CHAPTER SIX
6.2 CONCLUSIONS
This study has shown the nature of one of the major problems faced by medical professionals in six government hospitals in Yaounde, Cameroon, namely, access to information and the use of ICTs in the management of health information. This is manifested in the following: lack of health information, shortage of ICT equipment and auxiliaries, low usage of ICT tools (computers and Internet resources), the lack of knowledge on Internet services. The non- availability of ICT equipment and low usage and connectivity of ICTs has atremendous effect in the manner in which information is managed in the government hospitals surveyed as little amount of information is generated and fewer information needs are satisfied. Lack of adequate skills and knowledge on the use of ICT equipment point to the need to provide ICTs training to medical professionals.
The study further revealed that health information is captured, processed, stored and exchanged manually as there is limited ICT equipment such as computers. The computers that do exist are not used for the management of information. There is no Internet connectivity in the hospitals surveyed and low usage of Internet services generally by medical professionals (Internet usage which does take place, takes place outside of the hospitals). Hence, information is poorly captured, processed, stored, exchanged and used. Thus, information is not properly managed.
What also emerged from the study is that there are no laid-down principles to manage information and there is a lack of relevant health information due to a lack of health information activities. When health information is managed (captured, stored and exchanged or disseminated), this is mostly done on an ad hoc basis. In other words, information management by medical professionals in the surveyed hospitals in Yaounde is a sort of "hit and miss" activity.
From informal discussion with nurses, it was revealed that there is no culture of teamwork and information sharing
the researcher, aculture with little or no teamwork or information sharing is characterised by high information secrecy.
Given the results obtained, it may suffice to conclude that the application of ICTs by medical professionals in the management of health information in government hospitals in Yaounde is poor. In view of the research findings and ideas emanating from other studies examined during the review of related literature, the following specific conclusions are made.
6.2.1 The state of information and information management
This study revealed a general absence of relevant health information and a lack of information activities. These situations, whereby medical professionals are constantly in desperate need of adequate information, do exist in other developing countries. Studies by Musoke (2000:196), Pakenham-Walsh (2003) and Apalayine and Ehikhamenor (1995:369) have confirmed similar experiences from other in developing countries. From these studies, and the present one, an interesting observation that emerged is the similarity of likely explanations for the poor state of health information in these hospitals.
One major explanation for the poor state of information is the lack of awareness of the importance of information in the development of Cameroon. As a result, information related activities are marginalised or sidelined from the country's budget. Thus, library and information services are poor and those that exist have deteriorated due to alack of funds.
An example at hand is the Medical Library of the Faculty of Medicine Yaounde I that runs on an annual budget of 600 000 FCFA. This is approximately 1000 US dollars, at an exchange rate of 1USD: 600 FCFA (Andong 2002). During informal discussion with General Directors of the hospitals surveyed, the researcher enquired what percentage of the hospital's budget is spent on information-related activities. Surprisingly, from all the directors, there is nothing allocated to information-related activities (provision of ICT equipment such as computers and auxiliaries and Internet connectivity) in their budgets.
Formulating a national information policy and ensuring its effective implementation is a sign of recognising the importance of information. Hence, the allocation of an adequate budget, the appointment of trained and qualified information specialists to manage and co-ordinate information related activities in the government hospitals will:
• enhance proper management of information;
• increase the processes of generating information;
• improve information support activities; and overall
• improve the quality of health care delivery.
6.2.2 The level of ICT use
Another concluding observation that is important is the amount of ICT equipment (computers and Internet resources) for the management of information. in the hospitals surveyed, the study revealed a lack of ICTs and the level of ICTs usage was as a consequence low.
The advantages derived from the use of ICTs by medical professionals are numerous. information management processes can be enhanced and this would increase both the quality and quantity of accessed information, empowering both organisations and people and improving the quality of health services provided.
Since there are limited ICTs available in the hospitals usage is low as earlier indicated. Thus the volume of information generated and exchanged is equally low. This implies fewer information needs are met. It could be concluded that unless the level of ICT equipment is increased to access and generate relevant health information, the quality of health care delivery in the government hospitals surveyed will not be what it should. The need to provide ICTs to medical professionals ranked second on the list of recommendations put forward by respondents to improve the management of information.
6.2.3 The level of ICT education and training
Emerging from 6.2.2 above is the urgent need to provide ICT training to medical professionals in the hospitals surveyed. Effective use of ICTs presupposes that adequate training has been undergone. From the study, the findings revealed there is a great need to provide training on the use of leTs to medical professionals. It is concluded, therefore, that training and education on the use of ICTs, are essential to guarantee the use of ICTs and Internet resources in order to provide relevant information and hence improve the quality of health care services among medical professionals in the hospitals surveyed. The need to provide ICT training and education to medical professionals ranked first on the list of recommendations put forward by respondents to improve information management. This indicates the magnitude of the problem.