Healthcare provision in The Gambia : the role of health informatics
While technological advances in computing and telecommunications are revolutionising the way many organisations work, healthcare systems in The Gambia are very much lagging behind. No proper patient records or filing systems are in place. Delivery of effective healthcare depends on availability of routinely collected, good quality health data to provide useful information that is accessible when and where it is needed. Presently, in The Gambia, there is considerable scope for improvement in relation to such data. Electronic patient record system is long overdue. This research, focuses on the development of a Health Information System (HIS) capable of providing doctors, nurses and other healthcare professionals with quick and easy access to the appropriate information needed to care for their patients. A systems analysis has been undertaken to identify the full need for patient health data, the range of users and the extent of present paper-based provision. From this analysis, a requirements specification has been produced for a proposed health information and administration system (HIAS) to become operational and also successful in terms of efficiency and effectiveness. The requirements specification has taken the form of a series of precise statements of needs, buttressed with a corresponding justification in each case. By assessing what information and communication technology (lCT) is required and feasible, affordable and available in The Gambia, based on the extensive fieldwork involving interviews, observational study and questionnaires, a design specification (the logical and physical framework for the proposed ,IUAS) has also been produced as a precursor to the development of the proposed HIAS prototype. The approach,used will aid any implementor to progress from the proposed system to a fully functional one in an efficient and timely manner. Constraints in the programme of research were such that it was not possible to continue on with a prototype implementation based on this design. Hence it is now for The Gambia government to study and implement the proposed system. Several recommendations have been made in the areas of policies to be implemented, resources needed and training and motivation. In conclusion, the study has demonstrated the value or role of health informatics in the provision of health care in a developing country. It has contributed in the understanding of the complexities of the problems in The Gambia and developing countries, building this understanding in terms of requirements analysis and design specification and in methodological issues.