THE USE OF ELECTRONIC NOTIFICATION SYSTEMS (E-NOTIFICATION

SYSTEM) FOR REGISTERING BIRTHS AND DEATHS IN A DEVELOPING

COUNTRY: CASE STUDY OF KITUI COUNTY

BY

JOYCE MWIKALI

REG NO.

A RESEARCH PROJECT SUBMITTED IN PARTIAL FULFILLMENT OF

REQUIREMENT FOR DIPLOMA OF INFORMATION TECHNOLOGY.

2023
DECLARATION
Declaration by the Candidate

This thesis is my original work and has not been presented for a degree in any other University.
No part of this thesis may be reproduced without the prior written permission of the author
and/or Kiriri Women University.

JOYCE MWIKALI

Date: .......................................... Signature…………………………………

Declaration by Supervisors

This thesis has been submitted for examination with our approval as University Supervisors.

Name of Supervisor …………………………………………………………..

Date:……………………………… SIGN…………………………………...

KIRIRI WOMEN University, Kenya

DEDICATION
I hereby dedicate this research paper to my most esteemed lecturers, university staff and my
beloved parents for their highly appreciated contribution in my achievement.

ii
ACKNOWLEDGEMENT
I give thanks to God almighty for His love, Care and blessings. I also want to thank those in one
way or the other, who contributed to the success of this work. I appreciate the efforts made by
my supervisor, who saw me through the writing of this research project.

iii
ABSTRACT
Health organizations are increasingly investing in Information and Communication Technologies
(ICT) to improve work processes. One such technology is the e-Notification system, which
enables timely registration of births and deaths through an electronic platform. This study aims
to evaluate the adoption and utilization of the e-Notification system in developing countries, with
a focus on its implementation at Kitui GeneralState Hospital. The research takes a quantitative
approach, gathering data through survey questionnaires from nurses and doctors at the hospital.
The findings indicate that the system is user-friendly, and the staff has received adequate training
to operate it. Additionally, there is technical support available for system maintenance. However,
concerns have been raised about inadequate infrastructure. To address this, the study
recommends providing more computers and improving the ICT infrastructure.

iv
TABLE OF CONTENTS
DECLARATION.............................................................................................................................ii
DEDICATION...............................................................................................................................iii
ACKNOWLEDGEMENT..............................................................................................................iv
ABSTRACT....................................................................................................................................v
TABLE OF CONTENTS...............................................................................................................vi
LIST OF TABLES........................................................................................................................vii
LIST OF ABBREVIATIONS......................................................................................................viii
DEFINITION OF TERMS.............................................................................................................ix
CHAPTER ONE..............................................................................................................................1
INTRODUCTION...........................................................................................................................1
1.1 Background of the Study........................................................................................................1

1.2 Statement of problems...........................................................................................................2

1.3 Purpose of study.....................................................................................................................2

1.4 Research Objectives...............................................................................................................3

1.5 Research Questions................................................................................................................3

1.6 Research Hypothesis..............................................................................................................3

1.7 Significance of Study.............................................................................................................3

CHAPTER TWO.............................................................................................................................4
LITERATURE REVIEW................................................................................................................4

v
 2.1 Introduction............................................................................................................................4

2.2. E-Birth Notification..............................................................................................................4

2.3 E-Death Registration..............................................................................................................5

2.4 Business Benefits of e-Birth and e-Death Notification System.............................................5

2.7. CONCEPTUAL FRAMEWORK.........................................................................................6

CHAPTER THREE.........................................................................................................................7
RESEARCH METHODOLY..........................................................................................................7
3.1. INTRODUCTION................................................................................................................7

3.2 RESEARCH DESIGN...........................................................................................................7

3.3 TARGET POPULATION......................................................................................................8

3.4 SAMPLE SIZE AND SAMPLING TECHNIQUES.............................................................8

3.4.1 Sample size.........................................................................................................................8

3.4.2 Sampling Techniques..........................................................................................................8

