Lilian Final Corrections

FACTORS AFFECTING ADOPTION TO INFORMATION COMMUNICATION
TECHNOLOGIES (ICTs) BY HEALTH CARE ORGANISATIONS IN UGANDA:

A CASE OF SELECTED HEALTH FACILITIES OF KCCA
BY
KIRONDE NAMBOZE MUGENYI LILIAN

14/MMSPPM/34/133
A DISSERTATION SUBMITTED TO THE SCHOOL OF BUSINESS AND

MANAGEMENT IN PARTIAL FULFILLMENT OF THE REQUIREMENTS
FOR THE AWARD OF A MASTER’S DEGREE IN MANAGEMENT
STUDIES (PROJECT PLANNING & MANAGEMENT) OF
UGANDA MANAGEMENT INSTITUTE
MAY, 2021
DECLARATION
I, Kironde Namboze Mugenyi Lilian, declare that this dissertation titled, “Factors Affecting
Adoption of Information Communication Technologies (ICTs) By Health Care Organisations
in Uganda: A case study of health facilities in Kampala Capital City Authority (KCCA)” is
my original work and has not been submitted anywhere for any academic award.
Signature:………………………………… Date:……………………………………
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APPROVALS
This dissertation is submitted with the approval of my supervisors.
Supervisors:
Dr. Mary Muhenda
Signature:………………………………… Date:……………………………………
Ms. Jennifer Rose Aduwo
Signature:………………………………… Date:……………………………………
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DEDICATION
I dedicate this dissertation to my beloved parents on whose foundation and inspiration this
achievement stands. This dissertation is also dedicated to my dear husband and my children
whose support and inspiration enabled me to achieve the dream of attaining a higher degree.
iii
ACKNOWLEDGEMENT
First and foremost, I want to thank the Almighty God who has been the source of wisdom and
finances to enable me complete this course leading to the award of this higher degree
qualification to me.
I am grateful to my supervisors; Dr. Mary Muhenda and Ms. Jennifer Rose Aduwo for their
professional guidance, commitment and encouragement they extended to me, which enabled
me to accomplish this work in time.
My heartfelt gratitude goes to my husband Arch. Charles Batanudde Kironde who supported
me all through to this day, he still inspires and encourages me pursue further studies against
all odds.
Last but not the least, I thank the management of KCCA and its staff members who despite
their tight work schedules managed to put aside time to provide the necessary information
that was crucial for writing this report.
Thank you all and may God bless you abundantly
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TABLE OF CONTENTS
DECLARATION........................................................................................................................i
APPROVALS............................................................................................................................ii
DEDICATION..........................................................................................................................iii
ACKNOWLEDGEMENT........................................................................................................iv
TABLE OF CONTENTS...........................................................................................................v
LIST OF TABLES..................................................................................................................viii
LIST OF FIGURES..................................................................................................................ix
LIST OF ACRONYMS..............................................................................................................x
ABSTRACT..............................................................................................................................xi
CHAPTER ONE:INTRODUCTION.....................................................................................1
1.0 Introduction..........................................................................................................................1
1.1Background of the study.......................................................................................................1
1.1.1 Historical back ground......................................................................................................1
1.1.2 Theoretical background.....................................................................................................4
1.1.3 Conceptual background.....................................................................................................5
1.1.4 Contextual background.....................................................................................................6
1.2 Problem statement................................................................................................................8
1.3 Purpose.................................................................................................................................9
1.4 Specific Objectives of the study...........................................................................................9
1.5 Research Questions..............................................................................................................9
1.6 Research Hypotheses...........................................................................................................9
1.7 Conceptual frame work.....................................................................................................10
1.8 Significance........................................................................................................................11
1.9 Justification........................................................................................................................11
1.10 Scope................................................................................................................................11
1.11 Operational definitions.....................................................................................................12
CHAPTER TWO:LITERATURE REVIEW......................................................................14
2.0 Introduction........................................................................................................................14
2.1Theoretical Review.............................................................................................................14
2.2 Review of Literature..........................................................................................................16
2.2.1 The effect of ICT characteristics on ICT adoption.........................................................16
2.2.3 Employee Beliefs and Attitudes in relation to the Adoption of ICTs.............................22
v
2.3 Gaps in Literature Review.................................................................................................24
CHAPTER THREE:METHODOLOGY.............................................................................25
3.0 Introduction........................................................................................................................25
3.1 Research Design.................................................................................................................25
3.2 Study Population................................................................................................................25
3.3 Sample size and selection...................................................................................................26
3.4 Sampling Techniques.........................................................................................................26
3.5 Data collection methods.....................................................................................................27
3.5.1 Survey Method................................................................................................................27
3.5.2 Interview Method............................................................................................................27
3.6 Data Collection Instruments...............................................................................................27
3.6.1 Questionnaire..................................................................................................................28
3.6.2 Interview guide................................................................................................................28
3.7 Data quality control............................................................................................................28
3.7.1 Validity............................................................................................................................28
3.7.2 Reliability........................................................................................................................29
3.8 Data collection Procedure..................................................................................................29
3.9 Data analysis......................................................................................................................30
3.9.2 Qualitative analysis.........................................................................................................30
3.10 Measurement of variables................................................................................................31
3.11 Ethical considerations......................................................................................................31
3.12 Anticipated study limitation.............................................................................................31
CHAPTER FOUR:PRESENTATION, ANALYSIS AND INTERPRETATION OF
RESULTS................................................................................................................................33
4.0 Introduction........................................................................................................................33
4.1 The response Rate..............................................................................................................33
4.2 Demographic characteristics of respondents......................................................................33
4.2.1 Respondents’ Age...........................................................................................................34
4.2.2 Respondents’ gender.......................................................................................................34
4.2.4 Employment status..........................................................................................................37
4.2.5 Duration of employees at KCCA....................................................................................37
4.3 The relationship between ICT characteristics and its adoption by healthcare organizations
in Uganda.................................................................................................................................38
4.3.1 The cost of ICT in Health Care Organizations................................................................39
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4.3.2 The easiness to use ICT in Health Care Organizations (KCCA)....................................42
4.3.3 Pearson correlation coefficient between ICT characteristics and adoption of ICT........45
4.4 The relationship between organizational factors and adoption of ICT in Health Care
Organization.............................................................................................................................46
4.4.1 Administrative Support...................................................................................................46
4.4.2 Staff development...........................................................................................................49
4.5 The relationship between employee characteristics and adoption of ICTs by Health Care
Organizations in Uganda..........................................................................................................54
4.5.1 Employee beliefs towards use of ICT.............................................................................54
4.5.2 Employee attitude towards use of ICT............................................................................57
4.5.3 Pearson correlation between employee characteristics and adoption of ICT.................60
4.5 The elements under ICT adoption in Uganda....................................................................61
4.6 Multiple Regression Analysis Summary............................................................................63
CHAPTER FIVE: SUMMARY, DISCUSSION, CONCLUSION AND
RECOMMENDATIONS.......................................................................................................66
5.0Introduction.........................................................................................................................66
5.1 Summary of Study Findings...............................................................................................66
5.1.1 Relationship between ICT characteristics and ICT Adoption in healthcare facilities....66
5.1.2 Relationship between organizational factors and ICT adoption in Health Care facilities
..................................................................................................................................................66
5.1.3 Relationship between employee characteristics and ICT adoption health facilities.......67
5.2 Discussion of Study Findings.............................................................................................67
5.2.1Objective 1: The relationship between ICT characteristics and ICT adoption................68
5.2.3 Objective 3: The relationship between employee characteristics and ICT adoption in
healthcare facilities at KCCA...................................................................................................71
5.3 Conclusion..........................................................................................................................73
5.3.2 Relationship between organisational factors and ICT adoption in healthcare facilities. 73
5.4 Recommendations..............................................................................................................74
5.4.2 Relationship between organizational factors and ICT adoption in healthcare facilities. 74
5.5 Contributions of the study..................................................................................................75
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5.6. Areas for future Research..................................................................................................76
REFERENCES.........................................................................................................................77
APPENDENCES........................................................................................................................i
APPENDIX 1: QUESTIONNAIRE FOR EMPLOYEES AT KCCA........................................i
APPENDIX II: Interview Guide for Key Informants................................................................v
APPENDIX III: Table for Determining Sample Size from agiven Population.......................vi
viii
LIST OF TABLES
Table 3. 1: Sample size and sampling techniques used...........................................................43
Table 3. 2: Results of content validity for research tools.........................................................47
Table 3. 3: Reliability test results of research instruments......................................................48
Table 3. 4: Five point likert scale codes and their interpretation.............................................49
Table 4. 1: The response rate for the study..............................................................................51
Table 4. 2: Respondents age.....................................................................................................52
Table 4. 3: The cost of ICT in Health Care organizations.......................................................58
Table 4. 4: The easiness to use ICT in Health Care Organisations..........................................62
Table 4. 5: Pearson correlation results between ICT characteristics and adoption of ICT......65
Table 4. 6: Administrative support...........................................................................................66
Table 4. 7: Staff development..................................................................................................70
Table 4. 8: Pearson correlation for organizational factors and adoption of ICT......................73
Table 4. 9: Employee beliefs towards use of ICT....................................................................75
Table 4. 10: Employee attitude towards use of ICT.................................................................78
Table 4. 11: Pearson correlation for employee characteristics and adoption of ICT...............81
Table 4. 12: Adoption of ICT in healthcare organisations.......................................................83
Table 4. 13: Multiple Regression equation for both independent and dependent variables....85
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LIST OF FIGURES
Figure 1. 1 : Conceptual Framework........................................................................................25
Figure 4. 1: The gender of respondents....................................................................................53
Figure 4. 2: The Respondents’ Education level.......................................................................54
Figure 4. 3: Employment status for employees at KCCA........................................................56
Figure 4. 4: Time spent at KCCA by Employees.....................................................................57
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LIST OF ACRONYMS
DHIS District Health Management Information System
EMR Electronic Medical Record
HER Electronic Health Records
ICTs Information Communication Technologies
KCCA Kampala Capital City Authority
LFPR, Labour Force Participation Rate
MoES Ministry of Education and Sports
MoH Ministry of Health
MoICT Ministry of Information Communication and Telecommunication
SAQ Self-Administrated Questionnaire
TAM Technology Acceptance Model
UCC Uganda Communications Commission
UNHS Uganda National Household Survey
UTAUT Unified Theory of Acceptance & Use of Technology
WHO World Health Organization
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ABSTRACT
The study examined factors affecting adoption Information Communication Technologies
(ICTs) by healthcare organizations in Uganda focusing on Kampala Capital City Authority
(KCCA). The specific objectives included; to determine the relationship between ICT
characteristics and its adoption; the relationship between organizational factors and adoption
of ICTs and the relationship between employee characteristics and adoption of ICTs by
healthcare organizations in Uganda. The study adopted cross sectional and descriptive
research design where both qualitative and quantitative approaches of research were used and
a total number of 71 respondents was covered. Data was analyzed using thematic analysis for
qualitative while SPSS (descriptive and inferential statistics) were used. By far, the study
correlation findings revealed that ICTs characteristics significantly produce a positive effect
on ICTs adoption in the selected healthcare facilities of KCCA (P-value = 0.001 < 0.01 level
of significance & R-value = 0.726). Considerably also the study cited that organizational
factors also produce a significant positive effect on ICTs adoption in the selected healthcare
facilities of KCCA (P-value = 0.000 < 0.01 level of significance & R-value = 0.875). And
lastly, that employee characteristics also produce a significant positive effect on ICTs
adoption in the selected healthcare facilities of KCCA (P-value = 0.000 < 0.01 level of
significance & R-value = 0.769). Further still the findings also posited that in the regression
Model, employee characteristics produces the highest percentage of 62.3%, followed by
organizational factors with 45.8% and lastly tailed by organizational factors with a 36.3%
effect of causality on ICT adoption. And this therefore meant that the finial output of the
study was; ICT adoption = 0.576 + 0.363 (ICT characteristics) + 0.458 (Organizational
factors) + 0.623(Employee characteristics). The study recommended increase in budget
allocation for ICT, introduction of ICT training and involving employees in ICT
programming to avoid negative attitude toward adoption of ICTs. Future studies can research
why management in health care organisations does not put a lot of attention in terms of
budgeting towards improvement of ICT in the sector to increase its adoption and improve
efficiency.
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CHAPTER ONE
INTRODUCTION
1.0 Introduction
This study examined factors affecting adoption of Information Communication Technologies
(ICTs) by healthcare organizations in Uganda focusing on Kampala Capital City Authority
(KCCA) Health Units. This section provides introduction to the study which entails the
background, problem, purpose, objectives, research questions, hypotheses, conceptual
framework, scope, significance and justification.
1.1Background of the study
The background to the study covers the historical background, theoretical background
conceptual perspective and contextual background.
1.1.1 Historical back ground
The state of ICT in the health sector worldwide is not the same because there is no universal
approach in the implementation of ICT health systems. In some developed countries, more
than half of primary care physicians use Electronic Health Records (HER). Some of these
developed countries include; Sweden, the Netherlands and Australia which have their
physicians using electronic Health Records with 90%, 62% and 55%, usage respectively
(Mugo, 2014) cited in Furusa et. al, (2017). In other developed countries, even though the
diffusion of technology is high and the economy is stable, the adoption of ICT in health
systems continues to be low. Nzuki & Mugo, 2014), cited Furusa et. al., (2017) indicated that
in the United States, according to national electronic health records survey National Centre
for Health Statistics (2015), the percentage of physicians using any Electronic Medical
Record (EMR) system varied by state, ranging from 54% in New Jersey to 89% in
Massachusetts.
It is worth noting that although introduction of ICT in health systems is still low in some
developed countries, the success of e-health adoption has also been low for developing
countries, who are confronted with challenges of insufficient ICT health infrastructure and
lack of technical expertise and computer skills of employees hence, the global state of ICT in
health implies that the implementation of e-health systems does not solely depend on the
availability of technology but on other factors such as technical support in medical
institutions and poor experiences in ICT among health practitioners (Lam et. al. 2016) cited
in Furusa et. al., (2017).
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Important to note is that elements that impact on application of Information Communication
and Technology in improving the wellbeing of the people are not easily generalized,
somehow these issues have to be contextualized. Information Communication Technology
(ICT) is everywhere and hence the possibility of using it due to its value within organizations.
According to Nwakanma (2014) it has spread to all categories of organizations. Today it is
possible to convert data by both individuals& organizations. According to Buick (2003),
documentation has been made easy because the availability of computer facilities.
Farrell and Shafika (2007) appraised the use of ICTs by African countries. He deduced that
use of ICT by institutions is important at reducing the knowledge, technological and
economic gaps with other countries in the World. Scholars have noted that in the African
region, ICT growth has been slow within the health sector. The countries that have tried to
break even in ICT use in health include South Africa and Egypt which have had greater
advances in the discipline (Krumholz, 1997). This view is supplemented by Ellis (2009)
when he pointed out the issues of ICT application in Sub Saharan Africa. He notes that this
part of the World continues to make improvements in health management with application of
technology in a number of functions. These functions include software advancement in
different Health Care management aspects though there is still great need to understand
current technology transfer issues.
Indeed, Mayes (2003) presents a vital read on ICT use once he contends that subject matter
experts and professionals should reevaluate anyway best they will uphold Africa's latent
capacity and experience. He takes note of that so far, inferable from one or the other absence
of help, advancement and drive, the pattern inside the appropriation and use of ICT has
stayed a save for created economies. This was enhanced by Ellis (2009) when he noticed that
the populace support in ICT advancements is slanted to the degree that Africa is being
overlooked because of there are not many designers and clients getting back from Africa.
In Uganda, e-Health began inside the Nineteen Eighties once partner degree sound satellite
association was set up among Uganda and North American country for postgraduate training
support, to that was accessorial chart (EEG) transmission (House, Keough and Hillman, et. al.
(1987)cited in Kiberu, Mars and Scott (2017). the ensuing stages were automation of the
National Databank at the Ministry of Health(MoH) misuse n Microsoft Access (1997-2001)
trailed by Eysenck Personality Inventory information in 2002 for region wellbeing
2
information investigation (Kintu, Nanyunja, Nzabanita and Magoola, 2005) referred to in
Kiberu, Mars and Scott (2017). In 2011, the MoH embraced and broadened the District
Health Management information framework (DHIS2) to the 112 Districts of Health
Management Information System (Kiberu et. al., 2014) refered to in Kiberu, Mars and Scott
(2017). This electronic framework that is wide used in landmass intends to reinforce routine
wellbeing data report from the area level to the public base camp level (MoH), replacement
the predominant paper-based framework.
In Uganda, improvement of ICT is a quickly developing industry in particular in the telecom

business. This has empowered developments around m-Health devices, for example, the
ICT4MPOWER project started by the MoH, Uganda Communications Commission (UCC)
and the Ministry of Information Communication Technology (MoICT) with fundamental
reason to reinforce channels of correspondence among local area individuals at the low levels
and wellbeing staff at public level. The main site to profit was Mukono Health Center IV
(Kivunike, 2016) referred to in Kiberu, Mars and Scott (2017). In 2011, understudies of
Makerere University created 'Win Senga' a fetal pulse screen utilizing a brilliant phone
(Kizza, 2016) referred to (in the same place).
3
For the Ugandan case, the greater part of the wellbeing area the executives ICT developments
square measure some way or another new in light of the fact that the old methodologies have
proceeding to exist on board stylish advancements. This is frequently especially regarding
records the executives, cash the board, correspondence and systems administration (Moore,
2005).consistent with Ssewanyana, (2007), the presentation of PCs in associations could be a
brilliant factor that has not been caught by a few associations. He notes however that its
presentation has seen it adds thinking of, programming and investigation of projects and a
couple of associations actually notice it relentless to adjust to the current turn of events. The
previous examination in ICT however has shown structure edges from programming
framework adaption for comes the executives (Bakkabulindi, 2011). He any prominent that
there square measure numerous that have composed plentiful on the business and
appropriation of ICTs. Strikingly, they noticed that innovation might be applied in rural
comes, business the executives, wellbeing exercises programming, workers distinguishing
proof and elective drives. ICTs square measure serving to satisfy assortment of exercises, the
business needs either by governments or accomplices (Kendra and Taplin, 2004). It could be
noticed that while not missing some degree, utilization of worthy programming framework
makes ICT A fundamental a piece of the whole exhibition technique.
The Government of Uganda perceives e-Health as an empowering stage to improve medical

care conveyance by permitting specialists to counsel and analyze distantly, access patients'
clinical data, give region wellbeing data reconnaissance information and furthermore work
with research considers (Litho, 2010) referred to in Kiberu, Mars and Scott (2017). The
National Data Transmission spine and e-Government foundation project (NBI/EGI) presently
associate Uganda to adjoining nations and it links significant towns, urban areas, Government
Ministries and Departments notwithstanding six colleges.
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In Uganda, web entrance has consistently been developing and it is assessed at 31%. Phone
and cell phone inclusion given by private area media transmission organizations gives
availability to neighborhood government organization units including locale and country
networks. It is important that having better web transmission capacity in a non-industrial
nation like Uganda is a significant lift in ICT advancement and most examinations led have
shown that reception of ICT in wellbeing administration framework improves administration
conveyance essentially (Blaya, Fraser and Holt, 2010) referred to in Kiberu, Mars and Scott
(2017). The examination being scrutinized pointed toward setting up the situation with ICT
selection and use in Health Care Organizations in Uganda to evaluate the difficulties,
openings and great practices from examples of overcoming adversity in nations where it has
dominated. This will give essential to data during the strategy and dynamic cycle.
1.1.2 Theoretical background
The study adopted the Technology Acceptance Model (TAM) introduced by Fred Davis in
1989 as means of describing consumer acceptance and use of ICT (Davis, 1989). In 2008,
Venkatesh and Bala (2008) modified the Model from version two to TAM 3, whereby he
expanded the number of determinants that affect Perceived Usefulness and Perceived Ease of
Use to include the following; innovation, positive behavioral intentions and resultant use
behavior and in recent years, TAM3 has been and continue to be widely used in organizations
(Garavand et al., 2015).
Although this theory was developed from developed countries and targeted on general
technology innovation and adoption, it will still be relevant to the developing world. Hence,
ideas below this model are often applied to Ugandan case and notably within the health sector
to assess the extent to that it explains the adoption of ICT within the health care sector. The
speculation thus considers adoption of ICT from a wider perspective with specialize in the
developed world. This creates the requirement to judge it with specializing in the developing
world and particularly with the health sector in Uganda wherever most of the
structures are simply within the forming method.
1.1.3 Conceptual background

