Health workers’ adoption of digital health technology in low- and middle-income countries: a systematic review and meta-analysis
Minmin Wang, Kepei Huang, Xiangning Li, Xuetong Zhao, Laura Downey, Sondus Hassounah, Xiaoyun Liu, Yinzi Jin, Minghui Ren
Abstract
Objective: To conduct a systematic review and meta-analysis of the facilitators of and barriers to the acceptance and use of digital health technology by health workers in low- and middle-income countries. Methods: We searched several databases for relevant articles published until 25 April 2024. We extracted data on four unified theories of acceptance and use of technology factors (performance expectancy, effort expectancy, social influence and facilitating conditions) and six additional factors (attitude, habit, incentive, risk, trust and self-efficacy); how these affected the outcomes of behavioural intention and actual use; and the strength of association if reported. We conducted a meta-analysis of the quantitative studies. Findings: = -0.14, 95% CI: -0.29 to 0.01) as the primary barrier to both outcomes. Conclusion: Our approach of clustering the facilitators of and barriers to the acceptance and use of digital health technology from the perspective of health workers highlighted the importance of creating an enabling ecosystem. Supportive infrastructure, tailored training programmes and incentive policies should be incorporated in the implementation of digital health programmes in low- and middle-income countries.