3.5 DATA COLLECTION INSTRUMENTS.............................................................................9

3.6 DATA COLLECTION PROCEDURE..................................................................................9

3.7 DATA ANALYSIS TECHNIQUES....................................................................................10

3.8 ETHICAL CONSIDERATIONS.........................................................................................10

CHAPTER FOUR.........................................................................................................................11
RESEARCH FINDINGS...............................................................................................................11
4.1 INTRODUCTION...............................................................................................................11

4.2. DISTRIBUTION OF RESPONDENTS BY GENDER......................................................11

4.3. Close Ended Questions.......................................................................................................12

4.4. Open-ended Questions........................................................................................................13

4.5 Discussions...........................................................................................................................13

CHAPTER FIVE...........................................................................................................................15

vi
CONCLUSIONS AND RECOMMENDATIONS........................................................................15
5.1. CONCLUSIONS.................................................................................................................15

5.2. RECOMMENDATIONS....................................................................................................15

5.3 LIMITATIONS AND FUTURE RESEARCH....................................................................15

REFERENCES..............................................................................................................................16
APPENDICES...............................................................................................................................18
Appendix 1: Questionnaire Cover Letter...................................................................................18

LIST OF TABLES
Table 4.1: Distribution of Respondents by Gender ……………………………………………. 18

Table 4.2: Distribution of Responds by Age …………………………………………...……… 19

Table 4.3: Distribution by Marital Status …………………………………..………………….. 20

Table 4.4: Distribution by Education Level ………………………………....…………………..20

Table 4.5: Distribution by Income Levels ………………………………………….......……… 21

Table 4.6: Client’s History Distribution ………………………………………………......…… 22

Table 4.7: Distribution on Product Reliability …………………………………………....……. 23

Table 4.8: Distribution of Efficacy Agency Services ………………………………………….. 23

Table 4.91; Distribution on Accessibility of Agency Services …………………………...……. 24

vii
LIST OF ABBREVIATIONS
CBK: Central Bank of Kenya

POS: Point on Scale

KCB: Kenya Commercial Bank.

viii
DEFINITION OF TERMS

ix
CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Data from multiple sources indicates that approximately 230 million children under the age of
five and two-thirds of all deaths remain unregistered. Registering children's births is crucial for
establishing their legal identity and ensuring equal access to fundamental services and
necessities. Likewise, recording deaths, along with identifying the cause, provides essential
statistics for the public health system, enabling the development and implementation of programs
to enhance the overall well-being and health of the population. Therefore, the collection and
storage of birth and death statistics are vital for the welfare of a population. These statistics allow
agencies and governments to monitor progress, plan for more sustainable goals, and improve
universal health coverage. Namibia has made significant strides in this area, leveraging
Information and Communication Technologies (ICTs) since gaining independence. The
government, particularly focusing on the health sector, has developed national policies and
strategies to integrate ICTs effectively into the healthcare system. The Ministry of Health and
Social Services has been instrumental in making this initiative possible.

The Namibian Government, in collaboration with UNICEF, introduced the e-Notification

system, an electronic platform aimed at facilitating the registration of births and deaths. This
system is designed to gather various pieces of information related to birth and death
notifications, making it more accessible for all Namibians. Its objective is to ensure that at least
40% of children are registered within one year of birth, positioning Namibia as a leading country
in improved Civil Registration and Vital Statistics on the continent. The initiative is supported by
UNICEF and overseen by the Office of the Prime Minister of the Republic of Namibia through
an inter-Ministerial technical working group, as part of the country's broader e-governance
rollout. Initially piloted at Kitui General Hospital in 2021, the e-Notification system expanded to
all hospitals (public and private) across the country by 2023.
Despite substantial investments in the healthcare sector, evidence indicates that there is still
much to be done. The implementation of e-Notification in Namibia, for example, has been slow,
even though the results of such investments should be apparent. This sluggish progress may
contribute to suboptimal healthcare services. A possible reason for this delay could be the lack of
an assessment by the Ministry of Health and Social Services on the actual usage and impact of
the e-Notification system, making it challenging to justify the overall benefits of such an
investment in the healthcare sector.