The concept of adoption of ICT in Health Care Organizations is not a new phenomenon; it
has been used widely in the confluence of medical informatics and Public Health. Largely, it
has been used to improve service delivery in Health Care systems and flow of information
through Internet connectivity between rural areas and Gational grid (Mugo, 2014) cited in
5
Furusa et al, (2017). Adoption of ICT in Health Care Organizations should be viewed as both
the critical infrastructure that forms the foundation of information exchange among the users
of healthcare systems and as a means of improved health outcomes for all (Busagala &
Kawono, 2013) cited in (ibid)
As indicated by Mugo (2014), referred to in Furusa et. al; (2017), e-wellbeing includes a
decent change of activities that utilization electronic implies that to supply wellbeing related
data, assets and administrations. It's simply illustrated by World Health Organization (2016)
on the grounds that the utilization of ICT for wellbeing. Qureshi and ruler (2013) portray e-
wellbeing as any electronic trade of wellbeing information among the consideration area. The
idea of e-wellbeing in this way covers all parts of wellbeing through the use of innovation to
supply new ways for using and rising wellbeing administrations. For example, specialists will
give far off therapy to patients abuse e-wellbeing, while distinctive clinical experts will
utilize a comparative framework to follow illnesses and diverse scourge flare-ups in various
conditions (Moerman et. Al; 2014) referred to in Furusa et. al; 2017).
The World Health Organization (WHO) characterizes ICT in Health in light of the fact that
the utilization of information and correspondence advancements (ICTs) for wellbeing (WHO,
2016). e-Health licenses general wellbeing and initial consideration through exercises like
unwellness police examination, essential wellbeing data securing and investigation, backing
of local area specialists, tele-meeting, tele-instruction, examination and patient
administration. Dealing with a patient distantly exploitation ICT is viewed as extra prudent
proposes that of conveying care than moving a patient from or a medico to country or far off
areas.
Dealing with a patient distantly exploitation ICT is considered an extra affordable proposes
that of conveying care than moving a patient from or a medico to country or far off areas.
Gaining from the created world, sub-Saharan African nations territory unit grip e-Health as a
technique to upgrade openness to quality and surprisingly gave care, especially for poor and
weak networks (Scott and Mars, 2014). These arrangements utilize a spread of innovative
arrangements, just as on-line media, radio, affixed phones, television and various gadgets for
text electronic correspondence, bunch conversation, and videoconferencing and sharing
through email. In any case, for some non-industrial nations, e-Health stays a proof-of-idea
6
movement, with exclusively modest price incontestable among small pilot comes (Omaswa,
2016).
As it follows from the higher than, comprehension of ICT has been seen by creators as a
utilization of PCs among day by day work exercises. It doesn't make any difference whether
or not for brief term, medium term or since a long time ago run and this was moreover
reflected by Banister (2005). Assortment of Authors who have attempted to diagram ICT
have gone to accept that as an advancement call it's basically a technique among the
exchange structure and not the occasions that happen. It's a technique that proceeds as long
people can embrace and still receive. What stays critical to the advancement is
correspondence and time as set on board by Rogers and creator (2009).
Reception of ICT in Health Care Organizations involves a few perspectives anyway most
articulated ones epitomize getting new PC programming framework or equipment that region
unit extra refreshed with current Health Care administration each in camera and general
Health Care Organizations. Variables additionally formed by Bakabulindi (2011) as connects
region unit illustrated as sanction or restricting parts inside the conduct of a turn of events and
this has been applied inside the ICT build. It's depict as an exchange strategy on the grounds
that the elements that affect this improvement territory unit basically events that impact
accomplishment of reception and ought to be found out.
1.1.4 Contextual background

In Uganda, the first National ICT Policy was established in 2003 and this aimed at promoting
the use of ICT by Public Service (Ministry of ICT, 2012). This policy also incorporated
institutions of learning with the intention of enhancing ICT at early stages. The policy also
focused on integration of information, communication and technology in education system to
provide necessary distribution of ICT services among schools. When government of Uganda
established Ministry of information, communication and technology (ICT) in 2006, many
policies that aimed at promoting the use of ICT in education were established in the Ministry
of Education and Sports (MoES). These policies included the ICT policy on education for
primary and secondary schools which aimed at training teachers in ICT skills and ICT
initiatives in tertiary institutions (Uganda, ICT Policy, 2010). According to Magambo (2007)
while discussing ICT in organizations, various resources have been directed at improving
ICT facilities by the Ministry. This focused on capability and self-confidences far as
7
application information communication and technology is concerned by different Health Care
health organizations.
As indicated by Health area execution report, (2014), Uganda Government has consistently
worked in organization with other improvement accomplices in regards to advancements in
ICT. The emphasis has been on improving compelling and conveyance of Health Care
administrations in Uganda both at National Health Plan I and II help the consolation of
participation with advancement accomplices (Ministry of Health, 2012). In same manner,
Omaswa (2008) referred to in Kiberu, Mars and Scott, (2017)argued that given the intricacy
of the wellbeing administration conveyance and the arising scourges that need fast reaction, it
is important to foster ICT programs that will react to such requirements on schedule. He
further notes that there is need for the wellbeing specialist organizations especially in Uganda
to adjust to current innovation to empower speedy reaction. Essentially, Moore, (2005)
referred to in Kiberu, Mars and Scott, (2017) noticed that the majority of the wellbeing area
the board innovation developments are some way or another new as the customary
methodologies have kept on existing along current advancements particularly in records the
executives, monetary administration, correspondence and systems administration.
As indicated by the ICT National Survey 2017/18, the extent of Local Government (LG) staff
who reliably use PCs contain just 3.3%, while the extent that regularly utilize the Internet is
1.7%. Comparing figures for Ministries, Department and other Government Agencies
(MDAs) are 37% and 22.5%, featuring the computerized split among MDAs and LGs even as
government looks to standard e-taxpayer supported organizations to serve more residents all
the more efficiently and effectively. Also, ICT framework among LGs is insufficient with
24.1% of LGs having a web and 43.3% having a Local Area Network (LAN). Also, around
33% of LGs (31%) need institutional Internet access and 24.1% don't have an institutional
site (CIPESA, 2018).
According to Ssewanyana, (2007), the adoption of ICT and implementation

throughout designing and planning where as evaluating programs may be a recent
development. He explains that some health sector units still realize it laborious to adapt to the
current development. Kampala Capital City Authority (KCCA) is that the first of its kind
during which a neighborhood government has been reworked into a formidable Authority that
has become active in-service delivery. This development has associate with a
8
comparatively larger population to serve apart from sector sub units. It ought to be noted that
despite the introduction of ICT systems, health sector units have continuing to
consider ancient manual ways all told sector functions Associate in Nursing this was noted by
Nabudeele and Asiimwe(2011) and KCCA has not been an exception. There’s no study that
has thus far been administrated in reference to application of ICT by Kampala
Capital City Authority and it's vital to hold it move into the health sector organizations
inside KCCA.
1.2 Problem statement
Despite health sector putting enormous efforts in training staff in modern technology such as
management information systems to help in records management, financial tracking,
employee profiling and other health related information management systems, there have
been challenges associated with adoption of modern ICTs (Kayanja, 2013). This situation is
not only affecting the Government healthcare provision but also the private and civil society
health providers.
For instance, ICT use and adoption within Government Ministries, Departments and
Agencies (MDAs), is still a big challenge where ICT personnel account stood at only 1.9% of
the total work force and this defeats Government’s ambition to mainstream ICT in its
operations and to leverage ICT in health service delivery. Similarly, ICT infrastructure
among LGs is inadequate with 24.1% of LGs having an internet and 43.3% having a Local
Area Network (LAN) and this is due to inadequate ICT security and user experience design
(CIPESA, 2018).
Therefore, despite the value of ICT in health care management, its acceptability has remained
a challenge. ICT adoption by the employees has remained very low and this has eventually
affected sustainability since the limited use eventually affects the possibility of inclusion in
budgeting processes. It is however not clear where the challenge arises and the need to
investigate whether it is from the ICT characteristics, organizational factors or even the
employee characteristics becomes a necessary undertaking focusing on KCCA health
organizations.
1.3 Purpose
The study aimed at examining factors affecting ICTs adoption in the selected healthcare
facilities of Kampala Capital City Authority (KCCA).
9
1.4 Specific Objectives of the study
1. To establish the effect of ICT characteristics on ICTs adoption in the selected
healthcare facilities of Kampala Capital City Authority (KCCA).
2. To find out the effect of organizational factors on ICTs adoption in the selected
3. To establish the effect employee characteristics on ICTs adoption in the selected
1.5 Research Questions
1. What is the effect of ICT characteristics on ICTs adoption in the selected healthcare
facilities of Kampala Capital City Authority (KCCA)?
2. What is the effect of organizational factors on ICTs adoption in the selected
healthcare facilities of Kampala Capital City Authority (KCCA)?
3. What are the effect employee characteristics on ICTs adoption in the selected
healthcare facilities of Kampala Capital City Authority (KCCA)?
1.6 Research Hypotheses
1. ICTs characteristics significantly produce a positive effect on ICTs adoption in the
selected healthcare facilities of Kampala Capital City Authority (KCCA).
2. Organizational factors significantly produce a positive effect on ICTs adoption in the
3. Employee characteristics significantly produce a positive effect on ICTs adoption in
the selected healthcare facilities of Kampala Capital City Authority (KCCA).
1.7 Conceptual frame work
Independent Variables
nd Variables
Independent
ICT characteristics
 Cost implications to the Dependent Variable
organization
ICT’s Adoption at KCCA
 Perceived Ease of use
10  Acceptability
 Utilization
Organizational factors
 Administrative support
 Staff training and
development for ICT use
Employee characteristics
 Education & Innovation
Source: Adopted and modified by the researcher from the work of Kiberu, Mars & Scott,
(2017), Garavand et al., (201); Mbondji et al., (2014) and Nguyen et al., (2008).
Figure 1.1: The conceptual framework showing factors affecting ICTs adoption in the
A conceptual framework is coherent tools that explain the association between variables on
investigation (Amin, 2005). Flick (2014) further argues that, a conceptual framework
demonstrates the investigator understanding of a phenomenon under study. By far, the
conceptual framework in figure 1.1 above illustrates factors affecting as the independent
variable (IV) while the dependent variable (DV) was conceived as ITC Adoption. ITC
Adoption from the conceptual framework above was measured in terms of; (acceptability,
utilization and sustainability), while the independent variable (factors affecting) were
conceptualized in dimensions namely; ICT characteristics, organizational factors and
employee characteristics. Development of this conceptual frame work was in conformity
with Technology Acceptance Model (TAM) that demonstrates the concept of perceived easy
to use, innovation while ensuring proper behavior change to accept technological changes in
their organizations. Further still all predictor variables (ICT characteristics, organizational
factors and employee characteristics) were hypothesized as having a positive significant
effect on ICT adoption. This therefore stood to mean that an organization specifically in the
health sector will full access, utilize and sustain ICTs only if the cost of using such ICT is
reasonable, the administration provides the necessary support to the users through training
them and developing their ICT skills, so that such staff find the systems easy to use and with
a positive attitude towards ICT usability.
1.8 Significance
It will achieve board the factors that have an effect on adoption of ICTs which is able to
facilitate KCCA Management and policy manufacturers to plan ways on a way to improve
11
the observe for higher results. Similarly, the study results can offer steerage to Government
health directors, personal health sector suppliers and therefore the civil society on a way
to enhance their programs. Different researchers also will have the benefit of the results of the
study as a supply of literature that may be explored by different researchers in future. And to
academician this study can act as purpose of reference wherever future researchers in gaining
insight on key antecedents of ICT adoption.
1.9 Justification
Organizations’ adoption to ICT has always been a debatable topic. Well as a number of
scholars have conducted researcher on antecedents of ICT adoption (Like; Garavand et al.,
2011; Mbondji et al., 2014 and Nguyen et al., 2008). True that a wide studies have explored
the same phenomena under investigation, but evidence on record reveals that they tend to
have studied them in in international countries like; Indian, USA, Indonesia, Malaysia,
Nigeria, Kenya, Indonesia and Pakistan with greater focus on the education industry,
banking, private food and processing, hotels and manufacturing industry (See: Huang,
Blaschke & Lucas, 2017; Akomea-Bonsu and Sampong, 2012; Jenssen et. al., 2016; and
George et. al., 2018) but unfortunately fragments of them have looked at affects affecting ICT
adoption in health facilities in Uganda with specific interest in KCCA health facilities as is
the case for the currently proposed study. Considerably More note worth still, is the fact that
majority of the studies adopted purely quantitative approach and mainstream of them tend to
have ignore a mixed of both qualitative and quantitative approaches as is the case for the
currently proposed study. Hence providing a basis for investigating factors affecting ICTs
adoption in the selected healthcare facilities of Kampala Capital City Authority (KCCA).
1.10 Scope
1.10.1 Content scope
The study aimed at examining on the factors affecting ICTs adoption in the selected
healthcare facilities of Kampala Capital City Authority (KCCA). In this study, factors
affecting was perceived as the independent variable (IV) while ICT adopting was conceived
as the dependent variable (DV). In this case, the study considered measured ICT adoption in
terms of accessibility, utilization and sustainability while on the flipside still, the same study
considered ICT characteristics, organizational factors and employee characteristics as key
factors / predictors (IV) affecting ICT adoption. Considerable also, ICT characteristics
(predictor one) was further operationalize in terms of cost implication to the organization and
perceived Ease of use, organizational factors(predictor two) also operationalized in terms of
administrative support, staff training and development for ICT use. Lastly employee
12
characteristics (predictor three) was also operationalized in terms of education & innovation
and attitude towards ICT use
1.10.2 Geographical scope
This study was carried out within Kampala Capital Authority Health Units of (Kiswa,
Naguru, Kawala, Komamboga and Kisenyi with the assistance of Public Health department
employees. Kampala Capital City Authority is comprised of 5 divisions, Central, Kawempe,
Nakawa, Rubaga, and Makindye. KCCA is a legal entity established by the Ugandan
Parliament that is responsible for the operations of the capital city of Kampala in Uganda.
One of KCCA‘s mandated is responsible to provide health services to the population in
Uganda’s capital city; Kampala.
1.10.3 Time scope
The study utilized data on the challenge of ICT adoption in KCCA health care facilities for
four years from 2015& 2019 this is the period when major technologies were developed for
the health sector but on a flip side unfortunately limited health facilities had full accessed,
utilized and sustained such ICTs in place.
1.11 Operational definitions
Information, Communication and Technology (ICT): This refers to the technologies that
are used to provide access to information through telecommunications especially in health-
related terms. These ICTs will include; the Internet, wireless networks, cell phones, and other
communication mediums.
HealthCare Organizations: These refer to the companies or clinics that provide Health Care
services by clinical authorities like nurses, doctors, pharmacists, etc. Their fundamental
purpose is to provide well-being services at lower price to ensure that large number of people
are covered.
Electronic Medical Records (EMR): This refers to a digital version of the paper charts in
clinician offices, clinics, and hospitals which
containnotesandinformationcollectedbyandforthecliniciansinthatoffice, clinic, or hospital and
are mostly used by providers for diagnosis and treatment.
Health Information Systems (HIS): It is a system that facilitates gathering, aggregating,

analyzing and synthesizing of data from multiple sources to report on health situation and
13
trends (disease burden, patterns of risk behavior, health service coverage and health system
metrics).
KCCA: This refers to Kampala Capital City Authority and study covered health facilities
within this geographical area.
14
CHAPTER TWO
LITERATURE REVIEW
2.0 Introduction
The chapter presents information related to materials or documents that were reviewed
according to the specific objectives of the study. This chapter covers theoretical review and
empirical literature review which was done according to the specific study objectives.
2.1Theoretical Review
The study employed the Technology Acceptance Model (TAM) which is most
generally used model to explain consumer acceptance of data technology. In recent
years, TAM has been adapted to review various factors affecting consumers’
behaviour within the context of health information technology. additionally , taking
cultural trends and social context changes because the main factors, TAM focuses on the
attributes of a specific technology that drive consumers’ acceptance of the technology
and these include; Job relevance, output quality, and result demonstrability, computer
self-efficacy, perceived enjoyment, and objective usability (Garavand et. al., 2015).
Therefore, TAM may be a useful model for “developing strategies to extend the
acceptance of data technology, because it provides an immediate relationship between
acceptance of the technology, and therefore the technology’s perceived usability
and simple use” (Kim &Park, 2012). for instance , Kim and Park (2012) showed that an
extended TAM within the Health Care Organisations systems is significant in describing
the behaviour of individuals checking out medical services as
intentional. Supported TAM, Dunnebeil et. Al., (2012) showed that the perceived
importance of IT utilization is one among the foremost significant drivers for accepting
electronic health services. Orruno, Gagnon, Asua and Abdeljelil (2011) showed that
TAM is sweet at predicting physicians’ intention to use tele dermatology, and therefore
the most vital variable is that the perception of facilitators to using the technology (e.g.,
infrastructure, training and support). These findings suggest that TAM are
often effectively integrated with other theoretical approaches to know the acceptance of
digital health better.
In addition, the TAM theory results provide a satisfactory ground to research the
constructs, and suggest further analysis to verify it as a tool to gauge the utilization of
ICT. This study wishes to use this theory and assess how it explains the extent of
15
adaption of ICT. Studies on ICT implementation have tried to cause board organizational
characteristics liable for success or failure (Ginzberg, 1981). It should be noted however
that consistent with Venkatesh et. al., (2003), no exhaustive measure of the variability of
perceptions of ICT adoption has been established and therefore the reason behind is to
develop a unified theory of technology acceptance.
Observing from the implementation of the above models, it are often noted that ICT
innovations that are well implemented are important in determining adoption especially
when organisation members face new demands. to extend the speed of adopting by
organizational members, incentives are important. These could also be in sort of training
and rewards permanently performance as a results of ICT use. Health
Institutions aren't an exception during this development and so as to assess the strategies
KCCA health units have undertaken so as to reinforce ICT adoption, it is important that,
the UTAUT theory is applied.
Information technology (IT) acceptance could be a method that is influenced by complicated

