Strengthening the Public Health Management System (PHMS) Through the Integration of Healthcare Systems in Lesotho

The research aims to show that the integration of Information Technology (IT)-based healthcare information systems across healthcare facilities is a strategy that can strengthen the digital Public Health Information Management System (PHIMS) for Lesotho. The problem is that the delivery of healthcare services is not integrated and, therefore, is risky to patients. Three research questions guided the study: a) To what extent do the challenges encountered by healthcare professionals during the provision of care, affect the quality and safety of care? b) What are the appropriate critical success factors for a PHIMS to ensure efficiency? c) How could the policy/legal framework be formulated to effectively regulate the implementation of a PHIMS to ensure its efficiency? A case study design was adopted to conduct the research, where data were collected through interviews and a focus group meeting.
The Purposive Sampling Method was used to select the research participants to ensure that full insights regarding the healthcare services delivery would be gathered from experienced participants. Notably, due to the COVID-19 pandemic, interviews and focus group deliberations were conducted virtually. Data analysis was performed using thematic analysis techniques, in which after data were transcribed, similar phrases and ideas were categorised into codes, which were further clustered into themes, which were used to interpret the phenomenon under study.
Moreover, the findings reveal that firstly, the challenges encountered by healthcare professionals during the provision of care that compromise the safety and care of the patients are poor management of medical records, unavailability of historical data, and poorly designed Health Information Systems (HIS). Secondly, the critical success factors for an efficient PHIMS are good management of patient records, patient-oriented HIS, and functional HIS. Lastly, the findings indicate that a legal/policy framework is needed to regulate the implementation of a PHIMS and to provide policy guidance for smooth implementation.
Consequently, the research recommends that healthcare facilities migrate their patients’ medical records from paper-based to electronic. Moreover, a legal/policy framework must be developed to regulate and provide policy guidance for the implementation of the PHIMS. Furthermore, the research recommends a future study to determine how artificial intelligence can support the envisaged PHIMS to enhance healthcare services delivery and medical research.