1
1.2 Statement of problems
Banking services have been for a long time characterized with long queues, jamming of
machines, decreased human labour and low turnaround time as seen in many commercial
especially national bank of Kenya, post bank and Kenya commercial bank.

The slow operations often resulted to high costs, wastages of resources due to paper work and
bureaucracy making customers feel totally unsatisfied. Therefor Amy from of improvement to
enhance customer satisfaction in the banking sector is very much welcomed through adoption of
new strategies.

E-notification systems is a new strategy that had been adopted in most of commercial banks in
Kenya with it launch in 2010 by CBK. E-notification systems has been employed to increase the
market share of commercial Banks and offer banking services to their clients in varied places
increasing custom satisfaction.

Implementation of E-notification systems model has been guided by three major elements IE
Accessibility of banking agencies and efficiency in service delivery all these designed to render
maximum customer satisfaction.

There has been a lot of studies on E-notification systems, but these studies are not exhaustive
because e-notification systems is experiences a lot of new developments and new changes come
up on daily basis. In Kenya, E-notification systems is regulated by Central Bank of Kenya and
until now agents have not been allowed to offer all banking services to consumers. The study
therefore sought to answer the question; what is the impact of E-notification systems on
customer satisfaction?

1.3 Purpose of study.

This study is intended to establish the impact of E-notification systems on customer satisfaction
more specifically by Equity bank of Kenya Eldoret Branch.

1.4 Research Objectives

The objectives of this study were to:
1. Assess the extent to which Kitui General Hospital is using the E-notifications
system.
2. Examine the benefits and drawbacks the hospital is currently experiencing with
the introduction of the new system.
2
3. Access the use of the E-notifications system at Kitui General Hospital
4. Examine the ICT infrastructures available for the use of E-notifications at
Kitui General State Hospital.
5. Recommend suitable strategies and practices that can be employed to enhance
the use eNotification system at Kitui General State Hospital.

1.5 Research Questions

i. What are the benefits of e-Notification Systems?

ii. How did the e-Notification system change the way you work?

iii. What challenges do you face in the process of using the e-Notification system?

iv. How do you think those challenges can be addressed?

1.6 Research Hypothesis

1.7 Significance of Study.

3
CHAPTER TWO

LITERATURE REVIEW.

2.1 Introduction.
ICT Infrastructure in the health sector

Over the years, the utilization of Information and Communication Technology (ICT) in the
healthcare field has significantly increased, yielding numerous positive outcomes [9]. Its
widespread adoption in healthcare cannot be overstated [9]. According to [18], ICT is
progressively being integrated into every aspect of patient service delivery, and there have been
positive effects, including improved decision-making, reduced duplication of patient data, and
decreased errors made by nurses [18]. Various studies have emphasized the significance of
implementing digital health solutions in developing countries, which encompass electronic
records and health records [19]. The importance of digital health has been highlighted in the
context of Kenya, where it enables information sharing and facilitates faster decision-making
processes [21].
Many believe that ICT can greatly enhance the health system and ensure the delivery of proper
healthcare services [10, 11]. It is also anticipated that ICT, as a mechanism to improve
transparent and efficient governance, will contribute to the availability of better health services
[10, 11]. The e-Notification System, being an ICT-enabled system, falls into this category and is
expected to play a significant role in enhancing healthcare delivery. This study discusses two
types of e-Notification systems: e-Birth notification and e-Death notification.

2.2. E-Birth Notification

E-birth notification involves transmitting information about a child's birth to a centralized

system, automatically leading to the registration of the birth [17]. Additionally, this system
verifies the identity of the mother during registration, thus reducing fraud and trafficking. The
timely registration statistics provided by e-birth notification contribute to efficient government
planning, optimal resource allocation, and better monitoring of progress towards achieving
Sustainable Development Goals. Furthermore, the e-birth notification system establishes a link
between the hospital and the e-national Population Registration System in countries where it
operates, enabling monitoring of the country's birth rates.