external and internal factors (Alberta Health Services 2010; Ross et al. 2016). Many
competitor theoretical models are planned and accustomed study the determinants of
acceptance and use of latest IT (Zhang et al. 2015). However, within the context of e-health,
Rogers (1995) diffusion of innovation (DOI) theory has been wide accustomed create
mentally technology adoption (Caldwell & Kleppe 2010; Raingruber 2014). the speculation
seeks to grasp the style during which innovations unfold among and between communities.
As Rogers explains, innovation is perceived asa concept, method or a technology that's new
or unacquainted with to people inside a specific space or context, whereas diffusion is that
the method by that data concerning the innovation flows from one person to a different over
time inside the scheme (WHO, 2016).several studies have incontestable that Rogers’
innovation theory is AN applicable instrument to grasp technology adoption within the
context of e-health initiatives (Adams, Tranfield & Denyer, 2011; Raingruber, 2014; Lien &
Jiang, 2017). They found that the five constructs of Interior, that square measure relative
advantage, trial ability, compatibility, complexness and Observability, influenced the
way during which medical practitioners accepted new technology. it's been determined that
medical personnel settle for technology that's compatible with their work and processes (Lien
& Jiang, 2017).
16
Furthermore, new technology ought to provide relative advantage over this apply, during this
case ancient health approach. It ought to be tried and its impact ascertained before use and in
particular it ought to have low complexness through a easy interface (Zhang et al. 2015). The
idea has been chosen as a result of e-health is new and unacquainted with to several medical
practitioners. Additionally, there has been low level of diffusion of e-health systems
among the general public hospitals in Uganda. Hence, this theory was wont to study the
factors influencing e-health implementation by medical doctors publically hospitals in
Uganda.
2.2 Review of Literature
The following part of the review presents views of other scholars in relation to the subject
under investigation. The presentation is in line with objectives of the study;
2.2.1 The effect of ICT characteristics on ICT adoption
Different investigations inside the writing have investigated the acknowledgment of ICT in
medical services (De Rosis and Vainieri, 2017; Haluza and Jungwirth, 2018). For example ,
Cocosila and Archer (2010) read client purposes behind tolerating or opposing a versatile
ICT application for wellbeing advancement. The creators showed that inherent inspiration
might be an adequate justification appropriation: "As needs be, when helpfulness is a more
modest sum obvious, pleasure could likewise be a key factor for the reception of portable ICT
for wellbeing advancement".
Shiferaw and Zolfo (2012) showed that telemedicine execution doesn't rely just upon
mechanical elements, rather on multisectoral inclusion, e-government availability,
empowering approaches, and limit building measures: "There isn't any ideal 'one size fits all'
innovation and hence the utilization of joined interoperable applications, reliable with the
neighborhood setting, is extremely suggested". Haluza and Jungwirth (2018) expected ICT-
upheld wellbeing advancement methodologies to upgrade expectation for everyday comforts,
nature of medical care, and patient's information. In any case, financial angles,
acknowledgment by persistent promoters, and information security and protection were
considered on the grounds that the three most key hindering components for ICT
applications.
17
Computerized innovation can evaluate, screen, forestall, analyze or treat infections, screen
patients, for restoration or long haul care (Jenssen et. al., 2016; George et. al., 2018). For
example , assistive advances and restoration mechanical technology including unpretentious
checking sensors and wearable gadgets are utilized for individuals with incapacities to aid
their freedom to play out their everyday assignments. Computational recreations and
demonstrating approaches can show wellbeing related results. Advanced wellbeing can give
wellbeing data administrations to help information transmission, stockpiling and recovery for
clinical purposes.
Portable wellbeing, tele-health, telemedicine, tele-care, tele-instructing and tele-recovery are

different kinds of patient consideration which will be valuable for Health Care frameworks in
Africa. Since ICT helps general wellbeing and initial medical care through exercises like
illness reconnaissance, wellbeing information securing and examination, backing of
specialists , tele-consultation, tele-instruction, exploration and patient administration, ICT are
regularly wont to oversee patients distantly as a more proficient methods for giving medical
services than moving a patient/clinical expert to country territories (Jaana and Sherrard,
2018). Thusly, some of the significant ICT and mechanical arrangements incorporate online
media, radio, TV, fixed phones, and different gadgets for text informing, video conferencing,
remotely coordinating, and email.
As indicated by Uganda's 2013 public e-Health strategy, most e-Health applications and items
are run in storehouses and aren't viable, forestalling sharing of information and
administrations. A few innovation advancements have stayed as pilots for all occasions as
they're not interoperable as after effects of disparate stages. As in other non-industrial nations,
such e-Health drives are contributor subsidized and some of the time stay a proof-of-idea
wherein innovation is shown inside a restricted setting (Omaswa, 2016). the main part of such
drives will in general remain as little or medium-sized ICT projects or have slowed down or
deteriorated with the stoppage of benefactor financing. This has been ascribed to absence of
neighborhood possession and responsibility, backing and funding. Poor coordination and
correspondence, and a shortage of appropriate e-Health execution structures, likewise are
referred to as significant difficulties to economical e-Health programs (Omona and Ikoja-
Odongo, 2006) referred to in Kiberu Mars and Scott, (2017).
18
Uganda's National e-Health Policy additionally distinguishes the nonexistence of e-Health
principles and frameworks as difficulties. There are no public rules for secure administration
of people's electronic wellbeing data and administrations, putting individual information in
harm's way. This may in the end be an obstruction to reception of e-Health and hence the
acknowledgment of its advantages like improvement of wellbeing data sharing and successful
administration of the wellbeing framework (Jennings, Baily, Bottrell, and Lynn, 2007)
referred to in Kiberu, Mars and Scott, (2017). It are regularly noted from above survey that
utilization and appropriation of ICT in wellbeing administration in Uganda stays a huge test
which needs the governmentt and different partners to style and carry out far reaching plans
for e-wellbeing and this may essentially diminish costs getting to e-wellbeing by improving
in wellbeing habitats.
What's more, worldwide and local accomplices close by UNESCO financed a three-year tele-
centre project at Uganda's Nakaseke Multipurpose Community Tele-centre (MCT) to supply
administrations like printing, web/messages and telephone utilities. Moreover, telemedicine
administrations were offered between Nakaseke Hospital and Mulago National Referral
Hospital, pointed toward improving personal satisfaction for the local area. practically like
the web based tele-pathology connect among Uganda and Germany that was confronted with
moderate web speed, (Wamala, Katamba and Dworak, 2001) referred to in Kiberu, Mars and
Scott, (2017), the MCT project was compelled by helpless media communications
foundation, diligent force power outages and an ignorant local area. This structures one
among most noteworthy obstacles to ICT usage in wellbeing offices in Uganda which the
investigation current examination looked to investigate further.
19
It has been recognized that the qualities that Bakkabulindi (2009) alludes to as ICT substance
fundamentally affect its selection. This happens not during a solitary association anyway
through and through associations and at regardless of level inside the associations. The cost
of ICT has been place high inside the conversation of ICT attributes by totally various
understudies. in sync with Tusubira and Mulira (2004), the cost of a table prime (PC)
associated with the net is much of the time inconvenient for people in agricultural nations and
African country most importantly. Truth be told, for individuals who will manage the cost of
a pc, upkeep just as infection insurance is one more downside. It will be unequivocal that
however the higher than students have broadly looked at difficulties of ICT as far as costs,
absence of computer, one in every one of these examinations have analyzed the ICT attributes
that this investigation needed to manage.
This was the most explanation that Ssewanyana and Busler (2007) clarified that selection and
use of PCs and net is high in medium and colossal organizations. This is regularly altogether,
in organizations possessed by outsiders and not those claimed by Ugandans. The vast
majority of the little organizations that square measure essentially locally possessed have low
use of PCs on account of the cost in order to search for and look after them. The work of PCs
as a mechanical drive is also tortured by confined data and abilities that even once they
square measure available, they're not utilized. This infers that there's should enlarge ICT
training offices for the local business visionaries. This can work with them advantage of
chances identified with the appropriation of ICT.
Dealing with a patient distantly abuse ICT is considered an extra efficient recommends that
of conveying care than moving a patient from or a Dr. to provincial or distant areas (Litho,
2010) referred to in Kiberu, Mars and Scott, (2017). Gaining from the created world, desert
African nations square measure catch e-Health as an approach to help availability to quality
and equitable care, especially for poor and weak networks. These arrangements utilize a
scope of innovative arrangements, just as on-line media, radio, mounted phones, television
and various gadgets for text electronic correspondence, bunch conversation,
videoconferencing and sharing through email. In any case, for some agricultural nations, e-
Health stays a proof-of-idea action, with exclusively humble worth incontestable inside little
pilot comes (Omaswa, 2013) referred to in Kiberu, Mars and Scott, (2017).
2.2.2 Organizational Factors and the Adoption of ICTs
20
The organizational factors within the study are people who arise from within the
organization and have the potential to limit the adoption ability. the
subsequent review during this study is restricted administrative support, staff training
and development for ICT adoption. Administrative support is extremely important for
any innovations as has been revealed by variety of students. Consistent with Soanes
(2006), administrative support is an act of giving out or applying something in a
corporation. During this study, administrative support refers to the assistance and
guidelines given out by management in organizations to assist in computer and other ICT
facilities training and integration of ICT into the work operational programs.
Electronic Medical Records (EMRs) are used for storage, management and retrieval of
patients’ data. Shuaib et al. specifically reported that developed countries do well as far
as patients’ data are concerned, unlike the developing ones that also experience some
challenges, particularly with ethical issues in accessing patients’ data (Keny et al.,
2015). as an example , in Kenya, despite the rollout of EMRs to many sites, a project
was hampered by limitations like inadequate infrastructure, system interoperability and
lack of skilled expertise. Similar challenges including inadequate funding and resistance
from doctors were encountered in Uganda during implementation of EMRs, likeOpen
MRS, m Track and DHIS2 (Kiberu et al., 2014).
Regardless of the presence of a technique to guide implementation, or an evidence-based

need, if the setting isn’t’ ready’ to use these innovations, it'll not succeed. e-Health
readiness assessment in reference to physical infrastructure, technology equipment, user
and managers’ skills, policies, regulations and guidelines should be
undertaken before implementing any e-Health system. Three factors all a part
of readiness are identified as hindrances to adopting telemedicine in Uganda: lack of
data and skills, lack of policy and resistance from healthcare workers (Isabalija, Kituyi,
Rwashana, Mbarika, 2011). Therefore, it against this background that this study will
further investigate their effects in e-Health care units settings.
21
There are varieties of opportunities that exist which may be wont to tackle many of the
identified ICT challenges and affect its appropriate adoption. Conventional guidance
highlights the need for a defensible (health needs based, evidence based and prioritized)
e-Health strategy that invokes e-Health only demonstrated to supply viable solutions
(WHO, 2011). Similarly, the literature indicates that sustainability to be enhanced by
following a standard process extending from needs and readiness assessment, through
piloting and alter management, to evaluation, although the increase of ‘spontaneous
telemedicine’ offers an alternate route particularly for developing countries (Okui, et al.,
2011)
In Uganda, mobile e-health has specifically enhanced efficient communication about
medical healthcare services between MOH and districts through phone calls, emails and
short messaging services (SMS) (MOH, 2011) cited in Abandu & Kivunike, (2017).
Despite the good advantages of using mobile phones to accelerate health service
delivery, there's still scanty information that provide proper reasons why mobile
technology isn't adequately adopted in hospitals to enhance health service delivery
(UBOS, 2012)in Abandu & Kivunike, (2017).
The weakness of the prevailing information systems, few staff and distant health
facilities hamper the efficient mobilization of mothers (Mbondji et al., 2014; Nguyen et
al., 2008) cited in Abandu, & Kivunike, (2017). Although, the village health teams
(VHTs) are wont to accompany traditional paper-based health cards for mobilization,
they face challenges of poor facilitations, inconsistent follow-ups, unavailability of
outreach programs and insensitive staff attitudes (MOH, 2011; Bazos et. al., 2015;
Ssemaluulu et. al., 2010) in Abandu, & Kivunike, (2017). it's important to notice that
although many weaknesses are identified that hinder ICT adoption in hospitals, none of
those studies have focused on impact of ICT characteristics, organization factors and
employee characteristics on ICT adoption which the present study sought to deal with.
22
Past studies have tried to relate administrative support and ICT implementation. for
instance , Cameron and Ulrich (1986) found that lack of administrative support in
organizations within the least levels was a barrier in the Nigerian education institutions.
Krysa (1998) reported that successful implementation of ICTs can only occur through
supportive leadership. Additionally to managers developing a guiding tool for
implementation of technology, they will support the technological professional
development of employees. It also can be achieved through scheduling regular meetings
among staff using technology to plan and implement their daily work activities.
The above augurs well with Aryatuha (2007) who noted that training of the users and
constant technical support is usually important. Without this, albeit high-quality
hardware and software are available, they might be wasted or remain underutilized by
the users. The study by Walker (2005) suggested that continuous training should provide
support in order that staff can still keep and update with ICT. Consistent with Aryatuha
(2007), most of the African economies are so poor and where ICT is introduced, the
competency to handle it's very low. One has got to undergo vigorous training so as to
become a computer knowledgeable individual but high cost of ICT training would
hamper this process. Though many researchers advocate for the utilization of computers,
problems which affect the effective utilization of computers are still many.
Introduction of ICT is change initiated and implemented by change leaders which
will have a sustainable impact. Introduction of ICT isn't well planned; it are
often chaotic and sometimes involves the shifting of goals, discontinuation of activities
and making of unexpected combinations of operations. For any change process
to achieve success, however, it must be properly managed and organizational members
should be told about the upcoming change (Magala, 2001). It is therefore important
that the present study is administered to form an assessment of the factors that affect ICT
adoption within the Health Care Organizations and examine whether it's something to try
to to with administrative or staff development related factors and appropriate action be
taken.
2.2.3 Employee Beliefs and Attitudes in relation to the Adoption of ICTs
The effect of employee characteristics on adoption of ICT cannot be taken for granted since it
can determine adoption or non-adoption. The global move for the use application of ICTs by
23
organizations is due to quickness in implementing work, efficiency in performance, and
better customer services. This can only be achieved depending on the willingness of the team
members to use the facilities for the benefit of the clients.
As indicated by Nambisan and Wang (2000), embracing could be consequences of

inventiveness being used of PCs. It also mirrors the power to judge, settle for and utilize
groundbreaking thoughts. Further, Associate in nursing endeavor's selection capacity is also
upheld factors related with its interior abilities and necessities. Fuglie (2010) found that even
worry of the obscure will affect selection. Negative perspectives separate the person from
information primarily that that is considered conflicting with convictions, qualities, and
necessities. In same methodology, Akomea-Bonsu and Sampong (2012) tracked down that
the majority of the minuscule associations reputed a positive execution and various edges of
ICT selection. it had been noted yet that this depended on the laborer view of the
commitment of ICT the degree to that they sought after those edges.
As discovered from the on top of investigated writing, it is normally found out that if all
around authorized and hence the specialist attributes square measure in bicycle, utilization of
PCs and various developments has changed edges across a huge fluctuate of intra association
and put down association interfaces. It should be noted yet that non-industrial nation
associations square measure gradually understanding the positive effect of ICTs. This
proposes that with ICT use, associations will act a great deal of with efficiency and become
carefully organized (Buhalis, 2003). From this point hence, it's indispensable that an
examination is dispensed in wellbeing area associations any place writing has been confined
to check anyway the case is addressed and along these lines the examiner discovers KCCA,
the first material objective.
Data and correspondence innovation (ICT) is transforming into a ton of in style in tending
administration (Khan et al, 2006 and Saroj et al, 2008) referred to in Kiyuye et al., (2011).
Inside the past, PCs were dominantly wont to keep and keep up patients' clinical records.
Notwithstanding, as of late, the multiplication of portable processing gadgets has driven a
progressive change inside the computing world, any place ICTs are received for elements of
sharing tending experience across the globe. Since the initial Nineteen Nineties, propels in
PC and net technologies have made new possibilities for specialists and their patients. Inside
the developed countries, specialists use PCs to send live video, sound and high-resolution
pictures between two inaccessible areas moreover as analyzing patients in facilities that will
24
be a great many miles away. These technologies square measures being turned over to
agricultural nations because of their Brobdingnagian abilities in lessening tending costs
(McClure, 2007) referred to in Kiyuye et al., (2011). An investigation of this nature gets the
job done to find out the ICT appropriation as far as sufficiency, usage and property.
Kiwanuka et al, (2015) referred to in Huang, Blaschke and Lucas (2017)., in an investigation
of the District Health Information System in Uganda, accentuated the need to recognize
unmistakably between the "selection" of such a development by wellbeing suppliers difficult
to oppose when that advancement is presented by government and its "acknowledgment" by
those suppliers. Following Kollmann (2004), in Huang, Blaschke and Lucas (2017), they talk
about the "acknowledgment measure" which can be viewed as a dynamic, frequently non-
direct, movement from introductory impression of and perspectives to a hierarchical
intercession, through its, conceivably hesitant, appropriation to its acknowledgment, if all
goes as arranged, as a normal action. It is critical to take note of that albeit above researchers
have taken a gander at appropriation and acknowledgment measures, none of the
investigations unequivocally centered around ICT qualities, hierarchical elements and worker
attributes as block to ICT reception which the flow study tried to address in Health Care unit
settings at KCCA.
2.3 Gaps in Literature Review

It was observed from the literature review that Uganda has lagged behind in many aspects as
far adoption and integration of ICT in health care facilities is concerned. Most of the projects
that are already operational lack adequate human resource capacity, infrastructure
development and being donor funded; they operated in silos and lacked sustainability.
Literature indicated that most that ICT projects have lack prior planning stages of need and
readiness assessment which is a crucial stage in the success of implementation of the projects.
Although, it was noted that Uganda has taken many strides and initiative to adopt ICT such as
mobile applications and health information systems, these initiatives have remained mainly
centralized and health facilities in local government have been reached and have not
benefited much from these initiatives. There is no evidence in the literature of a holistic ICT
adoption policy and guidelines to help Health Care Organizations install and implement a
successfully. This is what the study seeks to address by suggesting possible
recommendations.
25
Considerably still, existing literature in here above provides a mixed result when found
reporting sometimes positive or negative association (Kiberu, Mars & Scott, 2017; Magala,
2001; Abandu, & Kivunike, 2017; Akomea-Bonsu and Sampong, 2012; Jenssen et. al., 2016;
Huang, Blaschke & Lucas, 2017; and George et. al., 2018) hence justifying that the
association debate on the variables under investigation is not closed but rather still open for
advanced ponderings. It is also true that a significant body of knowledge is reviewed on the
same phenomena in different context / settings (international, regional and national) but not
in Ugandan financial sector with specific interest in Let’s Talk Investment Limited (LTIL) as
cited by the current study.
26
CHAPTER THREE
METHODOLOGY
3.0 Introduction
This chapter has been developed basing on authentic scholars that have applied such methods
in other research environments and it describes the procedure used in gathering data and
analysis. This chapter presents research, study population, sample size determination,
sampling techniques, data collection methods and instruments, Data quality control,
procedure for data collection, data analysis, measurement of study variables and ethical
consideration.
3.1 Research Design
The study adopted cross sectional and descriptive research design. Across-sectional was
adapted to simply because study anticipated investigating on the phenomena (factor affecting
ICT adoption) at a single / particular point in time and for the shortest period of time
(Creswell, 2012). Further to note, a descriptive design as according to Creswell (2012) was
used so as to describe the characteristics of study elements in terms of gender, age, academic
background and longevity but also in the view of Orondo (2003) descriptive research design
comprises collecting data by administering a questionnaire to a sample of respondents. .
These designs were used because it allows examination of potential interactions among study
elements. Besides, it also includes different categories of subjects who represent the target
group in the population (Creswell, 2014).
Further still, the research design used both qualitative and quantitative research approaches
for data collection. The qualitative approaches were used because they are interactive,
participatory and allow chance for elaborating on the issues to the respondents in case they
don’t understand questions being asked (Amin & Martin, 2005). Mugenda and Mugenda
(2012), indicated that quantitative research approach is probably the best method available to
social scientists who are interested in collecting original data for purposes of describing a
population which is too large to observe directly.
3.2 Study Population

