A User-Centered Approach to the Development of E-Health Systems: A Case of Uganda

  • Aminah ZaweddeEmail author
  • Bernard Engotoit
  • Osbert Osamai Omeja
  • Peter Kahiigi
Conference paper
Part of the Lecture Notes of the Institute for Computer Sciences, Social Informatics and Telecommunications Engineering book series (LNICST, volume 275)


Over the years the quality of health service delivery has drastically improved through deliberate efforts that have been made to implement e-health systems in developing economies. In Uganda particularly, e-health systems have been introduced and implemented in both government and private-owned healthcare units. However, due to lack of a structured mechanism to guide the development of usable e-health systems there have been growing concerns related to usability challenges with the e-health systems. The challenges that include complexity of system user interfaces, limited interactivity of e-health systems, security and confidentiality concerns are attributed to ad-hoc design of system interfaces, limited involvement of users in the design process and misalignment of e-health interventions with user needs. In this research we examine the challenges of usability of e-health systems in Uganda. The research process was guided by the design science methodology that is premised on systems analysis, surveys and interactions with medical personnel and IT practitioners working with the health sector in the country. The overall goal was to identify the niches for the development of a user-centered approach to guide the development of e-health systems for enhanced and sustainable health services delivery in Uganda. The developed user-centered approach was evaluated by experts to ensure that it was fit for the development of usable e-health systems in Uganda.