Moreover, the e-birth notification system supplies the government and relevant stakeholders with
up-to-date and reliable information, facilitating improved planning for children's needs in areas
such as education, vaccination programs, social protection, and various health services. By
automatically registering the child at the time of delivery, unnecessary hurdles that mothers

4
typically face after leaving the clinic are eliminated [6]. It also reduces the burden of traveling
long distances and minimizes expenses associated with registering children after birth.

2.3 E-Death Registration.

The E-death notification system is designed to transmit information about an individual's death
to a centralized system, which must also include the cause of death [12]. This timely knowledge
of the cause of death plays a crucial role in identifying and responding to deadly disease
outbreaks [12]. Additionally, knowing the cause of death enables more effective planning of
health programs, allowing for better healthcare services and epidemiological studies.

However, despite the significance of the e-death notification system, there are challenges that
can hinder its progress [22], including:

 A majority of medical officers not completing death certificates or only completing a few
annually.

 Certifying officers may have limited knowledge of the deceased patient, especially if
their regular physician is unavailable.

 Certifying physicians may lack accurate information about the patient's medical history at
the time of completing the death certificate.

 Policy requirements for local registration may cause delays in timely registration.

 Insufficient funds may be a constraint.

These challenges need to be addressed to ensure the effective implementation and utilization of
the e-death notification system for improving public health and healthcare services.

2.4 Business Benefits of e-Birth and e-Death Notification System.

The importance of e-birth and e-death notification cannot be overstated, as both registrations are
crucial for national planning. Accurate records of births and deaths are essential, especially when
combined with population census data, as they play a central role in estimating the size of a
population, particularly in smaller communities.

The primary benefits of e-birth and e-death notification systems can be summarized as follows:

 Efficient and timely processing of birth and death records.

 Easy and quick updates to birth or death certificates.

 Prompt exchange and integration of data with government agencies.

5
  Provision of accurate data.

 Easy correction of errors.

 Enhanced security measures to prevent fraud.

These advantages highlight the significance of implementing e-birth and e-death notification
systems, as they streamline processes, ensure data accuracy, and enhance overall efficiency in
recording and managing vital statistics for effective national planning.

2.7. CONCEPTUAL FRAMEWORK.

Accessibility of e-
notofication services

Efficacy of e- User satisfaction

notification

Reliability of e-
notification systems

6
CHAPTER THREE

RESEARCH METHODOLY

3.1. INTRODUCTION
This chapter explains the methodology that was used in carrying out the research work. Crucial
issues that were discussed in this chapter includes, research design, target population, sample
size, data collection and techniques, questionnaires, data analysis techniques and ethical
considerations.

3.2 RESEARCH DESIGN

Research design is a plan utilized by a scholar to gather research participants and gather
information. It defines the necessary data, data collection and analysis methods, and how
research questions will be addressed [15, 16]. In this study, an exploratory research design was
employed, which helped identify the context and relevant factors related to the e-Notification
system in the health sector in Kenya. The exploratory design allowed the researchers to explore
the extent and usage of the e-Notification system in Kenya, leading to the identification of new
knowledge and understanding.

The study focused on all end users of the e-Notification system in Kitui General State Hospital,
located in the Kitui region of Kenya. Additionally, three health centers in the region, equipped
with e-notification facilities, were included in the study. Data was collected from hospital staff
through survey questionnaires, and the categories of respondents were nurses and doctors.
Judgmental (or purposive) sampling was used to select the sample, with eight doctors, forty-five
nurses, and two IT administrators participating in the study.

The researchers obtained consent from the hospital's management teams and informed consent
from all participants. Data analysis was performed using the Statistical Package for Social
Sciences (SPSS), and the findings were presented using tables and figures [14].

3.3 TARGET POPULATION

The study population comprised of 5 Equity agents each with an approximate Daily average of
30 customers served because they are in a highly populated. Therefore 5 equity agents together
with 30 customers made as the target population of 150 respondents.