In this study, the actual study population included 80 respondents which comprised of
employees within Kampala Capital City Authority (KCCA) Health Directorate. These
included the Directors, Managers, employees and Officers and Assistants. The study never
included the support staff of the Directorate. KCCA Health Directorate is composed of Public
27
Health and Environment Health Directorates, Department of sanitation and Environmental
Management and the Medical Services Departments (KCCA, HR Manual, 2016).Each of the
Directorates and Departments is composed of Directors, Managers, Supervisors, Officers,
Assistants and Support Staff.
3.3 Sample size and selection
It was established that KCCA Health Directorate is composed of Public Health and
Environment Health Directorates, Department of Sanitation and Environmental Management
and the Medical Services Departments. There are 5 Directors, 10 Managers and 65
employees or officers and this give a total of 80employees (KCCA, HR Manual, 2018). The
researcher using Krejcie and Morgan (1970) table of sample determination as cited in Amin,
(2005), (Appendix III), selected 5 directors and 10 managers, out if 65 employees only 56
were selected to participate in the study. Out of total population of 80 employees at KCCA
heath care units, only 71 respondents participated in the study as given in table 3.1
Table 3. 1: Sample size and sampling techniques used
Section Target Sample size Sampling technique
population
Directors/Deputy 5 5 Purposive sampling
Directors
Managers 10 10 Purposive sampling
Employees 65 56 Simple random sampling
Total 80 71
Source: KCCA Staff manual, 2018
3.4 Sampling Techniques
Amin, (2005) defined sampling as the process by which a researcher selects a sample of
participants for a study from the population of interest. The study used purposive sampling
techniques to select 15 Directors and Managers of Directorates and Departments respectively.
This technique was preferred because it is very informative and it also reaches targeted
population sample quickly by providing a researcher opportunity to select a sample that has
typical characteristics and knowledge of the topic under investigation (Amin, 2005). Amin
further notes that it is used on small samples and where the information possessed by those
samples is crucial for the study. In view of the current study, the Directors and Managers are
crucial in assessment where they were assumed to have necessary experience and knowledge
about the issues influencing adoption of information, communication and technology.
28
In addition, the researcher used simple random sampling technique which is a probability
technique to randomly pick 56 staff within the Directorates and Departments of KCCA
Health Care Units. This technique was used because it ensures that every person within the
sample population has equal opportunity of being selected to participate in the study and
reduces risks of bias from the researcher (Creswell, 2013). He further noted that selection of
an individual respondent does not necessary influence the processing of selecting other
participants for the study and these individuals are assumed to have typical characteristics
and knowledge of the study under investigation.
3.5 Data collection methods
The study made use of three commonly used methods for data collection and these included
are questionnaires, interviews and document review (Sekaran, 2003) and these are same
methods that were utilized by this study as detailed below:
3.5.1 Survey Method
In this method, a self-administrated questionnaire (SAQ) was employed to gather information
from the supervisors and officers at KCCA. An Amin (2005) stress that the questionnaire
helps in gathering information that ensures that adequate data and accurate one is collected.
This method was used because it helps to gather information in numerical form and from a
large population within shortest period which will supplement the information that will be
collected using other methods (Amin, 2005).
3.5.2 Interview Method
The method was employed to collect data using face-to-face conversation between the
researcher and purposely-selected key-informants specifically Directors from KCCA. This
method was used because it helps in collecting qualitative data which was used to supplement
information from other methods (Creswell, 2013). In addition, Amin, (2005), stresses that
interviewing method helps in generating detailed data especially if probing is adequately
done. This method involved preparing questions that are asked to each key informant without
diverting from the key study variables.
3.6 Data Collection Instruments
In line with different methods of collecting information, different data collection instruments
were adopted and these included; Self-administered questionnaires, Interview guide and
Document review checklist.
29
3.6.1 Questionnaire
According to Amin (2005), a questionnaire may have both close-ended questions which
provide options from which the respondents tick the most appropriate option or open-ended
questions where respondents are requested provide their own views in the spaces provided.
These well-designed questions allow respondents to give out their detailed views about the
study variables in question. Most of closed-ended questions were in form of a 5-Likert scale
with codes 1 representing ‘strongly disagree, 2 Disagree, 3 not sure, 4 agree and 5 strongly
agree,’ which required the respondents to tick in the answer that best suited their option on
each of the items designed in questionnaire. The questionnaire was selected because
according to Amin (2005), it is less expensive to administer and could be sent through email,
filled by a person at leisure and provides timely data quickly.
3.6.2 Interview guide
Mugenda & Mugenda (2012), indicate that this research instrument helps in structuring the
interview and ensuring that respondents are asked similar questions so as to allow
comparison of the data obtained. An interview guide as tool for collecting primary data was
formulated according to the specific objectives and was used to gather information from the
directors at KCCA health sector.
3.7 Data quality control
The researcher used both validity and reliability tests to ensure that instruments were
appropriateness and consistency in yielding research results and these are given in details
below:
3.7.1 Validity
Validity is often defined as the extent to which a research instrument is used to measure what
it asserts to measure and validity of a research instrument assesses the extent to which a
research instrument measures what it is designed to measure. In another words, it measures
the degree to which the results are truthful and therefore it requires research instrument
(questionnaire) to correctly measure the concepts under the study (Creswell, 2014).
The formula for validity test is given below:
CVI = n/N
n = is the number of questions deemed valid
N = Total number of questions in the questionnaire
30
Table 3. 2: Results of content validity for research tools
Dimensions No of Items Relevant CVI

ICT characteristics 12 10 0.833
Organizational factors 15 14 0.933
Employee characteristics 14 12 0.857
ICT adoption 7 6 0.857
Average % (CVI) 0.870
Table 3.2 presents an average all 0.870 and (0.833, 0.933, 0.857 & 0.857 respectively) on all
three variables had a CVIs that were above 0.7, imply that the tool was validity since it was
appropriately answering / measuring the objectives and conceptualization of the study.
According to Mugenda & Mugenda (2003), the tool can be considered valid where the CVI
value is 0.7 and above as is the case for all the four variables provided above.
3.7.2 Reliability
In addition to the validity testing, a reliability test for the questionnaire will be done by first
conducting a pilot study involving 20 respondents and subjecting the findings to a
Cronbach’s alpha coefficient test of reliability using the following formula presented by
Amin (2005).According to Gay (1996) the Cronbach Alfa coefficient to be considered
relevant, it should be 0.7 or above for rese arch instruments to be used. The reliability of
instruments was established using Cronbach Alpha Coefficient which tests internal reliability
and the average reliability test result for research was 0.84 which is recommended as given
below in 3.3.
Table 3.3: Reliability test results of research instruments.
Study variables Cronbach’s Alpha
ICT Characteristics 0.745
Organizational Factors 0.986
Employee characteristics 0.876
ICT adoption in Health Care organization 0.765
Average Cronbach Alpha coefficient for variables 0.843
3.8 Data collection Procedure

This involved getting a letter of introduction first by a student from Uganda Management
Institute which was presented to the concerned officials to allow collection of data (KCCA
31
Administrators). In the initial stages, physical visits were made to various departments,
sensitizing all the staff to speak out their minds as they fill the questionnaires. The researcher
selected and trained a Research Assistant and this helped in collecting information by
distributing questionnaires among the study participants.
3.9 Data analysis
The information collected from the respondents was analyzed using both quantitative and
qualitative approaches as explained in detail below:
3.9.1 Quantitative research design
Proceeding to data collection process, tentative codes were developed during the research
design stage. Data was then edited to ensure completeness, uniformity and accuracy (Amin,
2005). The investigator also checks for errors and edited to ensure accuracy, generate
numerical codes based on the Likert scale, and then enter data in Statistical Package for
Social Sciences (SPSS) version 21 to be considered for further analysis (SPSS Guide, 2012).
Bio data information was analyzed using ‘Descriptive analyses where both tables and pie
charts were presented in percentages frequencies, Mean and standard deviation.
More so, Correlation analysis was also conducted so as to establish whether there is a
significant or there is no influence between the variables under study (Sig value < or > 0.005
and R-value). ‘Regression analyses were also carried out so as to establish the extent to which
the Independent variable (IV) and its dimensions cause change/variability in the dependent
variable (DV). The decision here was based on R-Square from the Model summary table; P-
value from the ANOVA table and Beta values from Table of Coefficients respectively (Amin,
2005). The following regression model was used to show factors affecting ICT adoption;
Y = a + β1X1 + β1X2 + β1X3
Where: Y = ICT adoption; a =constant, β1, β2 and β3, = Regression coefficients; X1= ICT
characteristics; X2= Organizational factors; X3= Employee characteristics; e = Error term.
3.9.2 Qualitative analysis

According to Gay (1996), the process of Qualitative data analysis involves making sense/
meaning out of the text and images. The study applied a “Thematic Data Analysis”. Here the
researcher first prepared data for analysis were participant’s voice recording were transcribed
into verbatim so as to generate a tertiary document (Yin, 2009).The researcher then read
through the data to validate accuracy of the information and familiarize or obtain a general
sense of information, code the data using predetermined codes were paragraphs were also
labeled with terms or descriptive label, themes were also generated based on/ aligned to the
32
research objectives, integrate themes and finally interpreting the meanings of the themes by
comparing findings with past literature/ theoretical information so as to enhance effective
data presentation (Creswell, 2008).
3.10 Measurement of variables
The measurement of the study variables were measured by developing the questionnaire with
a questions formulated in five (5) Likert scale where by one (1) stands for strongly disagree
to a range of five (5) which stands for strongly agree. Here, the respondents were provided
with alternative options from which they chose their best options on ICT characteristics,
organizational factors and employees’ characteristics. A researcher used nominal scale to
measure items on demographic characteristics of the respondents and ordinal measurement
applied to questions that were design in form of 5 likert scale questions (Amin, 2005) as
illustrated in the table 3.4.
Table 3. 4: Five point Likert scale codes and their interpretation
Description Ranges for mean Codes for scale Interpretation

Strongly Agree 4.20-5.00 5 Very high
Agree 3.40-4.19 4 High
Neutral/undecided 2.60-3.39 3 Average
Disagree 1.80-2.59 2 Low
Strongly Disagree 1.00-1.79 1 Very low
Source: Adopted in Amin, (2005).
3.11 Ethical considerations
This is an academic research and thus the researcher ensured accurate reporting, respect
confidentiality and anonymity of the respondents. The research respondents were briefed
about the research and given a chance to ask questions for clarity to make sure voluntary
participation; they weren't required to supply names as how of ensuring privacy of
individual respondents. Proper appointments were made with respondents to make
sure that they're met in their time of convenience to be ready to give appropriate
response. the aim of the info being collected was well communicated to the respondents
to avoid cases of bias.
3.12 Anticipated study limitation
The study in general terms, it never faced major challenges apart from few respondents who
could not answer and return questionnaires within agreed period and as a result some
questionnaire were not collected and entered for data analysis. This is supplemented by
33
Mugenda &Mugenda (2012), where stressed that surveys that are distributed with time
constraints usually face serious challenges because possible respondents feel overworked and
too busy. In addition, KCCA being a very busy environment, some appointments were
postponed but researcher made other appoints and at the end of data collection, out of 15
interviews, only two (2) were missed.
34
CHAPTER FOUR
PRESENTATION, ANALYSIS AND INTERPRETATION OF RESULTS
4.0 Introduction
The section provides analysis of the study findings according to the specific objectives of the
study. Part one of this chapter presents response rate and socio-demographic characteristics
of the respondents and last part of the chapter presents empirical study results which are
analyzed according to the specific objectives of the study. Here, descriptive statistics were
used to present analysis of demographic characteristics while inferential statistics helped in
establishing direction and influence of both independent and dependent variables.
4.1 The response Rate
This study covered simple of 56 participants who were given questionnaires which were
filled well and completed except that three (3) people who never returned questionnaires, in
total data of 53 questionnaires was entered for analysis. We observed that KCCA employees
had busy work schedules; hence this was the reason for the three who failed to complete and
return the questionnaires. The results are provided in table 4.1.
Table 4.1: The response rate for the study
Category Questionnaires given out Returned Response Rate

Officers at KCCA 56 53 95
No. of planned Actual done
interviews
Directors/Deputy 5 5 100
Managers 10 8 80%
Source: Primary data, 2021
Response rate information presented in table 4.1 revealed that56 questionnaires which were
distributed to the officers in different departments of KCCA Health Care services only 3
questionnaires were not returned, hence 53 questionnaires were returned. Then out of 15
interviews which were planned to be conducted; only 13 were conducted success and two
were missed. On average, the response rate for the study stood at 91%.
4.2 Demographic characteristics of respondents
The information about the socio-economic background of respondents presented here cover
issues like; age, gender, highest level of education, employment status and duration in
service. These characteristics are assumed to influence a lot about how people perceive,
35
interpret and responses to different issues pertaining to ICT access and use at KCCA health
organisations as detailed discussion is given below:
4.2.1 Respondents’ Age
The study examined information about age of respondents because age is a very important
element in determining a person’s capacity to perceive issues to do with access and utilize
technology in this modern era and how ICT influence their daily life work routines to remain
relevant and competitive in this ever-changing technological environment. The summary of
information about the respondents’ age is given in Table 4.1.
Table 4. 2: Respondents age
Respondents’ age groups Frequency Percentages

20-25 2 4%
26-31 15 28%
32-37 22 42%
38 and above 14 26%
Total 53 100%
The findings given in table 4.2, revealed that most respondents (42%) were aged 32-37 years
followed by those aged 26-31 years (28%), (26%) were aged above 38 years and above.
Finally, (4%) for respondents were aged 20-25 years. The implication is that most of the
study participants were found to be below 50 years.
4.2.2 Respondents’ gender

Important to this study was sex of respondents as men and women may be affected by access
and use of ICT differently in organization. It is important to note that men and women may
differ in their usage of ICTs and benefits that accrue to men and women from social
engagement and economic participation may also differ significantly. Figure 4.1 gives the
summary of findings on gender of respondents.
36
Male
Female 53%
47%
Source: Primary Data, 2021

Figure 4.1: The gender of respondents
The study findings presented in Fig 4.1 revealed that (53%) of the study participants were
males while (47%) were females. This may imply that KCCA as an authority maybe is
recruiting more male workers than females with less ICT skills compared to men and this
may hinder e-health services since few employees have required skills to deliver such
services which a necessitated a study of this nature.
The results concur with previous studies gender differences and similarities in access and
use of data Communication and Technology (Gillwald, Milek & Stork, 2010). Their
studies acknowledged that the extent of ICT utilization differs among both men and
ladies . as an example , men’s decisions to use technology are strongly influenced by
their perception of ICT usefulness, while women’s decisions are influenced by their
perceptions of the technology’s easiness to use.
This is supported by (Mottin-Sylla 2005), cited in Gillwald, Milek & Stork, (2010), who
noted that the majority of the studies in recent years on women’s access to and usage of
ICTs argue that there's a significant gender divide in ICT access and usage especially
against women mostly in developing countries like Uganda. Contrarily to the present
argument, Gillwald, Milek & Stork, (2010), noted that there's evidence of a digital divide
of an equivalent magnitude in high socio-economic groups within the countries
surveyed, which showed shape gender disparity between male and feminine access and
use of technology. The study indicated that women’s rate of ICT access and
utilization doesn't increase in tandem with increases in national rates of internet
penetration.
4.2.3. Education levels
37
In this study, education of the respondents was considered as it helps to provide important
information regarding matters of ICT access and adoption in organizations. This does not
only impact the way respondents understood importance of ICT in their daily live but also to
adopt it quickly to suit in ever changing technological work environment. It also how helps to
them to quickly learn and became flexible to apply the new knowledge and skills which are
normally required in ICT innovation and operations. Education also helps workers to quickly
undergo training and coaching to acquire new ICT skills required which may not be easy for
someone who has less education or who has never been to school. The study results on
education of respondents are summarised in Figure 4.2.
Masters Degree
Post Graduate
2%
11%
Diploma
53%
Bachelors Degree
34%
Source: Field Data, 2021
Figure 4. 2: The Respondents’ Education level.
The findings as presented in Fig. 4.2 shows that most respondents (53%) had Diploma level
of education followed by those who had Bachelor’s degree (34%), postgraduate level of
education (11%) and lastly Masters’ degree level of education with two percent. The study
findings indicated that majority of study participants at KCCA have high level of education
and could easily read and answer questions within the questionnaire hence, the study results
can be considered reliable.
The highest levels of education in Uganda and KCCA in particular could be attributed to the
implementation of the constitutional provision about education for everybody. The
Constitution of the Republic of Uganda (1995), Article 30 and 34 (2) states that every
38
Ugandan has a right to basic education, for all is also recognized as a right under the
Universal Declaration of Human Rights. The government filled this mandate by introduction
of a policy on Universal Primary Education,1997 and Universal Secondary Education, 2007.
On opposite notwithstanding, it appears there even more chat in understanding this correct
schooling since 18% of people matured 15 years or more in Uganda don't have any proper
training; the extent of females (25%) was more than twice that of their male partners (10%)
and it was additionally seen that there is an immediate connection among income and the
degree of instruction (Uganda National Household Survey (UNHS, 2014). The Labor Force
Participation Rate (LFPR), that actions the extent of the Uganda's populace that connects
effectively in financial improvement exercises puts guys at 60% and females at 47% and
might be sway on their degrees of wages and later alone their capability to get more
significant levels of instruction.
4.2.4 Employment status

The study sought views on type of the employment contract or status different people held as
this may influence the income levels, training opportunities and other benefits received by
different employees according to the types of contract one received at the time of recruitment.
The study results on employment status are presented in figure 4.3.
Probation
8%
Contract
Permanent 30%
62%
Source: Primary Data, 2021.

