In order to evaluate the importance of computers in their day-to-day activities, respondents were asked to rate the usefulness of acomputer for supporting their daily work. The findings (see Chart 5.5) revealed that just over half of the respondents who used computers 41 (56.1 %) declared that they were very useful. Surprisingly, despite using computers 2(2.1 %) respondents said computers were not useful.
were very satisfied and appreciated the usefulness of a computer to support their daily activities.
One of the reasons put forward by the medical professionals for the low utilisation of computers was lack of equipment and training. It was discovered that some medical professionals have acquired basic computer training on word- processing and other programmes, but that this training had been obtained on apersonal basis. The major suggestion put forward to encourage and motivate medical professionals to use computers was the provision of a general computer centre equipped with computer auxiliaries.
Discussion
The underpinning objective of this section was to examine the extent to which ICTs (computers and computer auxiliaries) were used in the management of health information. By ICTs, the researcher is referring to the use of computers and Internet resources, in capturing, processing and disseminating health information. Computers and Internet facilities offer their users numerous advantages such as speed, consistency, precision and reliability. Under the right circumstances computers have the capabilities to enhance efficiency, in the sense that they can store and process very large quantities of data and information and provide multiple access to timely, relevant, accurate and reliable information to planners, decision makers, administrators and health professionals.
The extent to which medical professionals are able to use computers has a potential bearing on the efficiency in their work. For example, the availability and use of computers that are linked with communication software makes it possible for computers to network with other computers, share and exchange ideas and resources and provide Web access.
With such anetwork, medical professionals would be able to confer with each other by holding an electronic discussion via e-mail, or send a single message to numerous recipients who comprise an identifiable interest group.
The creation of acentral network depends, amongst other things, on the medical professionals' ability and willingness to use computers comfortably. In terms of the potential of computers in the health sector, such as the hospital, Wilson and Smith, in Wilson (2000: 199), point out that "the creative use of computer technology is one of the most promising means of improving the quality, timeliness, clarity, presentation, and use of relevant information" to improve health care delivery. Rowley (1993:113) added that the role of information technology, particularly the personal computers, as a means of facilitating information handling, is necessary to move straight into effective and appropriate solutions to some of the problems of information storage and retrieval. Because computers have the advantage of storing large amounts
of health data, quick updates and analyses of specific diseases or health facilities with graphs and trends can be provided.
Among others, Kanamugire (1998:137) cautions that one of the major factors that hinder the use of ICTs in some African countries are the costs involved in acquiring the equipment, both hardware and software, and its installation, connectivity and maintenance once provided. This is due to the fact that the equipment is manufactured outside the continent, ipso facto rendering it expensive. The cost involved in installing an adequate computer centre is often beyond the budget of most health institutions (Maele 2002:5). Besides being connected and having access to equipment and infrastructure, formal skills are also required (Chisenga 2000) and these skills are not imported.
The present study revealed that the hospitals surveyed do not have sufficient ICT equipment such as computers.
Those that are available are reserved for senior staff members and mostly used for administrative purposes or activities. Furthermore, there is low usage of the computers that are available. It was therefore suggested that hospitals should provide training on ICTs to all medical staff in order to overcome the non-usage of computers by medical professionals. Although the results show a low usage of computers in the hospitals surveyed the vast majority of respondents appreciated the usefulness of a computer to assist them in their daily activities.
Some of the medical personnel have taken the initiative to train themselves. Furthermore, it was also observed that computers at the hospitals surveyed were, as mentioned, used mainly for administrative purposes. That is, computers are found at the secretariats of the director, or the office for the chief of administrative affairs. Meanwhile, some strategic offices, such as the hospital's statistic office, general consultation, pharmacy and reception, where the hospital's bills are paid, do not have computers. That is, the activities/operations done in these offices are done manually. As a result, simple operations often take longer than expected. For instance, at the Yaounde Central Hospital, it is common to see long queues in front of the pharmacy and the general reception as people queue to buy medications and to pay their hospital bills. Below is an excerpt of informal discussions with a nurse and a patient lamenting their frustrations on the state of activities at the hospital.
...can you imagine that the Yaounde Central Hospital, being one of the biggest hospitals in Yaounde, has no computer in the pharmacy? From personal observation, an average of 100 people come to the pharmacy to buy drugs and the average number of medications bought by each person is three. The most frustrating process of my job is that for every medication, I have to establish a pro-forma invoice. That is why there is always avery long queue in front of the pharmacy at every moment of the day. Meanwhile, at the Ministry of Public of Health, there are at least two computers
In another conversation with a patient who came to the hospital for consultation:
"... 1arrived at the hospital at7:00 am and it is getting to 10:00 am I have not been able to see a doctor. I was informed by the nurse attendant at the reception that my file has been carried to the archive.
Unfortunately, the nurse who works at the archive is not available... " (Ngock2002).
These activities could have been done efficiently and effectively with a computer (Wilson and Smith, in Wilson (2000:199)).
From the findings on the use of computers, two important issues emerged. Firstly, there is a lack of ICTs (computers and Internet resources) in the hospitals surveyed. Secondly, the question of computers being reserved for directors and/or senior medical staff is important. These issues can be attributed to the fact the hospitals' directors and officials have not yet acknowledged the importance of information, in general, and health information, in particular, as an important resource that should be made available to every individual and, most particularly, to the medical professionals. The presence of timely information would enable medical professionals and decision-makers make rational and wise decisions. Since the directors have not yet accepted information as an important resource to support decision-making, providing the necessary ICT tools to facilitate the management of information might seem difficult to accomplish.