3.4 SAMPLE SIZE AND SAMPLING TECHNIQUES

According to Chandran (2004) sampling is the selection of a portion of population such that the
selected portion represents the population adequately. The research employed stratified random

7
sampling in selecting respondents. The population was segregated into several mutually
exclusive subpopulations or strata.

3.4.1 Sample size

The sample consisted of eight (8) doctors, forty-five (45) nurses, and two (2) IT administrators
were selected. This gives a total of fifty-five (55) participants who all successfully completed a
data collection phase and their data was using for data analysis. The response rate was 93%
which is adequate to carry an investigation.

3.4.2 Sampling Techniques

This study identified categories of respondents as nurses and doctors that
participated in the study. The sample was identified through Judgmental (or
Purposive) Sampling. Judgmental sampling is a non-probability sampling technique
where the researcher’s judgment is based on who will provide the best information
to meet the objectives study. Purposive sampling is used in situations where the
specialty of authority can select a more representative sample that can bring more
accurate results than by using other probability sampling techniques. Non-probability sampling is
any sampling method where some elements of the population have no chance of selection, or
where the probability of selection cannot be accurately determined. This strategy was chosen
because the agents would only give questionnaires to customers who visit them within one week.
The convenience sampling (sometimes known as accidental or opportunity sampling) used is a
type of non-probability sampling which involves the samples being drawn from that part of the
population which is close to hand. That is, a participant is selected because it is readily available
and was convenient to be selected.

3.5 DATA COLLECTION INSTRUMENTS.

The researcher employed two data collecting methods in the study. These entailed

I. Researcher developed questionnaires, and

ii. Interview schedule.

When researching human beings, it is crucial to recognize that no single source of information
can offer a comprehensive perspective in any study due to bias and individual viewpoints.
Therefore, employing multiple methods of data collection becomes essential to enhance the
reliability and validity of the gathered data (Smith, 2005). According to Schofield and
Anderson (2004), using a combination of data sources and collection methods acts as a
validation process, cross-checking the data obtained. The incorporation of various data collection
approaches, such as interviews and questionnaires, strengthens the validity and reliability of the
information by compensating for the limitations of each method.

8
The primary data collection technique utilized in this study involved distributing questionnaires
to the respondents, allowing them sufficient time to answer. As noted by Mugenda and Mugenda
(2003), questionnaires are easier to administer compared to interviews and ensure respondent
confidentiality as their identities are not disclosed. The questionnaire technique was preferred
because it covers a wide range of areas and can reach a larger number of respondents at a lower
cost, saving valuable time.

3.6 DATA COLLECTION PROCEDURE.

The study involved preparation of a project proposal. Which was approved by the lecturer in
charge. Then I proceeded to distribute the questionnaires to the selected agents who would give
to the customers who would visit them. During data collection, every selected customer was
given a questionnaire to fill and give back the forms to the agents in sealed envelopes for
confidentiality. The researcher collected the forms after three days. Some questions aimed at
measuring the expectation of the customers. These were statements that sought to describe how
services at the agents should be like. The statements were coined in such a way that they express
a desire of the respondents for a particular attribute of service quality. Other questions sought to
measure perceptions.

3.7 DATA ANALYSIS TECHNIQUES

Frequency counts of the responses were then obtained, to generate descriptive information about
the respondents that participated in the study and to illustrate the general trend of findings on the
various variables that were under investigation. This involved the use of percentages and tables
because they help to summarize large quantities of data whilst making the report reader friendly
(Mugenda And mugenda , 2003). The data from the interviews was carefully read. The responses
were edited for grammatical correctness, coherence and precision and presented as quotations so
as to triangulate the data obtained through the administration of the close ended instruments,
which is qualitative in nature. The responses were organized; coded and analyzed using
descriptive statistics (tables, frequencies, percentages).

3.8 ETHICAL CONSIDERATIONS

During this research process, the researcher upheld integrity and high moral standards. The
researcher sought permission from the agents before distributing the questionnaires. The
researcher kept time, respected the respondents’ feedback and decision and treated the
information given by the respondents with confidentiality.