Figure 4. 3: Employment status for employees at KCCA
Study findings in Figure 4.3 indicated that most of the respondents had permanent
employment with 62%, 30% of them were on contract while 8% of the employees were on
probation. This implies that majority being in permanent employment status had opportunity
39
of enjoying all benefits including training in new computer software (ICT) that may be
introduced to KCCA in order to protect their jobs in this ever-changing technological
advancement environment.
4.2.5 Duration of employees at KCCA
The study thought the views of the respondents about the period they have spent working in
KCCA and this was important to this study in that people experience at work can either
influence them negatively or positively in face of new changes in the organisation. It is
possible that people who have been working using old styles like paper work in conducting
their activities of service delivery may find it difficult to change now to new computer
software where they may not be having a lot of knowledge and experience compared to new
employees who maybe having ICT training in latest ICT software from training institutions
which they could apply in delivering of Health Care services. The results on duration of
service for respondents is given in the figure 4.4:
less than 6 months

13%
5 years and above

40% 1-2 years
19%
2-3 years
28%

Figure 4. 4: Time spent at KCCA by Employees.
The study findings as given in Figure 4.5 revealed that majority of study participants had
worked for 5 years and above at KCCA Health Care offices, followed by who had worked for
2-3 years with 28%, those who had worked for 1-2 years with 19% and 13% for those who
had worked for less than 6months. This implies that most employees were assured of their job
security, therefore introduction of new software technologies would comply them to get
training in new ICT applications to maintain their jobs.
40
4.3 The relationship between ICT characteristics and its adoption by healthcare
organizations in Uganda.
This section presents the study findings in form of a 5 Likert scale format as extracted from
the questionnaire where by a mean score which is above 3 implies agreement, a mean score
that equals to 3 indicates neutral and a mean score which is below 3 shows disagreement. In
same way, Standard Deviation which can be corrected to one (1) like (.9954) and above
indicates agreement and standard deviation whose score cannot be corrected to one (1) for
instance, (.3785) it shows disagreement. According to study objective one, the findings are
presented in three parts namely; i) Cost in adoption of ICT, ii) Ease to use the ICT and
iii)Pearson correlation coefficients between two study variables.
4.3.1 The cost of ICT in Health Care Organizations
The study findings on each statement made about the cost of ICT as stated in questionnaire
are presented using percentages, mean and standard deviation (Std D) under the following
codes: 1 which stands for Strongly Disagree (SD), 2 which stands for Disagree (D), 3 which
stands for Not sure, 4 which shows Agree (A) and 5 which indicates Strongly Agree (SA) as
given in tables 4.2
Table 4. 3: The cost of ICT in Health Care organizations
Cost of ICT SA A N D SD MEA StdD

N
Not easy to purchase computer 9% 47 6% 21 17 3.593 .8225
software % % %
Too costly to install computer software 7% 45 6% 30 11 3.475 .7642
% % %
Computer software maintenance fee is 13 38 9% 17 23 3.468 .6841
high % % % %
The organization has many things to 13 34 17 17 19 3.456 .6741
spend on % % % % %
Most good software systems are not 17 26 17 25 15 3.436 .6652
accessible % % % % %
It is expensive hiring software expert 21 32 2% 24 21 3.514 .6861
% % % %
Source: Primary Data, 2018
41
The study findings provided in table 4.3 revealed that on statement that it is not easy to
purchase computer software, most respondents (56%) agreed while 38% of them disagreed
and only 6% of them were not sure about this statement. These results are supported by a
mean of 3.593 and standard deviation (StdD) of .8225 which indicates moderate level of
agreement.
On the statement that the cost of installation of computer software is high, most respondents
(52%) agreed while 41% of them disagreed and only 6% of them remained neutral. This is
supported by a mean of 3.475 and StdD of.76402 which indicates a moderately level of
agreement.
In addition, on the statement that computer software maintenance fee is high, most of the
respondents (51%) agreed while 40% of them disagreed and only 9% of them were not sure.
This is reflected by a mean of 3.468 and Std D of.6841 which indicates a moderate level of
agreement. On the statement that the organization has many things to spend on, most of the
respondents (47%) agreed while 36% of them disagreed and 17% of them were not aware.
This is supported by a mean of 3.456 and Std D of .6741 which indicates a moderate level of
agreement.
Further, when respondents were asked to comment on statement that most good software
systems are not accessible, most of them (43%) agreed while 40% disagreed and 17% of
them remained neutral. This is reflected by a mean of 3.436 and StdD of .6652 which
indicates a moderate level of agreement. On statement that it is expensive hiring software
expert, most respondents (53%) agreed while 45% of them disagreed and only 2% of them
remained neutral. This is supported by a mean of 3.514 and StdD of.6861 which shows a
moderately level of agreement for this statement.
The study findings are further supplemented by qualitative information from key informant
interviews where it was revealed that that although adoption and utilization of ICT in
organization is of great significance to both health workers and clients in KCCA Health Care
organization, its access and adoption is marred by many obstacles and inconsistencies. Most
of the key informants revealed that some of the most pronounced impediments to use of ICT
in health centres include; poor working conditions, ICT equipment being too costly, high
levels of ICT ignorance among the people, lack of elaborative ICT policy provisions for
health in Uganda among others.
42
Information from key informants further revealed that the Uganda is still faced with
enormous challenges in its quest to improve technology adoption and utilization in health
sector. Indeed, they agreed that they are very few health facilities in Uganda including big
hospitals are not computerized and even those which are computerized, internet access is
always very slow and sometimes unable to operated. In support of this one Director from
health department had this to say:
“Internet access and utilization is still big challenge in Uganda and it going to take
some time to have all health centres fully operational with internet services. Infact,
this problem is not affecting health facilities at KCCA alone, most hospitals, including
big national hospitals like the Mulago hospital, still use manual systems of recording
and storing patient information.” (Interview with a female Director at KCCA health
Department, January 28, 2019)
Information from the key informants also indicated that the cost of accessing the internet,
maintaining the equipment and buying new ICT software is still hindering factors for the use
and adoption of ICT at KCCA. In addition to the costs and status of infrastructure, several
health facilities are at KCCA can easily share information and work together because of the
incompatibility of equipment and ICT software. In other cases, costs of installing internet
facilities and maintaining it is also as challenge for poor countries like Uganda.
Qualitative information from key informants further indicated that most of the information
used in ICT in healthcare organizations is in English languages which is not used or known to
a large portion of Ugandan population. For instance, those who understand English and have
access to internet, may still find challenges in comprehending the medical jargon or terms
used in most of ICT software or healthcare facility sites. In line with these finding, one
Manager at KCCA had to say:
“Regarding the use and ICT adoption in health facilities, it was really tough for the
employees to cope with the recent introduction of new ICT software changes since
most of them did not have knowledge and skills in using such software. It was
important therefore, that management had to organize and conduct ICT training
workshop to equip employees with relevant skills and experience in using such ICT
software.”
43
(Interview with one male manager from Human Resource department at KCCA on January
31st, 2019) He further notes that:
“I did conduct an ICT training workshop since most employees could not ably use the
new software in recording and transmitting the health information. We also hired
consultants who were had necessary expertise to share with health workers and since
then, the application of ICT in health has greatly improved here at KCCA. I
personally managed their modules and video tutorials to run the workshop. After
following the instructions and suggestions, I got a positive result. After that, I always
try to organize such types of workshops at regular intervals throughout the year.”
In same way, qualitative information indicated that healthcare organizations at KCCA have
consistently suffered from grossly inefficient and inadequate resource allocation meant to
improve the status of ICT infrastructures, improve the quality of health service delivery and
motivate the worker to make proper use of ICTs. Other challenges in adoption of ICT in
health facilities at KCCA included; insufficient telecommunications infrastructure, limited
coverage of ICTs in the country, high telecommunication tariffs, inappropriate or weak
policies, organizational inefficiency and lack of locally innovated ICT content in health
among others.
4.3.2 The easiness to use ICT in Health Care Organizations (KCCA)
The study findings on each statement made about the easiness with use ICT as stated in
questionnaire are presented using percentages, mean and standard deviation (StdD) under the
following codes:1 which stands for Strongly Disagree (SD), 2 which stands for Disagree (D),
3 which stands for Not sure, 4 which shows Agree (A) and 5 which indicates Strongly Agree
(SA) and the study are summarized in table 4.4.
Table 4. 4: The easiness to use ICT in Health Care Organizations
Easiness to use ICT SA A N D SD Mea Std

n D
Some employees not comfortable using 13 42 8 32 6% 3.845 .920
software packages % % % % 7
Not easy to apply computer software in 7% 40 4 21 28 2.774 .574
some projects % % % % 2
The activities are more non -computer 14 57 8 19 2% 4.324 1.13
44
oriented % % % % 7
No software packages tailored to Health 10 34 9 30 17 2.981 .567
Care work % % % % % 9
Computers are not easy to apply since most 17 28 4 20 32 2.792 .541
work is field oriented. % % % % % 2
Activities carried out by health 10 30 8 34 18 2.675 .534
organizations cannot be arranged by a % % % % % 5
computer system
The study results as indicated in table 4.4 revealed that most respondents (55%) agreed that
on the statement that some employees not comfortable using software packages while 38% of
them disagreed and only 8% of them were not sure. This is reflected by a mean of 3.845 and
Std D of .9207 which shows high level of agreement. On the statement that it is not easy to
apply computer software in some projects, most respondents (48%) disagreed while 47% of
them agreed and only 4% remained neutral. The study results are supported by mean of 2.774
and Std D of .5742 which shows low level of agreement.
In addition, the statement that the activities of the organization are more non-computer
oriented, most of respondents agreed with 71% while 21% them disagreed and only 8% of
them remained neutral. This is evidenced by a mean of 4.324 and Std D of 1.137 which
shows very high level of agreement for this statement. On the statement that there are no
software packages tailored to Health Care work, most of the respondents (47%) disagreed
while 44% of them agreed and only 9% of them were not sure. This is reflected by a mean of
2.981 and Std D of .5679 which shows low levels of agreement.
Finally, the study participants were asked to comment on issue that the computers are not
easy to apply because most work is field oriented, most of them 52% disagreed while 45% of
them agreed and 3% of them remained neutral. This is reflected by a mean of 2.792 and Std
D of .5412 which shows low levels of agreement. On the statement that activities carried out
by health organizations cannot be arranged by a computer system, most of the respondents
(52%) disagreed while 40% of them agreed and only 8% of them were not sure. This is
reflected by a mean of 2.675 and Std D of .5345 which shows low levels of agreement for
this statement.
45
These findings concur with qualitative information which was obtained from interviews
which revealed that ICTs are considered faster and less expensive than transporting either
patients or doctors or papers from one place to another, something that is done easily and
saves of time and costs. ICTs enhance access to more accurate and timely information as
opposed to the manual systems of storing and transferring information that are still
commonly used in several hospitals in Uganda.
Furthermore, they revealed that use and adoption of ICT in healthcare organizations has been
hampered by lack of local ownership and accountability, support and funding. Poor
coordination and communication, and a lack of proper e-Health implementation frameworks
in the country. Most of the directors who were interviewed at KCCA indicated that there are
no national guidelines to secure management of individuals’ electronic health information
which places most clients’ private information which has continued to hinder adoption and
utilization of ICT in health centres in Uganda. To support the findings above, one Director
noted:
“ICT in Health innovations can reduce healthcare costs and enable access to better
quality healthcare provided there is adequate infrastructure. However, consistent
power blackouts, loss of internet connectivity and the presence of an unskilled health
workforce has been a major hindrance for not only KCCA but almost the entire
country. However, on good note, despite the existing barriers, sustainable ICT in
Health service delivery and programmes can implemented and maintained in
Uganda. (Interview with One Male Director at KCCA, August 28, 2018).
In same way, information from key informants further revealed that one of the biggest
challenges of ICT adoption at health facilities at KCCA has been ignorance about ICT use
among health workers, inadequate training opportunities in ICT for employees and lack of
proper policy guidelines at work place and health centres regarding ICT use. Consequently,
many of them suggested that there is a need to design appropriate ICT policies and
regulations that will guide in health workers either in government or private entities to learn
how to integrate ICT in normal work operations to ease access to Health Care services at
KCCA in particular and Uganda in general.
In support of the above argument, one Female Director noted:

46
“Although the adoption of ICT in Health Care Organisations has encountered many
barriers like poor infrastructure, unskilled employees and uncertain environment,
there is a ray of hope in case of Government will and support to by providing funds
for training of employees in ICT programming and implementation. In fact, during
past years, training activities were costly and time consuming for the employees but
nowadays, training is done by experts at work place using real gadgets which makes
this more practical than theoretical class lectures” (Interview with a male manager
from Human resource department at KCCA, August 29, 2018)
He further noted that:
“ICT has reduced the distance and time barrier of today’s training process.
Employees are now able to learn better within the shortest period of time if they are
already equipped with practical skills and ready to put them into practice. This is very
possible, I have seen this work here after few sessions of ICT training, employees are
able apply such ICT in their daily work activities. This is mainly attributed to the fact
that they are able to learn from the modern techniques displayed in the workshop.”
4.3.3 Pearson correlation coefficient between ICT characteristics and adoption of ICT
The information on testing the effect between these two study variables was obtained using
inferential statistics where by Pearson Correlation Coefficient was computed to establish if
there was degree of influence between two study indicators and study findings are
summarized in table 4.5.
Table 4. 5: Pearson correlation results between ICT characteristics and adoption of ICT
Correlation coefficient
ICT Adoption of
characteristics ICT
ICT characteristics Pearson correlation 1 .726
Sig. (2-tailed) .001*
N 53 53
Adoption of ICT Pearson correlation .726 1
Sig. (2-tailed) .001*
N 53 53
** Correlation is significant at the 0.01 level (2-tailed)
Pearson correlation results as presented in table 4.5 depicts a strong and positive correlation
(r=.726) between ICT characteristics and adoption of ICT. The study results further indicated
a significant statistical relationship between the study variables given that p value (p=.001) is
47
less than at 0.01recommended level of significance. Hence, the results have confirmed that
ICT characteristics have positive significant relationship with adoption of ICT in Health Care
organizations at KCCA.
To establish the degree of influence and direction of relationship between these study
variables, coefficient of determination (r2) was computed as follow: That is r2 =
(0.726x0.726) x 100 = 53%. This implies that when ICT characteristics is well understood by
employees in healthcare organizations and are implemented, then adoption ICT in
organization will be very ease and vice versa. Therefore, the remaining 47% may account for
other variables which were not including in this study but which still have potential to affect
utilization of technology in healthcare organizations in Uganda.
Therefore, from the researcher’s point of view, in order for KCCA to enhance access and
utilization of information, communication and technology in Health Care Organizations,
govern should design comprehensive ICT training contents to ensure that all workers in
health departments are equipped with skills and knowledge to remain relevant in this ever-
changing technological environment.
4.4 The relationship between organizational factors and adoption of ICT in Health Care
Organization
The findings in this section are presented in three parts namely; i) administrative support, ii)
staff development and iii) Pearson correlation between two study variables. Information was
obtained using questionnaire which was in form of 5 likert scale as detailed below:
4.4.1 Administrative Support
Information about the influence of administrative support in access and adoption of ICT at
KCCA Health Care Organizations was obtained by using a questionnaire which was designed
in form of a five (5) likert scale and the study results from the respondents are summarized in
table 4.6 by percentages, mean and standard deviation.
Table 4. 6: Administrative support
Administrative support SA A N D SD Mea Std

n D
Management provides financial support 15 52 4% 20 9% 4.356 1.12
% % % 7
Management provides technical support 9% 53 15 16 7% 3.987 .876
48
% % %
Management identifies ICT needs in 23 34 8% 24 10 3.830 .864
organisation % % % %
Management identifies relevant ICT 9% 52 16 9% 14 3.875 .965
Software % % %
Management is aware of role of ICT in its 21 55 7% 15 2% 4.385 1.23
work % % % 4
Management hired skilled personnel to 24 40 4% 20 12 3.962 .976
support ICT % % % %
ICT needs are considered during 12 48 16 14 10 3.857 .986
budgeting % % % % %
Source: Field data, 2018
The results as shown in table 4.6 indicated that majority of the study participants (67%) were
in agreement with statement which says that the management provides financial support
while 29% of them disagreed with statement and 4% did not decide. These results are
supported by a mean of 4.356 and Std D of 1.127 which show very high level of agreement.
On the statement that management provides technical support, majority of the respondents
(62%) agreed while 23% of them disagreed and 15% of them remained neutral. This is
reflected by a mean of 3.987 and Std D of .876 which show high level of agreement for this
statement.
In addition, study participants were told to give their own options about the element in the
questionnaire which stated that “management identifies ICT needs in organization”. Indeed,
majority of the respondents (57%) were in agreement while 34% disagrees and only 8%were
not sure. This is supported by a mean of 3.830 and Std D of .864 which shows high level of
agreement. On the statement that management identifies relevant ICT Software, majority of
the respondents (61%) agreed while 23% disagreed and 16%were not sure. This is reflected
by a mean of 3.875 and Std D .965 which shows high level of agreement.
Furthermore, the statement that management is aware of role of ICT in its work, majority of
the study respondents (76%) did agree, 17% did not agree and only 7% remained neutral.
This is supported by a mean of 4.385 and Std D of 1.234 which shows very high level of
agreement. On the statement that management hired skilled personnel to support ICT,
49
majority of the respondents (64%) agreed while 32% disagreed and only 4% remained
neutral. This is reflected by a mean of 3.962 and Std D of .976 which shows high level of
agreement. Finally, when asked to comment on the statement that ICT needs are considered
during budgeting, majority of the respondents (60%) agreed while 24% disagreed and 16% of
them were not sure. This is reflected by a mean of 3.867 and Std D of .986 which indicates
high level of agreement.
The above study findings are supplemented by qualitative from key informants interviews
which revealed that ICT adoption and implementation in healthcare facilities at KCCA
gained momentum in areas such as health portals, electronic health records (EHR), electronic
medical records (EMR), personal health records (PHR), and health information systems
(HIS), telemedicine, and diagnosis and this mainly in area of HIV/AIDS and ART
management where donor have been very keen in trying to minimize the disease incidence as
much as possible. In reaction to these findings, one supervisor had this to say:
“In Uganda, the ICT use and adoption in health service delivery is slow but with
steady progress, ICT in health is gradually eliminating paper-based health and
Health Care and this has significantly lowered the costs and expanded the access to
health in many healthcare organizations in Uganda, although there are still serious
gaps, I am optimistic that we shall reduce them and have full function ICT units in
every health facility at KCCA.” (Interview with one male supervisor, health services
at KCCA in August 2018).
Regarding administrative support, he further noted that:

“As management, we try to ensure that the budget for ICT unit is put into
consideration, we also lobby for budget allocation for training of our staff since most
of them lack ICT skills in handling health related issues including entering medical
record in computer other than using paper. This will significantly save us a lot of cost
in regard to paper work, printing and maintenance of all hardware materials
required.”
In addition, qualitative information from the key informants indicated that most of the ICT
health projects are funded by development partners and these dedicate what should be
considered when designing ICT software, planning for procurement, installing and experts
that will be required to operate such systems. This leaves a country with limited choices or
50
options influencing decision making. Sometimes, these ICT health projects requires to hire
services of experts from donor countries. This is mainly because of limited funds from the
Government to manage these ICT costs.
Other factors regarding administrative support that limit the adoption of ICT include the
following: It is very expensive to maintain a pool of technical staff to address various
technical support issues locally; expensive to provide 24/7 support and monitoring; expensive
to sustain knowledgeable technical staff locally; difficult to cope with turnover of technical
staff; difference in quality of maintenance procedure at health unit and difficult to sustain in
the long run of ICT in healthcare facilities with already resource constrained public
administration.
In reaction to this argument, one manager had this to say:
“Here at KCCA, ICT is mainly centralized, the only people who are at the forefront of
managing all ICT related activities are in ICT department who are stationed at City
Hall which leaves the 8 health facilities under KCCA without full time ICT technical
staff. Even the budget allocation to the department is not enough to cater for backups
like generators, maintenance of internet servers and computers. This is still making
our work very slow as most people still move with heavy loads of reports in form of
paper work.” (Interview with one male manager, ICT department at KCCA in August
27, 2018)
Furthermore, the key informants revealed that although there is has been some registered
progress in regard to use of ICT in health facilities, a lot is still desired. There is still lack of
necessary ICT technical compatibilities; limited network coverage which limits the number
of health centres that could participate in some of the mHealh projects coupled with pricing,
promotion and distribution strategies and sometimes lack of lack Government Information
Infrastructure (GII). In some areas there is no or limited network that connects all
Government agencies including healthcare facilities.
4.4.2 Staff development
Study findings indicate the respondents’ options on the statements made on staff development
and adoption of ICT in Health Care Organizations at KCCA. These were obtained from the
field using a questionnaire that was designed in form of five (5) likert scale are summarized
in table 4.7 using percentages, mean and standard deviation.
Table 4. 7: Staff development
51
Staff development SA A N D SD Mea Std
n D
ICT knowledge is considered while 12 47 10 27 4% 3.876 .988
recruiting staff % % % %
Staff members are usually provided with 8% 51 6% 18 16 3.875 .976
training in ICT % % %
Organization organizes ICT training 17 42 6% 20 15 3.868 .965
workshops % % % %
Training for ICT use is an individual 19 46 5% 20 10 3.987 .943
initiative % % % %
Staff members allowed to express their 13 43 21 14 9% 3.751 .941
ICT training needs % % % %
Management identifies current software 16 42 11 20 10 3.868 .897
systems and helps staff get training % % % % %
Strategies are usually designed to retain 18 46 11 24 10 3.869 .984
employees with ICT skills. % % % % %
Experts are usually invited to provide ICT 16 49 2% 23 10 3.894 .987
training to employees. % % % %
Study results in table 4.7 indicated that majority of respondents (59%) were in agreement
with statement that ICT knowledge is considered while recruiting staff whereas 31%
disagreed and only 10% remained neutral. This is reflected by a mean of 3.876 and StdD
of .988 which shows high level of agreement. When the study participants were requested to
give their options about issue that staff members are usually provided with training in ICT,
majority of (59%) were in agreement whereas 35% disagreed and only 6%were not sure. This
is reflected by a mean of 3.875 and Std D of .976 which indicates high level of agreement.
Further still, when study participants were asked to give their options on whether the
organization organizes ICT training workshops, majority (59%) were in agreement while
35% disagreed and only 6% remained neutral. This is supported by a mean of 3.868 and Std
D of .965 which shows high level of agreement. On the statement that training for ICT use is
an individual initiative, majority of the respondents (65%) agreed as against 30% of those
who disagreed and only 5% remained neutral. This is reflected by a mean of 3.987 and Std D
52
of .973 which shows high level of agreement. Similarly, on the statement that staff members
are allowed to express their ICT training needs, majority of the respondents (56%)were in
agreement while 23% disagreed and 20%were not sure. This is reflected by a mean of 3.751
and .941 which indicates high level of agreement.
On the statement that management identifies current software systems and helps staff get
training, majority of the respondents (58%) were in agreement as 30% disagreed and only
11%remained neutral. This is supported by a mean of 3.868 and Std D of .897 which shows
high level of agreement. Likewise, on the statement that strategies are usually designed to
retain employees with ICT skills, majority of the respondents (64%) were in agreement while
34% disagreed and only 11% were not sure. This is reflected by a mean of 3.869 and Std D of
.984 which shows high level of agreement. Lastly, when the respondents were asked to
comment on the statement that experts are usually invited to provide ICT training to
employees, majority (65%) were in agreement while 33% disagreed and only 2% remained
neutral. This is supported by a mean of 3.894 and StdD of .987 which shows high level of
agreement.
The study findings are supplemented by qualitative information from the key informant
interviews which revealed that perhaps the greatest related to organizational factors that
influence adoption of ICT and more specifically staff development was lack of enough
budget funds allocated to training and building capacity of human resource aspect to the use
of ICT in health services delivery. They revealed that there is special budget for ICT
development but this has remained majorly central and other lower health facilities under
KCCA are not covered by this budget allocation. This greatly hampered ICT adoption among
the health facilities. The health facilities with ICT elements are those mainly dealing with
ARTs to track the clients and used for follow up purposes. In support of these findings, one
supervisor at KCCA had this to say:
Although we have the ICT unit that is fully operational here, it does not solve
challenges faced in other health facilities, it is totally centralized and training of
employees has not been treated as priority. It is assumed that most employees who are
recruited now, have the necessary computer skills and they can use such skills to do
all ICT related activities in the Authority; however, this may not apply universally
across all departments and all employees. (Interview with one male supervisor at
KCCA head office on august 29, 2018).
53
He further noted:
At health facility level, there are still a lot of challenges and adoption of ICT is next to
impossible. For instance, in some health centres,one computer can be shared by the
In-charge and many other health workers. Therefore, lack of enough computers still
poses a big challenge for adoption of ICT in health service delivery at KCCA health
facilities.
Other challenges mentioned that hinder ICT adoption related to organizational factors
mentioned by key informants included; low budget allocation, lack of training opportunities,
employees’ attitude of fear towards introduction of new ICT changes, limited ICT
infrastructures like ICT units at lower health centres. Also mentioned was, breakdown of
internet network and low levels of privatization of operators and difficulties in achieving
technology transfer among different health facilities at KCCA.
In addition, the qualitative information revealed that management at KCCA has tries to lobby
Government and other development partners through proposal writing to mobilize funds for
purchase ICT software and install it to many eight (8) health facilities which still operating
most of its activities manually with heavy loads of paper work. This is mainly aimed at
helping management at KCCA to plan well for available funds in order to increase efficiency
and effectiveness in employee productivity by reducing workloads in health facilities. In
reaction to these findings, one Director had this to say:
In terms of administrative support and staff development, the Authority has a fully
functioning ICT unit which provides all the necessary expertise and we don’t need to
hire experts to install ICT software, we make use of this unit, however, having
professionals in ICT alone does not help the organization to fully use ICT, we need to
have every employee (users) equipped with skills too otherwise inadequate human
resource well-trained in ICT and insufficient awareness and experience in the use of
ICTs have continued to be a hindering block to ICT adoption. (Interview with one
Director in charge of health service at KCCA in August 29,2018).
E4.4.3 Pearson Correlation Coefficient between Organizational Factors and Adoption of

ICT
Information on testing the effect between these two study variables was obtained using
54
there was a relationship between the two study variables. The Pearson correlation test results
are given in table 4.8.
Table 4. 8: Pearson correlation for organizational factors and adoption of ICT
Correlation coefficients
Organizational factors Adoption of ICT
Organizational factors Pearson correlation 1 .875
Sig.(2-tailed) .000*
N 53 53
N 53 53
*Correlation is significant at 0.01 level (2-tailed)
The Pearson test results above indicate a strong correlation (r=.875) between organizational
factors and adoption of Information Communication and Technology (ICT) in Health Care
Organizations at KCCA. In addition, study findings revealed a significant statistical effect
between the study two study variables as provided by p value (p=.000) is less than
recommended significance level at 0.01. Hence, the study results have confirmed that
Organizational Factors have a positive significant effect on ICTs adoption in Health Care
organizations at KCCA.
To determine the strength of the relationship, coefficient of determination (r2) was computed
as follow: That is r2 = (0.875x0.875) x 100 = 76%. This implies that when organizational
factors that influence adoption of ICT in healthcare organizations at KCCA are careful
considered and implemented by the management, then the rate of ICT use and adoption will
automatically increase and vice versa. Hence, the remaining 24% may account for other
factors that influence adoption of ICT in healthcare organizations in Uganda other than
organizational factors. Therefore, from the researcher’s point of view, this is a major area that
needs a lot of attention if the management in Health Care Organizations at KCCA needs to
improve the use and adoption inn health service delivery.
4.5 The relationship between employee characteristics and adoption of ICTs by Health
Care Organizations in Uganda.
For easy presentation, the study findings in this section, are presented in three parts and these
include the following Source: Primary data, 2021
55
:i) Employee beliefs towards use of ICT ,ii) Employee attitudes towards use of ICT and iii)
Pearson correlation between Employee characteristic and ICT adoption. Information was
obtained using questionnaire which was in form of a 5 Likert scale as detailed below:
4.5.1 Employee beliefs towards use of ICT
The information about the employee beliefs toward used of ICT was obtained from the field
using a questionnaire that was designed in a five (5) Likert scale ranging from one (1) for
Strongly Disagree to five (5) strongly agree and the study findings about responses made on
the statements about employee beliefs are summarized in table 4.9.
Table 4. 9: Employee beliefs towards use of ICT
Belief SA A N D SD Mea Std

n D
Some people don’t use certain technologies 11% 53 3% 28 6% 3.88 .978
because they see no value. % % 4
People tend to use information they already 9% 62 3% 26 -- 4.24 .992
know % % 7
Some managers don’t use certain innovation 17% 62 10 9% 2% 4.25 .996
since they are not used to them % % 3
Some managers believe that they are already 14% 40 8% 14 24 3.75 .879
using is always best. % % % 4
New technologies come with their own 13% 38 5% 27 17 3.76 .765
challenges % % % 5
People enjoyed current ways of doing things 10% 38 11 30 11 3.75 .753
% % % % 4
Some technologies can distort work in 12% 40 9% 35 4% 3.77 .784
56
progress % % 5
The study results above revealed that majority of the respondents (63%) were in agreement
with statement that some people don’t use certain technologies because they see no value
while 34% disagreed and only 2% remained neutral. This is reflected by a mean of 3.884 and
Std D of .978 which shows high level of agreement. On the statement that people tend to use
information they already know, majority of the respondents (71%) agreed whereas 26%
disagree and only 3% remained neutral. This is supported by a mean of 4.247 and Std D
of .992 which shows very high level of agreement.
In addition, when the study participants were asked to give their views on the statement that
some managers don’t use certain innovation since they are not used to them, 79% of them
were in agreement while 11% disagreed and only 10% not sure. This is reflected by a mean
of 4.253 and Std D of .996 which shows very high level of agreement. On the statement that
some managers believe that they are already using is always best, most respondents (54%)
were in agreement while 38% disagreed and only 8% were not sure. This is reflected by a
mean of 3.754 and Std D of .879 which shows high level of agreement.
Further, when the participants were asked their views on issue that new technologies come
with their own challenges, most of them (51%) were in agreement whereas 44% disagreed
and only 5%were not sure. This is supported by a mean of 3.765 and Std D of .765 which
shows moderate level of agreement. On the statement that people enjoyed current ways of
doing things, most of the respondents (48%) agreed while 41% disagreed and only 11% were
not sure. This is reflected by a mean of 3.754 and Std D of .753 which shows a moderate
level of agreement. Lastly, on the statement that some technologies can distort work in
progress, most of the respondents (52%) agreed while 39% disagreed and only 9% remained
neutral. This is evidenced by a mean of 3.775 and Std D of .784 which indicates a moderate
level of agreement.
The study findings from the field are supplemented by the qualitative information from
interviews which indicated that most employees didn’t exhibit positive beliefs toward
introduction of new ICT software in healthcare organizations. Many of the employees with
permanent contracts fear that such changes are meant to take away their jobs. However, they
57
still find it difficult to embrace adoption of ICT easily in their daily work activities. In
support of this, one supervisor had this to say:
“Employees are always skeptical about any new innovation or changes in work their
environment, they fear almost everything new even if it has nothing to do with their
jobs because most of them are permanent jobs hired by Ministry of Public Services.
We as directors our job is to coordinate and guide the implementation of any changes
including installation of new ICT software and encourage our employees to welcome
such changes with positive hearts and allow change in behavior.” (Interview with a
female supervisor at KCCA in August 29, 2018).
Information from key informants further revealed that a number of health facilities at KCCA
have challenges which hinder adoption of ICT to make health service delivery quick and
easily accessible among population. These include human resource trained in use and
installation of ICT, computers, servers and ICT units and data base and other information
management.
In support of these findings, one male Director noted that:
“There is no infrastructure to support e-health usage at this hospital. A lot of
technologies such as computers, mobile and monitoring devices which are required to
implement ICT at the health center are missing. Those which are available are now
old and slow, internet network is always on and off and this cans easily hinds
adoption and implementation of ICT.” (Interview with a male director KCCA in
August 28, 2018).
He further noted:
“Here at central, most of the issues related to use and adoption of ICT don’t rise but
when you move to our health facilities in the communities, the situation is daring and
it’s important to note that without the required infrastructure in place, most of the
health facilities are rendered incapacitated to adopt and implement ICT in health
systems for the betterment of the health service delivery.
Moreover, data from key witnesses demonstrated that despite the fact that there are numerous
difficulties in regards to the representatives' perspectives at KCCA being used and reception
of ICT, the vast majority of them show a ton of premium in completing their task; they will
tune in and gain from those with ICT skill. The greater part of them do see the value in that in
spite of the fact that there are still issues being confronted like restricted spending plan for
ICT exercises, restricted information and abilities among representatives, power outages,
58
there is a beam of expectation that once Government gives it interest and focuses on the
utilization of ICT in all wellbeing places, selection will be expanded.
4.5.2 Employee attitude towards use of ICT
The information about the employee attitude towards use of ICT in health organizations care
facilities at KCCA was obtained using a questionnaire which was designed in form of 5 likert
scale format, ranging from one (1) Strongly Disagree to five (5) Strong Agree and the
responses from the respondents are summarized in tab le 4.10.
Table 4. 10: Employee attitude towards use of ICT
Attitudes SA A N D SD Mean Std

D
We don’t use specialized software 10% 43% 13% 19% 15 3.768 .879
systems even our partners don’t use %
them.
Some ICT software systems are 10% 47% 8% 29% 6% 3.985 .894
difficult to apply.
We are already happy with ways in 9% 38% 12% 30% 11 3.638 .786
which we do work. %
Some software packages need a lot of 9% 40% 11% 17% 23 3.762 .772
time to learn and use. %
Some software packages are 10% 41% 7% 35% 7% 3.758 .868
59
expensive to sustain.
When there is breakdown in some 8% 40% 10% 35% 7% 3.721 .767
software, the loss in information is
high.
Some health-related activities may not 15% 32% 8% 22% 23 3.605 .764
need software systems. %
The study findings as given in table 4.10 revealed that most respondents (53%) were in
agreement with the statement that we don’t use specialized software systems even our
partners don’t use them while 34% disagreed and 12% remained neutral. This is supported by
a mean of 3.768 and Std D of .879 which show high level of agreement. On the statement that
some ICT software systems are difficult to apply, majority of the respondents (57%) were in
agreement whereas 35% of them disagreed and only 8% of them were not sure. This is
reflected by a mean of 3.985 and Std D of .894 which show high level of agreement.
In same way, when the study participants were asked about their opinion on the statement
that we are already happy with ways in which we do work, most of them (47%) were in
agreement while 41% disagreed and 12% remained neutral. This is evidenced by a mean of
3.638 and Std D of .786 which shows a moderate level of agreement. On the statement that
some software packages need a lot of time to learn and use, most respondents (49%) agreed
while 40% of them disagreed and 11% of them remained neutral. This is reflected by a mean
of 3.762 and Std D of .772 which shows a moderate level of agreement.
Further, on the statement that some software packages are expensive to sustain, most of the
respondents (51%) agreed while 42% disagreed and only 7% remained neutral. This is
supported by a mean of 3.758 and Std D of.868 which show high level of agreement. On the
statement that when there is breakdown in some software, the loss in information is high,
most of the respondents (48%) were in agreement whereas 42% disagreed and only 10% were
not sure. This is indicated by a mean of 3.721 and Std D of .767 which shows a moderate
level of agreement. Lastly on the statement that some health-related activities may not need
software systems, most of the respondents (47%) were in agreement whereas 45% disagreed
and only 7% remained neutral. This is reflected by a mean of 3.605 and Std D of .764 which
shows a moderate level of agreement.
60
The study findings are supplemented by qualitative information from the key informants who
revealed that attitude of many health personnel still hinder adoption and implementation of
ICT in health facilities at KCCA. Many of them; nurses were recruited without the
knowledge of ICT and most of them still find it comfortable using papers and pens in
collecting medical related records. However, this paper work is increasingly becoming
bulkier and more expensive for the organization which needs to be sorted out quickly by
equipping those health workers with necessary ICT skills. In reaction to these findings one
supervisor noted:
“In my opinion, the attitude of health workers towards use and adoption of ICT in
health service delivery can be put at 36% and this is work in progress, many of these
workers own smart phones and these phones can be used to do all ICT related
activities, we only just need to deal with behavioral change among our employees. Am
glad the proposals are under way to decentralize the ICT activities to other 8 lower
health facilities under KCCA for easy coordination and service delivery”. Interview
with one male supervisor for health services at KCCA in August 29, 2018).
The subjective data further showed that issues identified with individual character (time of
respondent, schooling level, ICT abilities and information), administration approach, lacking
ICT offices are a portion of the variables that cutoff ICT usage among Health Care
Organizations at KCCA. It was referenced that fundamental to this test is the way that there
are deficient spending assets which can be utilized to upgrade innovation use, these
incorporate buying of establishment machines and PC programming ICT in all heath offices
to produce data that may be very helpful as well as gathering, stockpiling and dispersal of
clinical data. In support of these findings, one female Director stressed:
“The major setback in the use of ICT in health service delivery is poor infrastructure,
internet breakdown and inadequate staff with ICT skills. Limited ICT tools have been set
aside for the medical departments especially those handling ART in HIV related cases,
however, this department also don’t have electronic medical records, you find out that in
one health facility, all departments use computers for ART to transmit the information.”
Interview with one female Director, health services at KCCA in February 28, 2019).
Again, another Director commented:
“ICT adoption in healthcare service delivery is not only expensive to purchase, install
but also requires hiring of experts to do training in order for employees to get
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equipped with ICT skills and knowledge for successful use of ICT in health service
delivery.” (Interview with one male Director, department of human resource in
August 27, 2018).
In addition, the information from key informant above indicated that most health workers
lack ICT skills which would have been used to improve the use and adoption of ICT. This is
important because health workers who have computer and ICT competence and experience
are the ones to acknowledge and understand the importance of ICT in their work place
environment and this continue to affect both private and government health facilities in
Uganda. In reaction to the above findings, one manager stressed that:
“Here, many health workers do not have adequate ICT skills and knowledge since it
is assumed that in this digital era, most health workers including nurses and Doctors
have had experience of interacting with computer during their studies. However, it
has been discovered that this theory or assumption is not right since most of them are
in the beginner’s category of computer literacy. There is a need nowadays for every
health worker to be conversant with technology that supports healthcare service
delivery.” (Interview with a male manager, health services department at KCCA in
August 27, 2018).
4.5.3 Pearson correlation between employee characteristics and adoption of ICT