User-centered E-health systems Developing economies 


  1. Abran, A., Khelifi, A., Suryn, W., Seffah, A.: Consolidating the ISO usability models. In: Proceedings of 11th International Software Quality Management Conference, vol. 2003, pp. 23–25, April 2003Google Scholar
  2. Fanta, G.B., Pretorius, L., Erasmus, L.D.: An evaluation of eHealth systems implementation frameworks for sustainability in resource constrained environments: a literature review. In: IAMOT 2015 Conference Proceedings, Cape Town Google Scholar (2015)Google Scholar
  3. Bevan, N.: International standards for usability should be more widely used. J. Usability Stud. 4(3), 106–113 (2009)Google Scholar
  4. Bedeley, R.T., Palvia, P.: A study of the issues of e-health care in developing countries: the case of Ghana. In: Twentieth Americas Conference on Information Systems, Savannah (2014)Google Scholar
  5. Bogale, G.F., Pretorius, L., Erasmus, L.: An evaluation of e-health systems implementation frameworks for sustainability in resource constrained environments: a literature review. In: International Association for Management of Technology IAMOT 2015 Conference Proceedings (2015)Google Scholar
  6. Buonodono, D.: Structured walkthrough process guide (2014)Google Scholar
  7. Goldberg, L., et al.: Usability and accessibility in consumer health informatics: current trends and future challenges. Am. J. Prev. Med. 40(5), S187–S197 (2011)CrossRefGoogle Scholar
  8. George, D.: SPSS for Windows Step by Step: A Simple Study Guide and Reference, 17.0 Update, 10/e. Pearson Education India, Delhi (2011)Google Scholar
  9. Harrison, R., Flood, D., Duce, D.: Usability of mobile applications: literature review and rationale for a new usability model. J. Interact. Sci. 1(1), 1 (2013)CrossRefGoogle Scholar
  10. Hevner, A.R., March, S.T., Park, J., Ram, S.: Design science in information systems research. Manag. Inf. Syst. Q. 28(1), 6 (2008)Google Scholar
  11. Kubbo, M., Jayabalan, M., Rana, M.E.: Privacy and security challenges in cloud based electronic health record: towards access control model. In: The Third International Conference on Digital Security and Forensics (DigitalSec 2016), p. 113, September 2016Google Scholar
  12. Kiberu, V.M., Mars, M., Scott, R.E.: Barriers and opportunities to implementation of sustainable e-Health programmes in Uganda: a literature review. Afr. J. Prim. Health Care Fam. Med. 9(1), 1–10 (2017)CrossRefGoogle Scholar
  13. Kim, J., Rigdon, B.: Sustainable architecture module: introduction to sustainable design. National Pollution Prevention Center for Higher Education (1998). Accessed June 2015
  14. Kinzie, M.B., Cohn, W.F., Julian, M.F., Knaus, W.A.: A user-centered model for web site design: needs assessment, user interface design, and rapid prototyping. J. Am. Med. Inform. Assoc. 9(4), 320–330 (2002)CrossRefGoogle Scholar
  15. Lau, F., Kuziemsky, C.: Handbook of eHealth Evaluation: An Evidence-Based Approach. University of Victoria, Victoria (2016)Google Scholar
  16. Ministry of Health: The Annual Health Sector Performance Report 2016/17 (2016).
  17. Mumford, C.: Five measures of software usability that impact user buy-in (2014). Accessed 5 Sept 2016
  18. Mundy, D.: A question of response rate. Sci. Editor 25(1), 25 (2002)MathSciNetzbMATHGoogle Scholar
  19. Nahurira, E., Businge, J., Nakato, R.: A framework for assessing information systems adoption and utilization in the healthcare. Int. J. Comput. Trends Technol. 39(2), 89–99 (2016)CrossRefGoogle Scholar
  20. Namakula, S., Kituyi, G.M.: Examining health information systems success factors in Uganda’s healthcare system. J. Glob. Health Care Syst. 4(1), 1–16 (2014)Google Scholar
  21. Pankomera, R., van Greunen, D.: A model for implementing sustainable mHealth applications in a resource constrained setting: a case of Malawi. Electron. J. Inf. Syst. Developing Countries 84(2), e12019 (2018)CrossRefGoogle Scholar
  22. Peffers, K., Rothenberger, M., Tuunanen, T., Vaezi, R.: Design science research evaluation. In: Peffers, K., Rothenberger, M., Kuechler, B. (eds.) Design Science Research in Information Systems. Advances in Theory and Practice, DESRIST 2012. LNCS, vol. 7286, pp. 398–410. Springer, Heidelberg (2012). Scholar
  23. Peffers, K., Tuunanen, T., Rothenberger, M.A., Chatterjee, S.: A design science research methodology for information systems research. J. Manag. Inf. Syst. 24(3), 45–77 (2007)CrossRefGoogle Scholar
  24. Polit, D.F., Beck, C.T., Owen, S.V.: Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Res. Nurs. Health 30(4), 459–467 (2007)CrossRefGoogle Scholar
  25. Scandurra, I., Åhlfeldt, R.M., Persson, A., Hägglund, M.: Building usability into national eHealth strategies, an action research approach. In: The 4th Infrastructure Workshop on Infrastructures for Healthcare: Action Research, Interventions, and Participatory Design, Tromsö, Norway, June 2013Google Scholar
  26. Taiwo, O.O., Awodele, O., Kuyoro, S.O.: A usability framework for electronic health records in Nigerian healthcare sector. Int. J. Comput. Sci. Eng. (IJCSE) 5(01), 16–20 (2016)Google Scholar
  27. Vélez, O., Okyere, P.B., Kanter, A.S., Bakken, S.: A usability study of a mobile health application for rural Ghanaian midwives. J. Midwifery Women’s Health 59(2), 184–191 (2014)CrossRefGoogle Scholar
  28. Viitanen, J.: A user-centred approach to healthcare ICT development. Licentiate’s Thesis, Espoo, 18 May 2009Google Scholar
  29. Zawedde, A.: Modeling the dynamics of requirements process improvement. Technische Universiteit Eindhoven (2016)Google Scholar

Copyright information

© ICST Institute for Computer Sciences, Social Informatics and Telecommunications Engineering 2019

Authors and Affiliations

  • Aminah Zawedde
    • 1
    Email author
  • Bernard Engotoit
    • 1
  • Osbert Osamai Omeja
    • 2
  • Peter Kahiigi
    • 2
  1. 1.School of Computing and ITMakerere UniversityKampalaUganda
  2. 2.National Information and Technology Authority of UgandaKampalaUganda

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