9
CHAPTER FOUR

RESEARCH FINDINGS

4.1 INTRODUCTION
This chapter includes data analysis presentation and interpretation. The chapter is presented in
the following manner, Close ended questions, open ended questions.

4.2. DISTRIBUTION OF RESPONDENTS BY GENDER.

Table 4.1: Distribution of Respondents by Gender.

GENDER FREQUENCY VALID CUMALATIVE

PERCENTAGE

FEMALE 33 32 97

MALE 22 22 100

TOTAL 55

In gender characteristic it was found that the majority of respondents who accessed e-
notification system were females with a total of 32 respondents and the male were only 22. this
would mean that women feel more satisfied with e-notification than men.

4.3. Close Ended Questions.

Figure 1 displays the analysis of the collected data

10
Based on the responses received, the majority of the hospital staff (75%) indicated that they are
well-trained in using e-Notification systems, while 25% stated otherwise. This suggests that there
may be a need for further training to ensure proper usage of the facilities, as all participants
emphasized the necessity for consistent training to keep up with evolving technology trends.
Additionally, all respondents agreed that e-Notification systems are effective for collecting
proper statistics of e-births and e-deaths. This indicates that the availability of the system makes
gathering birth and death statistics easier, while ensuring accurate and timely record storage and
retrieval. However, 26% of the participants mentioned not using e-Notification systems
frequently, with many possibly lacking adequate training, highlighting the need for enhanced
training for staff managing the e-Notification system.
Interestingly, despite some staff not using e-Notification systems, 98% of them found the system
easy to use, and the same percentage agreed that technical support is available when needed.
Nevertheless, a significant concern was raised by 58% of the respondents, indicating that
hospitals lack sufficient ICT infrastructure to fully succeed in implementing e-Notification
systems. Although the difference in the percentage views on this issue is relatively close (42%),
it remains evident that a considerable number of respondents reported inadequate ICT
infrastructure in hospitals, hindering the full potential of e-Notification systems.

4.4. Open-ended Questions

11
The participants provided insights on the following questions:

The responses were filtered and categorized in the table below

Moreover, the participants expressed that e-notification is a swift and dependable process. They
also highlighted that e-Notification will streamline the process of obtaining birth and death
certificates for parents and the community since everything is automated. However, some
participants were concerned that implementing e-Notification might increase their workload, as
they are currently involved in manually recording birth and death statistics on paper before
transferring them to computers.
Despite acknowledging the numerous benefits of the e-Notification system, the participants
shared that they still face several challenges. These challenges include a shortage of computers,
slow network connectivity, and insufficient staff. They also noted that data entry can be time-
consuming, leading to difficulties in the overall process.

4.5 Discussions
The study confirmed the presence of a functional e-Notification system in Kenyan hospitals.
According to the respondents, the system is user-friendly, and the staff handling it are adequately
trained, with technicians available for maintenance when required. However, it was noted that
12
adequate funding is necessary to cover operating expenses, maintenance costs, and regular
upgrades that are common with ICT systems [13].

Moreover, based on the analyzed data, e-Notification systems offer numerous benefits. These
include easy access to information, provision of accurate and reliable data, availability of prompt
statistics for decision-making, readily accessible birth and death certificates, streamlined
information management, and reduced paperwork.

Despite these advantages, respondents also highlighted some challenges. Insufficient computers
and slow network connections were noted, and the manual recording of work on paper caused
time-consuming data entry and challenges in searching for the cause of death. Additionally,
issues were raised regarding the lack of proper identification for deceased individuals,
particularly when parents and relatives are involved. Lastly, there is a shortage of staff assigned
to perform these services.

13
CHAPTER FIVE

CONCLUSIONS AND RECOMMENDATIONS.

5.1. CONCLUSIONS
This paper explores the implementation of the electronic birth and death notification system (e-
Notification) in developing countries, using Kitui General Hospital as a case study. The study
evaluates the hospital's utilization of the e-Notification system and investigates the benefits and
challenges associated with its introduction. Additionally, the paper examines the available ICT
infrastructure at Kitui General State Hospital for supporting e-Notification. Finally, below are
recommended strategies and practices to improve the utilization of the e-Notification system at
Kitui General Hospital.