The information on testing relationship between these two study variables was obtained using
there was relationship and statistical significance between the two study variables. The
Pearson correlation results are presented in table 4.11.
Table 4. 11: Pearson correlation for employee characteristics and adoption of ICT
Correlation coefficients
Employee characteristics Adoption of ICT
Employee characteristics Pearson correlation 1 .769
N 53 53
N 53 53
*Correlation is significant at 0.01 level (2-tailed
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The test results as shown above indicate a strong and a positive correlation (r=.769) between
employee characteristics and adoption of ICT in health organization care organizations at
KCCA in Uganda. Similarly, inferential statistics indicated a significant statistical
relationship between the study two study variables as given by p value (p=.000) which is less
than a recommended significance level (0.01).
In addition, the study used coefficient of determination (r2) to determine level of significance
and relationship between two study variables and computation is as follows: That is r2 =
(0.769x0.769) x 100 = 59%. This implies that when employee characteristics that influence
adoption of ICT in healthcare organizations at KCCA are dealt with by management,
employee will have enough training to equip themselves with current ICT skills and
knowledge which in turn will increase adoption and use of ICT. Hence, the remaining 41%
may account for other factors that influence adoption of ICT in healthcare organizations in
Uganda.
Therefore, from the researcher’s point of view, employee characteristics are a very important
aspect since it involves human resource practice. In order for the organization to succeed not
only in adoption of ICT is required but also the general organizational performance. This can
be enhanced through refresher courses and training in new ICT innovation to remain relevant
and competitive in the market environment.
4.5 The elements under ICT adoption in Uganda
The study findings in this section present analysis on the statement made about the ICT
adoption in healthcare organizations at KCCA. Information was obtained using questionnaire
which was in a 5 likert scale format. The likert scale ranges from one (1) Strongly Disagree to
five (5) Strongly Agree. The responses on the statements about the ICT adoption in Uganda
are summarized in table 4.12.
Table 4. 12: Adoption of ICT in healthcare organizations
ICT Adoption SA A N D SD Mean Std
D
Employees find it hard to adopt ICT use 15 47 17 19 2% 3.867 .984
if they have not used if before % % % %
Those who have been introduced to ICT 19 47 11 15 7% 3.887 .898
in schools adopt faster than those have % % % %
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not
At times organizations use ICT software 23 47 7% 17 5% 4.264 1.17
systems and then abandon it % % % 8
Organizations communicate with each 15 43 23 9% 9% 3.852 .853
other on new ICT innovation % % %
Employees need to be educated on new 32 41 2% 15 9% 4.175 1.15
software technologies % % % 3
Patience needed among the staff when a 24 53 7% 11 4% 3.820 .851
new software is introduced % % %
Management need to hire experts from 32 32 9% 15 11 4.124 1.12
whom other employees can learn % % % % 9
Study results in the table above revealed that majority of the study participants (62%) were in
agreement with the statement that employees find it hard to adopt ICT use if they have not
used if before while 21% disagreed and 17% remained neutral. This is reflected by a mean of
3.867 and Std D of .984 which shows high level of agreement. On the statement that those
who have been introduced to ICT in schools adopt faster than those have not, majority of the
respondents (66%) agreed whereas 22% disagreed and only11% remained neutral. This is
supported by a mean of 3.887 and Std D of .898 which shows high level of agreement.
In addition, when the study participants were interviewed on issue that at times organizations
use ICT software systems and then abandon it, majority of them (70%) while 22% disagreed
and only 7%. This is reflected by a mean of 4.264 and Std D of 1.178 which shows very high
level of agreement. On the statement that organizations communicate with each other on new
ICT innovation, majority of the study participants (58%) agreed and 18% did not agree while
23%did not decide on this statement. This is reflected by a mean of 3.852 and Std D of .853
which shows high level of agreement.
Further, the study participants were asked their opinion on issue that the employees need to
be educated on new software technologies, majority of them 73% were in agreement while
24% disagreed and only 2% remained neutral. This is reflected by a mean of 4.175 and Std D
1.153 which shows very high level of agreement. On the statement that organization need to
be patient with staff when a new software is introduced, majority of the respondents (77%)
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while 15% disagreed and only 7% remained neutral. This is reflected by a mean of 4.320 and
Std D of .986 which shows very high levels of agreement.
Lastly, the study participants were asked their opinion on issue that management need to hire
experts from whom other employees can learn, majority of them (64%) were in agreement
while 16% disagreed only 9% were not sure. This is supported by a mean of 3.978 and Std D
of .986 which shows high level of agreement. These findings are supplemented by qualitative
information from the key informants which revealed that ICT adoption is affected by limited
internet bandwidth, which hamper ICT use and implementation in healthcare facilities in
KCCA.
Further still, key informants revealed that most internet connection is done by private sector
facilities and partners thus KCCA only coordinates and guides their activities. This implies
that there is limited choice when it comes to issues of ICT in health since the Government of
Uganda has not invested a lot of funds to make it useful in all facilities around the country.
Many health workers need to be trained and equipped with latest ICT skills yet this issue is
not prioritized at KCCA.
4.6 Multiple Regression Analysis Summary
In order to understand the statistical significance and contribution of the Model and each
individual independent variable (ICT Characteristics, organizational factors and employee
characteristics) on dependent variable (ICT Adoption in healthcare organizations), a
regression by Pearson correlation coefficients was computed and the tests results are provided
in Table 4.13.
Table: 4.13for regression on Medical records disposal and Service quality.
Table: 4.13 for regression on Medical Records Appraisal and Service quality.
Variables Regressed R-square F-value Sig-value Interpretation
Factor affecting (IV) Vs. ICT Significant effect

Adoption (DV) 0.724 23.661 0.000
Coefficients Beta t-value Sig.
(Constant) 0.576 0.000 Significant effect
ICT Characteristics 0.363 5.532 0.000 Significant effect
Organizational factors 0.458 13.062 0.000 Significant effect
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Employee characteristics .623 5.768 0.000 Significant effect

Results in table 4.13 provides a 0.724 R-square indicating that the factors affecting explains
only a 72.4% (0.724*100) effect of variability on ICT Adoption in the selected healthcare
facilities of Kampala Capital City Authority (KCCA). Further still, a Sig-value of 0.000 that
was less than 0.01 level of significance and an F-value of 13.661 being above 1 also indicates
that the model factors affecting inclusive of all the three dimensions (ICT characteristics,
organizational factors and employee characteristics) significantly effects on the rate of ICT
Adoption in the selected healthcare facilities of Kampala Capital City Authority (KCCA).
Further still, the F- value of 23.661 that was above 1 also signifies that at least one of the
three predictor variables (ICT characteristics, organizational factors and employee
characteristics) produce an effect on DV (ICT adoption).
So as to get answers on which predictor variable produce something on DV in percentage, the

table also presented Beta-values and their respective t-values and P-value so as to determine
the percentage effect of each dimension in the model produce on ICT adoption (DV). To start
with is a Beta-value of 0.363which indicates that predictor variable ICT Characteristics
statistically producing a 36.3% causality on ICT Adoption in the selected healthcare facilities
of Kampala Capital City Authority (KCCA). Further still, a t-value of 5.532 being greater
than 2 and a sig-value of 0.000 being below 0.01 level of significance also signposts that
indeed the indeed the predictor variable ICT Characteristics was significant in the model. No
wonder, almost 36.3% of the total variations in ICT Adoption in the model was explained by
ICT Characteristics.
Also to note, the same table also presents a Beta –value of 0.458, a P-value of 0.000 < 0.01
and and a t-value of 13.062 which was above 2 all statistically revealing that organizational
factors in the model produce a 45.8% (0.458* 100) and a t-value of 13.062 on ICT Adoption
in the selected healthcare facilities of Kampala Capital City Authority (KCCA).
Lastly on employee characteristics, a corresponding Beta-value of 0.623also indicates that
predictor variable employee characteristics statistically producing a 62.3% (0.628* 100)
causality on ICT Adoption in the selected healthcare facilities of Kampala Capital City
Authority (KCCA). Further still, a t-value of 5.768 being greater than 2 and a sig-value of
0.000 being below 0.01 level of significance also signposts that indeed the indeed the
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predictor variable employee characteristics was significant in the model. These therefore
stand to mean that almost 62.3% of change on ICT Adoption in the selected healthcare
facilities of Kampala Capital City Authority (KCCA).
Convincingly therefore, study finial output is the Model Y = a + βX1 + βX2 + βX3
Where: Y = ICT adoption; a =constant, β1, β2 and β3, = Regression coefficients; X1= ICT
characteristics; X2= Organizational factors; X3= Employee characteristics; e = Error term.
This will mean that the finial output of the study was; ICT adoption = 0.576 + 0.363 (ICT
characteristics) + 0.458 (Organizational factors) + 0.623(Employee characteristics)
Conclusively therefore, the above model output statistically indicates that among the factors
affecting ICT adoption in the selected healthcare facilities of Kampala Capital City Authority
(KCCA), employee characteristics produces the highest percentage of 62.3%, followed by
other factors / Constant with almost 0.576%, then organizational factors with 45.8% and
lastly tailed by organizational factors with a 36.3% effect of causality on ICT adoption.
.
CHAPTER FIVE
SUMMARY, DISCUSSION, CONCLUSION AND RECOMMENDATIONS
5.0Introduction
This chapter presents the summary of the research findings, discussions, conclusions and the
recommend actions drawn from study as detailed below:
5.1 Summary of Study Findings
The summary of research findings is presented according to the specific objectives as it
explained in detailed below:
5.1.1 Relationship between ICT characteristics and ICT Adoption in healthcare facilities
The summarized research findings on ICT characteristics revealed that the innovation is of
great importance in accelerating e-health service delivery when ICT is well planned and
adopted in most health care units in Uganda. However, the ICT potential and advantages have
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been marred by many obstacles that hinder health organizations in acceptance, utilization and
sustainability of the adoption. Some of most pronounced challenges mentioned included; high
costs of ICT equipment, low levels of ICT awareness by potential users and lack of
elaborative ICT policy.
Study findings on ICT characteristics revealed that the ICT infrastructure development is
unable to adequately support the potential benefits of ICTs in health care organizations. For
example, very few health facilities are computerized and even those which are computerized,
internet access is always very slow and sometimes unable to connect or accessed. Internet
access and utilization is still a big challenge in Uganda and it may take a while to have all
health centres fully operational with services due to high costs. The findings revealed that this
problem is not only affecting health facilities at KCCA but also big national hospitals like the
Mulago Hospital where they still majorly use manual systems of recording and storing
potential medical information.
5.1.2 Relationship between organizational factors and ICT adoption in Health Care
facilities
Summarized study findings revealed that ICT adoption in healthcare facilities at KCCA
gained momentum in areas such as health portals, electronic health records (EHR), electronic
medical records (EMR), personal health records (PHR), and health information systems
(HIS) and this mainly in area of HIV/AIDS and ART management. It was noted that ICT use
and adoption in health service delivery is slow but with steady progress, ICT in health is
gradually eliminating paper-based health and Health Care and this has significantly lowered
the costs and expanded the access to health in many healthcare organizations in Uganda,
although there are still serious gaps.
Further, the investigation discoveries uncovered that major authoritative variables at KCCA
that cutoff the reception of ICT in Health Care Organizations included; significant expenses
of keeping up ICT specialized staff, significant expenses in giving all day, every day backing
and checking. Moreover, different difficulties are high turnover of specialized staff and
supporting ICT reception in since a long time ago run. At KCCA, ICT is principally brought
together and overseen by ICT specialized work force in ICT division, leaving in excess of 8
wellbeing offices under KCCA without fast ICT activity support.
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5.1.3 Relationship between employee characteristics and ICT adoption health facilities.
Summarized findings on employee characteristics revealed that most employees do not
exhibit the positive beliefs toward introduction of new ICT software in Health Care
Organizations which hinders the smooth operation. It was further revealed that employees are
always skeptical about any new innovation or changes in their work environment, they fear
almost everything new and ICT innovations and adoption are not spared. Findings also
indicated that a number of health facilities at KCCA don’t have enough human resource
personnel trained in use and installation of ICT, computers, servers and ICT units which
continue to hinder ICT adoption and usage.
In addition, study findings revealed that although there are still some few challenges
regarding the employees’ attitudes concerning ICT adoption and use in health care
organizations at KCCA, most employees have already shown positive attitudes and interest
towards learning from ICT technical group the skills and knowledge required to cope up with
new ICT innovations at their respectively work stations. Several employees now do
acknowledge and appreciate that although there are still obstacles in ICT adoption like
limited budget for ICT activities and power blackouts, there is a ray of hope that once
Government takes ICT adoption as a top priority, many problems will be significantly
reduced.
5.2 Discussion of Study Findings
The study findings are discussed here details according to the specific objectives of the study
in order to maintain the logical flow and proper analysis of the study findings as they have
been presented and interpreted in previous chapter as illustrated below:
5.2.1Objective 1: The relationship between ICT characteristics and ICT adoption

