehensive strategy aimed to unearth both statistical trends and nuanced personal perceptions regarding the adoption and use of technology in healthcare data management. RESULTS Despite a prevalent reliance on paper-based records, a broadly positive attitude towards digital technology was observed among healthcare workers. Notable challenges were identified, including disparities in data sharing, access, and the variability in the adoption and comfort level with technological devices. These issues underscore the critical need for enhanced infrastructure and digital literacy among healthcare providers. CONCLUSIONS The findings highlight the transformative potential of digital technology in Botswana's healthcare sector, conditioned on addressing existing barriers. Specifically, the study calls for focused educational initiatives tailored to mitigate disparities in technology usage and to foster a cohesive understanding of data sharing practices among healthcare professionals. "Project Kamogano" underscores the opportunity for significant improvements in healthcare data management in Botswana, leveraging healthcare professionals' optimistic attitudes towards digital innovations. The study advocates for targeted interventions aimed at bridging the digital literacy gap and infrastructure enhancements, thereby facilitating effective patient care and informed public health strategies through strategic system upgrades and interoperability enhancements.