5.2. RECOMMENDATIONS
To address the challenges identified, several recommendations are proposed. Firstly, since
medical personnel in developing countries often lack adequate access to medical data and
facilities, it is crucial to provide them with sufficient computers. This will enable them to
perform their duties more effectively. Additionally, a functional high-speed network should be
established to enhance overall productivity.

Family members must be encouraged to present accurate identification for their loved ones,
especially in cases of death, to facilitate easy traceability.

Although respondents indicated that they are well-trained for their job, it is necessary to hire
more staff to alleviate the burden on the existing workforce. Long-term success relies on factors
such as reliable sophisticated equipment and the availability of technical staff to operate and
maintain such equipment.

It is also recommended to implement periodic staff development programs to keep them updated
on any new developments in the field of e-Notification. This will greatly contribute to improved
performance in the hospital.

5.3 LIMITATIONS AND FUTURE RESEARCH

The research was limited to Kitui General Hospital in Kenya, with participation restricted to the
staff of that hospital. As a result, the findings may not be applicable to a broader population.
Nevertheless, the study provides an overview of the utilization, benefits, and challenges of the e-
notification system. To obtain a more comprehensive understanding, future research should
encompass other hospitals and also include the perspectives of the general public regarding the
effectiveness of the system.

14
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the challenges experienced by vulnerable groups in using digital health
services in the COVID-19 era.
BMC Health Serv Res 22, 188 (2022). https://doi.org/10.1186/s12913-022-
07584-4
[21]Iyawa, G , Herselman, M & Botha, A. (2019). Digital Health Innovation
Ecosystems: Identifying Key
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[22] Public Health Informatics Institute (2016). Next Generation Electronic
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Supporting Improved Quality and Timeliness of Vital Records Data

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APPENDICES
Appendix 1: Questionnaire Cover Letter

QUESTIONARES ON: IMPACT OF E-NOTIFICATION SYSTEMS ON Registering Births

and Deaths

Dear respondent,

I am Joyce Mwikali, a Diploma student of Kiriri Women University. I am doing a survey on

impact of E-notification systems on customer satisfaction as part of partial fulfillment for
requirement of achievement of my Diploma; there I will be grateful if you help me with filling
out this questionnaire. Most of the questionnaire have multiple choices and easy to answer.
Please reply as soon as possible. Every response is really important.

Thank you in advance.

Yours faithfully,

Joyce Mwikali

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PART A: Questionnaire:
1. What is your gender? (Please select one)
 Male
 Female
 Prefer not to say
2. What are the benefits of e-Notification Systems? (Select all that apply)
 Faster and more efficient data processing
 Timely access to birth and death statistics
 Improved accuracy and reliability of information
 Automated record storage and retrieval
 Facilitates decision-making processes
 Other (please specify): _________________
3. How did the e-Notification system change the way you work? (Please provide your
response)

4. What challenges do you face in the process of using the e-Notification system? (Select all
that apply)
 Insufficient access to computers
 Slow network connectivity
 Lack of proper training on the system
 Difficulty in capturing data
 Challenges with identifying individuals (e.g., parents not carrying identification)
 Staff shortage for handling e-Notification tasks
 Other (please specify): _________________
5. How do you think those challenges can be addressed? (Please provide your response)
Thank you for participating in this questionnaire. Your responses will contribute to our research
on the effectiveness and challenges of the e-Notification system. Your feedback is valuable to us.

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PART B: Tick where necessary

1. How can you rate the reliability of e-notification systems products?

Excellent [ ]

Good [ ]

Very satisfactory [ ]

Less satisfactory [ ]

2. How efficient do you find e-notification systems customer services?

Supper efficient [ ]

Moderate efficient [ ]

Efficient [ ]

Less-efficient [ ]

3. How accessible are the e-notification systems?

Easily accessible [ ]

Hardly accessible [ ]

Accessible [ ]

Not accessible [ ]

Thank you for your response

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