The study findings on ICT characteristics specifically cost of ICT in Health Care facilities at
revealed that costs and status of infrastructure in most health facilities at KCCA hinder the
proper adoption of ICT. Some of equipment and ICT software lack compatibility, costs of
installing internet facilities and maintaining it is also still a major challenge. Other findings
included; high cost of purchasing computer software systems, installation, hiring experts,
updating and maintenance.
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These above discoveries are upheld by the Miller and West (2007) who focused on that the
underlying expense of carrying out an Electronic Medical Record in a wellbeing place might
be pretty much as high as $US54, 000 to $US64, 000 for each taking part doctor, with
continuous expenses of $US21, 000 for every doctor each year. They further noticed that
associations should consider costs related with arranging, determining prerequisites, altering
and re-redoing frameworks, preparing suppliers, and reengineering the conveyance of
medical care frameworks to oblige emergency clinics.
On other hand, the study disclosures revealed that, it was hard for by far most of the staff to
oversee current show of new ICT programming changes since most of them didn't have data
and capacities in using such programming. This vital all laborers to go through getting ready
to be proficient them secure the central capacities and data. Regardless, there is continually
confined spending plan for such startling changes and activities in Government workplaces
and trained professionals. Various factors referred to included; huge costs of foundation of PC
programming, tremendous costs of PC programming upkeep, huge costs of utilizing
organizations of ICT experts to plan and keep up the item structures.
The above disclosures are as per Zakaria, Mohd, Yusof. what's more, Zakaria (2010), who
zeroed in on that legitimate culture is a huge part that should be given due idea. They further
communicated that an amazing and beneficially supervised affiliation customarily ensures
that their bosses and laborers fathom the fundamental feelings and approaches managing
conduct change both inside the affiliation and in external business associations. They showed
that a culture that raises change is accepted to be a more supporting environment for
development customers than a culture that progresses reliability and conviction. Impediment
towards utilization of ICT in clinical benefits structures will consistently surface aside from if
the lifestyle is responsive towards changes, and with the exception of if people are set up to
recognize novel contemplations and even more basically support the changed conditions later
on.
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Also, the examination discoveries on simplicity to utilize ICT in medical services
communities uncovered different elements that frustrate ICT acknowledgment, usage and
maintainability in Health Care associations at KCCA. These included; absence of expected
abilities to utilize PC programming bundles and hard to utilize some PC programming in
certain undertakings inside the country. The discoveries are line Mulusew 2015) who noticed
that yet ICTs are imperative in medical services frameworks, the reception rate is amazingly
restricted inside the asset restricted nations. He demonstrated that gratitude to this reality and
other contributing components, medical care offices from agricultural nations have
encounters of helpless information the executives, powerless proof based dynamic practices,
experience of changed clinical blunders and lack of common sense. moreover , helpless
framework, the executives issues, expertise related issues, asset deficiency, poor ICTs access
likewise influence ICTs access and use inside the wellbeing offices in agricultural nations.
Similarly, Mugo (2014), refered to in Furusa et al., (2019), agrees with discoveries. He
focused on that in many agricultural nations, ICT reception actually face huge loads of
difficulties including absence of assets to furnish wellbeing establishments with current
advancements, helpless arrangements that neglect to manage present moment and long haul
needs. Additionally noted were restricted financial plans assigned to the wellbeing area and
absence of information correspondence innovation (ICT) abilities and information.
5.2.2 Objective 2: The relationship between organizational factors and ICT adoption in
healthcare facilities at KCCA
The study findings regarding organizational factors that influence ICT adoption especially
administrative support in Health Care Organizations at KCCA revealed that management
provides financial and technical support. It also identifies both ICT needs and relevant ICT
Software required in health care organizations at KCCA. This indicates that the support and
interest of top management in organizations is very crucial in determining the success or
failure of any change or new ideas being implemented in the organization. Hence if KCCA is
to implement ICT in health successfully, then expertise in ICT should be put into
consideration. The above findings are in line with Goldzweig, Towfigh, Maglione, &
Shekelle, (2009) cited in Kiberu, Mars & Scott, (2017), who noted that
whereas there's increasing evidence documented by systematic reviews that ICT can
improve the standard and safety of health care by reducing its cost in developed
economies, the evidence is a smaller amount robust in developing economies. They
indicated that ICT adoption remains hampered by lack of political will, socioeconomic
71
inequalities worsened by increased poverty levels; technology infrastructure and
operational issues; and skills and human resource.
In addition, the study findings revealed that management is conscious of role of ICT in
its work, hires skilled personnel to support ICT and ICT needs are considered during
budgeting. This suggests that management at KCCA is fully conscious of the
advantages that accrue to the organization when ICT is adopted in healthcare
facilities. For instance, reduced operational cost from purchase of stationery, proper
coordination and quick service delivery. However, the findings also indicated that the
majority of the ICT health projects are funded by development partners who usually
dedicate on ICT procedures and policy framework to the extent of bringing their ICT
experts thus leaving the recipient countries including Uganda with limited chances to
develop their ICT potentials.
This is in line with Knittel, Miller and Sanders (2016), cited in Ogechi & Olaniyi (2018),
who suggested that ICT, improves health care delivery and public health. They illustrated
that ICT like hardware sensors, mobile applications, telemedicine, and health
information technology improve health care and health outcomes. this will only be
possible with Government support and funding.
On staff development, study findings revealed that ICT knowledge is taken into
account while recruitment exercise of the workers and staff members are
usually given training in ICT especially those in ICT department. this suggests that when
it involves human resource development aspect like training of employees out of the ICT
department in latest ICT software, management at KCCA doesn’t purpose it. In same
way, more study findings revealed that perhaps the best organizational factors that
hindered ICT adoption was lack of enough budget fund allocation to the training function
and building capacity of human resource. Although it had been noted that there's a
special allowance development at KCCA, these funds have remained majorly centralized
and other lower health facilities don’t benefit much from this budget. This has continued
to hamper ICT adoption in health care organizations under KCCA.
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The above findings are supported by Chang, Mwanika, Kaye, et al., (2012) cited in
Kiberu, Scott, (2017) noted that human resources for e-Health comprise doctors, ICT
professionals and electronic content developers. However, such factors are always
limited in developing countries including Uganda which hinders desired interest to put
in ICT in health centres. They further indicated that the majority health cadres have low
levels of computer literacy and skills to use ICT equipment and systems, especially those
in rural areas. Therefore, integrating ICT within the present hospital setting is seen as an
additional burden to the nurses and doctors. this is often considered added
responsibility which pulls them faraway from their core duties.
In addition, the study findings revealed that management identifies current software
systems and helps staff to urge training. It comes up with strategies are designed to retain
employees with ICT skills and only invites experts to supply ICT training to
employees. This suggests that when considering installing ICT in healthcare facilities,
KCCA should make sure that top management especially those in ICT unit have
necessary expertise to transfer knowledge and other ICT skills to the
opposite employees. Study findings further revealed that at health care facility level,
there are still numerous obstacles to ICT adoption. In some health care units, one
computer is often shared among many doctors including the power in-charges.
The above study findings are in line with Mugo (2014), cited in Furusa et.al., (2019),
who stated that in many developing countries are faced with lack of resources to equip
health institutions with modern technologies poor policies that fail to deal with short-
term and long-term needs (Busagala & Kawono, 2013). In Furusa et.al., (2019), limited
budgets allocated to the health sector and lack of data communication technology (ICT)
skills and knowledge also are noted. Within the same way, Rodrigues, (2003) cited in
Ogechi & Olaniyi (2018) concurs with findings where he stated that folks are
central within the value-added creation of e-Health products and services and an
organization’s human resource is that the key to success. He further noted that
technologies are designed during away that permits people to perform certain functions.
Attitudes of citizenry and therefore the resource capabilities of the organizations
ultimately determine the success of ICT undertakings.
5.2.3 Objective 3: The relationship between employee characteristics and ICT adoption
in healthcare facilities at KCCA
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The study findings on employee characteristics and more specifically on employee beliefs,
revealed that some people don’t use certain technologies because they see no value. It is said
people tend to use information they already know. Some managers are not ready to shift from
their traditional ways of doing business to embrace new ICT innovation in health care
organizations. This implies that changing employees’ beliefs and attitudes toward ICT
adoption is very crucial and should be given a priority when considering purchase of new
computer software.
The above findings are in line with Benjamin and Levinson (1993: P.30), cited in Zakaria,
Mohd Yusof. & Zakaria, (2010), who noted that “the greater the functionality of an ICT
system, the more levels of learning and adjustments are required to use it most especially
among the users or employees.”In same line, Zakaria and Yusof (2001) in (ibid) also concur
that readiness and willingness to learn about the new technology at a greater depth and the
customization of each of the processes are key issues. These need to be taken into account
when planning or undergoing technological change and only then can the learning and
transition processes during ICT adoption and implementation be a success among employees.
As respects worker convictions, the investigation uncovered that new advancements
accompany their own difficulties. Some of representative saw new ICT reception in a
negative manner like; it can misshape work in progress. This infers that representatives some
of the time don't avoid change as a result of dread to lose their positions yet; they are
consistently open to accomplishing something the manner in which they are acclimated with.
Thus to challenge such insights and convictions, the executives at KCCA need to include the
representatives in arranging, planning and execution of ICT, if ICT appropriation at KCCA is
to succeed. Moreover, the discoveries uncovered that when there is political will by the
Government and the executives of KCCA to help the buy and establishment of ICT in
wellbeing offices, a ton of advantages building from this endeavor will figured it out. This
won't just profit representatives at KCCA yet the overall population. Model, there will be fast
admittance to administrations by patients and medical care suppliers will have decreased
weariness.
The above discoveries are in accordance with Bada and Madon, (2006) referred to in Kiberu,
Mars and Scott, (2017), who noticed that a focal objective of human asset advancement
includes expanding the information, abilities, limits surprisingly in social orders and the
advancement of their prosperity through monetary development and improvement. Likewise,
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Oyelaran-Oyeyinka and Lal (2006) cited in Kiberu, Mars and Scott, (2017), additionally
agreed when they found in their examination that, mechanical advancement requires abilities
updating through worker preparing and express learning of the new innovations. They fought
that company's presentation is exceptionally connected with learning abilities, levels of
innovation and a large group of firm-level information, abilities, and experience.
5.3 Conclusion
As observed from the study findings, ICT adoption in health care organizations is of great
important as e-health services delivery accelerate access to medical services to patient and
ease the work of medical personnel. Despite ICT adoption potential benefits, its acceptability,
utilization and sustainability is still low and marred by many obstacles these include; high
costs of purchasing ICT equipment, low levels of awareness and skills from potential users
and technological incompatibility. All the above need immediate attention from the
management at KCCA if ICT adoption to be successful.
5.3.2 Relationship between organisational factors and ICT adoption in healthcare
facilities
It can be concluded from the study findings that, management at KCCA has tried to put in
place conditions to improve ICT adoption in health care organizations by putting budget
allocations for ICT department and recruitment of technical support. These efforts are aimed
at improving ICT adoption and provide quick access to health services. Despite these efforts
by management to improve ICT adoption, it’s acceptance, utilization and sustainability is still
wanting. This is mainly attributed to lack enough budget funding, low organisational ICT
infrastructure and inadequate human resource with necessary ICT technical compatibilities.
In addition, limited internet network coverage and power blackouts are among the challenges
which need immediate solutions if ICT adoption is to be successful.
As indicated by the study results, it can be observed that some employees do not exhibit the
positive beliefs and attitudes towards ICT adoption in health care organizations at KCCA. It
is however important to note that; employees do not necessarily look at new ICT innovation
as a threat to their jobs but; feel comfortable to remain working with their old ways of
delivery. Hence to improve ICT adoption in Health Care organization, the focus and priority
should be put at training employee in new ICT software to minimize cases of resistance to
75
change. This is so because; human resource function is a key in implementing any change in
organization including ICT adoption.
5.4 Recommendations
As observed from the results of the study, most of the ICT software and hardware materials
where discovered to be very expensive. Therefore, there is a need for Government to consider
increasing budget allocation meant to improve the access, use and adoption of ICT in heath
service delivery among health facilities at KCCA.
It was noted that most of ICT software application are not easy to use by most health
workers, therefore is need to involve health workers and other employees as primary users of
ICT in planning, designing operation manual and actual implementation. This enables
employees to equip them with necessary skills and knowledge to take ICT adoption. There is
need for intensive programmes and measures geared to removing financial barriers inhibiting
access, use and adoption of ICT in healthcare facilities at KCCA. Hence, shielding poor and
vulnerable populations from being consumed in medical expenses. This can be possible only
if KCCA in particular and the Government of Uganda in general can invest in ICT tools such
as computers, the Internet and mobile phones.
5.4.2 Relationship between organizational factors and ICT adoption in healthcare

facilities
As it was discovered during the study that, ICT use at KCCA is majorly centralized. The 8
health facilities are not having ICT units; those which have mainly support ART projects.
Therefore, there is need for management at KCCA to lobby Government for more funds to
support health centres. This will to enhance coordination and reduce costs incurred in paper
work which makes health service delivery more effective.
It was observed that most ICT infrastructure like computer laboratories, internet connection,
power backups, access to smart phones is still challenge for many healthcare facilities at
KCCA. Where these ICT tools are available, they are not enough for all employees.
Therefore, there is a need for management at KCCA together with Government of Uganda to
consider prioritizing adoption and implementation of technologies. This will reduce
unnecessary delays and costs due increased use of papers.
76
There is a need for policymakers and private sector actors in the health industry to put into
consideration ICT latest trends in health service delivery. Therefore, the stakeholders have
the responsibility to design and implement ICT software program which are costly friendly.
The software program can be used and sustained in different health service at KCCA with
potential of maximize the benefits while suppressing the burden of costs.
Results from the study indicated that KCCA, most of the employees lacked ICT skills except
those who are hired to work in ICT department. Therefore, it is important to know that human
resource development is crucial asset in determining proper utilization of new introduced
ideas or ICT programmes. Thus, there is a need for management at KCCA considers training
sessions in ICT for employees to increase their approval for adoption of information
communication and technology.
It was indicated during study that KCCA does not offer any special training to its employees
on ICT since there is not budget allocation targeting such activities. Therefore, there is for
management of KCCA to plan and budget for training and ICT workshops where experts in
ICT can be hired and called upon to guide the users on lasted ICT software, its application
and how to use them health service delivery in Uganda.
There is a need for ICT department at KCCA to plan and develop a comprehensive ICT
training manual to cope with skill shortages in case of employee turnover. Therefore, ICT
should, therefore, be employed to alter the channels through Health Care services are
fundamentally delivered, to change work place environment, to enable different skill mixes in
clinical teams, to empower different clinicians to make decisions about patient care, and to
empower patients to self-care through ICT skills training.
5.5 Contributions of the study

The findings from the study contribute to the larger debate on ICT adoption in health service
delivery and its benefits to the economy. There is a need to put in place policies and
regulatory framework support ICT access, use and adoption as a way of reducing unnecessary
delays and costs for proper coordination and monitoring of health service delivery.
The study findings also provide the benchmark for policy debates and arguments on which
mechanisms and strategies that can be utilized in improving access, use and adoption of ICT
77
in healthcare organization. It was noticed that most of the ICT projects in Uganda are donor
funded. Most of them have remained at pilot stage due to limited funds and this limits
decision making power of government to install ICT programmes.
The success of the new approaches that will be used will act as benchmarks for best practices
from both international and national ICT implemented projects. These can be used by future
researchers, academicians and policy makers in designing and implementation of ICT in
healthcare organization for effective service delivery.
5.6. Areas for future Research

 Future studies can investigate why Government does not have considerable budgets to
support ICT in the health organizations.
 Research can also be carried to examine the effects of socio-economic factors on use
and adoption ICT in health organizations.
 There is a need to conduct a study to design and implement sustainable telemedicine
information systems in Uganda.
 New research study can be conducted to investigate how ICT use in the Agricultural
sector since this is backbone of our economy.
78
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83
APPENDENCES
APPENDIX 1: QUESTIONNAIRE FOR EMPLOYEES AT KCCA

Dear respondent
This questionnaire is intended to seek your view on the study of the factors affecting adoption
of ICTs in health organisations in Uganda using the case of KCCA. The research is being
undertaken as part of the requirement for the award of a master in management studies at
iganda management institute. You are kindly requested to spare some of your valuable time
and indicate your opinion on each question and statement. The information provided will
only be used for academic purposes and will therefore be treated as confidential.
Thank you
Please tick the appropriate option, any response you give will be respected
SECTION A: DEMOGRAPHIC CHARACTERISTICS
1. Age: 1. 20-25 years 2. 26-31 years 3. 32-37 years, 4. 38 and above
2. Sex: 1. Male 2. Female
3. Highest level of Education
1. Certificate 2. Diploma 3. Bachelor’s Degree, 4. Post Graduate
4. Employment Status: 1. Probation 2. Contract 3. Permanent
5. Duration of service: 1. Less than 6 months 2. 6months -1year 3. Over 2 yeara
4. over 3 years 5. Over 5 years
SECTION B: FACTORS AFFECTING ICT ADOPTION
This section seeks information on the characteristics of ICT and its adoption. Respondents are
requested to indicate their responses by selecting appropriate items by circling the number
that best describes their view or opinion based on the following scales:
Strongly agree (SA)-5, Agree (A)-4, Not sure (N) -3, Disgaree (D)-2, Strongly Disagree
(SD)-1
i
Section B1: ICT Characteristics
B1(i) Cost of ICT SA A NS D SD
1 It is not easy to purchase computer software systems
2 The cost of installation of computer software is high
3 Computer software maintenance fee is high
4 The organisation has many things to spend on
5 Most good software systems are not accessible
6 It is expensive hiring software expert
B(1) (ii) Ease of use
1 Some employees not comfortable using software
packages
2 Not easy to apply computer software in some projects
3 The activities are more non -computer oriented
4 There are no software packages tailored to Health
Care work
5 The computers are not easy to apply because most
work is field oriented.
6 Activities carried out by health organisations cannot
be arranged by a computer system
SECTION B2: ORGANISATIONAL FACTORS

B2(i) Administrative Support SA A NS D SD
1 Management provides financial support
2 Management provides technical support
3 Management identifies ICT needs in organisation
4 The Management identifies relevant ICT Software
5 Management is aware of role of ICT in its work
6 Management hired skilled personnel to support ICT
7 The ICT needs are considered during budgeting
B2(ii) Staff development
1 ICT knowledge is considered while recruiting staff
2 Staff members are usually provided with training in
ICT
ii
3 The Organisation organizes ICT training workshops
4 Training for ICT use is an individual initiative
5 Staff members allowed to express their ICT training
needs
6 The Management identifies current software systems
and helps staff get training
7 Strategies are usually designed to retain employees
with ICT skills.
8 Experts are usually invited to provide ICT training to
employees.
SECTION B3: EMPLOYEE CHARACTERISTICS

Strongly agree (SA)-5, Agree (A)-4, Not sure (N) -3, Disgaree (D)-2, Strongly Disagree
(SD)-1
B3(i) Employee Beliefs
1 Some people don’t use certain technologies because
they see no value.
2 People tend to use information they already know
3 Some managers don’t use certain innovation since
they are not used to them
4 Some managers believe that they are already using is
always best.
5 New technologies come with their own challenges
6 People enjoyed current ways of doing things
7 Some technologies can distort work in progress
B3 (ii) Employee attitudes
1 We don’t use specialized software systems even our
partners don’t use them.
2 Some ICT software systems are difficult to apply.
3 We are already happy with ways in which we do
work.
4 Some software packages need a lot of time to learn
and use.
iii
5 Some software packages are expensive to sustain.
6 When there is breakdown in some software, the loss
in information is high.
7 Some health-related activities may not need software
systems.
SECTION B4: CONCEPT OF ADOPTION OF ICT

No. Adoption of ICT in healthcare organisations SA A N D SD
1 Employees find it hard to adopt ICT use if they have not
used if before
2 Those who have been introduced to ICT in schools adopt
faster than those have not
3 At times organisations use ICT software systems and
then abandon it
4 Organisations communicate with each other on new ICT
innovation
5 Employees need to be educated on new software
technologies
6 Patience needed among the staff when a new software is
introduced
7 Management need to hire experts from whom other
employees can learn
THANK YOU FOR PARTICIPATION
iv
APPENDIX II: Interview Guide for Key Informants
1. In your opinion, how do you assess the cost of ICT in terms of purchasing ICT
equipment and software packages, installation and maintenance?
2. What is your view on the cost of hiring ICT experts?
3. What factors do you think affect ICT use in your organization?
4. Highlight the administrative support given to the organization in terms of ICT use.
5. What do you think administration in not doing enough?
6. How do you assess ICT training for staff in your organization?
7. Which ICT training opportunities do employees have in the organization?
8. How do you assess the employees’ belief in the use of ICT in your organization?
9. How do you assess the employees’ attitude in the use of ICT in your organization?
THANK FOR YOUR TIME AND RESPONSES
v
APPENDIX III: Table for Determining Sample Size from agiven Population
N S N S N S N S N S
10 10 100 80 280 162 800 260 2800 338
15 14 110 86 290 165 850 256 300 341
20 19 120 92 300 169 900 269 3500 346
25 24 130 97 320 175 950 274 4000 351
30 28 140 103 340 181 1000 278 4500 354
35 32 150 108 360 186 1100 285 5000 357
40 36 160 113 380 191 1200 291 6000 361
45 40 170 118 400 196 1300 297 7000 364
50 44 180 123 420 201 1400 302 8000 367
55 48 190 127 440 205 1500 306 9000 368
60 52 200 132 460 210 1600 310 10000 370
65 56 210 136 480 214 1700 313 15000 375
70 59 220 140 500 217 1800 317 20000 377
75 63 230 144 550 226 1900 320 30000 379
80 66 240 148 600 234 2000 322 40000 380
85 70 250 152 650 242 2200 327 50000 381
90 73 260 155 700 248 2400 331 75000 382
95 76 270 159 750 254 2600 335 100000 384
Source: Krenjcie and Morgan (1970) in Amin (2005)
vi
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FACTORS AFFECTING ADOPTION TO INFORMATION COMMUNICATION

TECHNOLOGIES (ICTs) BY HEALTH CARE ORGANISATIONS IN UGANDA:

KIRONDE NAMBOZE MUGENYI LILIAN

A DISSERTATION SUBMITTED TO THE SCHOOL OF BUSINESS AND

Adoption of Information Communication Technologies (ICTs) By Health Care Organisations

This dissertation is submitted with the approval of my supervisors.

Dr. Mary Muhenda

Ms. Jennifer Rose Aduwo

Thank you all and may God bless you abundantly

Table 3. 2: Results of content validity for research tools.........................................................47

Table 3. 3: Reliability test results of research instruments......................................................48

Table 3. 4: Five point likert scale codes and their interpretation.............................................49

Table 4. 1: The response rate for the study..............................................................................51

Table 4. 2: Respondents age.....................................................................................................52

Table 4. 3: The cost of ICT in Health Care organizations.......................................................58

Table 4. 4: The easiness to use ICT in Health Care Organisations..........................................62

Table 4. 6: Administrative support...........................................................................................66

Table 4. 7: Staff development..................................................................................................70

Table 4. 8: Pearson correlation for organizational factors and adoption of ICT......................73

Table 4. 9: Employee beliefs towards use of ICT....................................................................75

Table 4. 10: Employee attitude towards use of ICT.................................................................78

Table 4. 12: Adoption of ICT in healthcare organisations.......................................................83

Figure 4. 1: The gender of respondents....................................................................................53

Figure 4. 2: The Respondents’ Education level.......................................................................54

Figure 4. 3: Employment status for employees at KCCA........................................................56

Figure 4. 4: Time spent at KCCA by Employees.....................................................................57

DHIS District Health Management Information System

EMR Electronic Medical Record

HER Electronic Health Records

ICTs Information Communication Technologies

KCCA Kampala Capital City Authority

LFPR, Labour Force Participation Rate

MoES Ministry of Education and Sports

MoH Ministry of Health

MoICT Ministry of Information Communication and Telecommunication

SAQ Self-Administrated Questionnaire

TAM Technology Acceptance Model

UCC Uganda Communications Commission

UNHS Uganda National Household Survey

UTAUT Unified Theory of Acceptance & Use of Technology

WHO World Health Organization

In Uganda, improvement of ICT is a quickly developing industry in particular in the telecom

The Government of Uganda perceives e-Health as an empowering stage to improve medical

1.1.3 Conceptual background

1.1.4 Contextual background

According to Ssewanyana, (2007), the adoption of ICT and implementation

1.7 Conceptual frame work

Health Information Systems (HIS): It is a system that facilitates gathering, aggregating,

Information technology (IT) acceptance could be a method that is influenced by complicated

Portable wellbeing, tele-health, telemedicine, tele-care, tele-instructing and tele-recovery are

2.2.2 Organizational Factors and the Adoption of ICTs

Regardless of the presence of a technique to guide implementation, or an evidence-based

As indicated by Nambisan and Wang (2000), embracing could be consequences of

2.3 Gaps in Literature Review

3.2 Study Population

Dimensions No of Items Relevant CVI

3.8 Data collection Procedure

3.9.2 Qualitative analysis

Description Ranges for mean Codes for scale Interpretation

Category Questionnaires given out Returned Response Rate

Respondents’ age groups Frequency Percentages

4.2.2 Respondents’ gender

Source: Primary Data, 2021

4.2.3. Education levels