Digital Health and Data Utilisation for Improved Primary Health Services Delivery: Multi-Site Perspectives from Quality Improvement Teams in Council Hospitals in Tanzania

Abstract

Abstract Background Digital health plays an indispensable role in facilitating data analysis and use for enhancing healthcare delivery across health settings. However, there is scant information on the extent to which digital health influences the improvement of primary health services delivery through data use. This study examined the determinants that influence the use of digital health to improve health service delivery in council hospitals in Tanzania. Methods A cross-sectional design was employed in six regions, involving 12 council hospitals. We used a self-administered questionnaire to collect data from 203 members of hospital quality improvement teams. Descriptive analysis was used to determine the frequency, proportion, and mean of responses, while bootstrapping analysis was conducted to test the statistically significant influence of digital health factors on data use for improving health service delivery. Results Results show moderate agreement on data compatibility for planning and decision-making, with 40.4% of respondents agreeing it supports ordering commodities, 43.8% for staff allocation, and 38.4% for planning. However, dissatisfaction was higher for user-friendliness (47.8%), reliability (up to 65.5%), and usefulness (up to 63.5%). Overall, 50.2% (M=2.74±0.87) disagreed that digital systems effectively support data use. Structural model analysis confirmed significant positive influence of usefulness (β=0.199, p<0.001) and access to quality data (β=0.729, p<0.001) on data use, which strongly impacted service delivery (β=0.593, p<0.001), despite some factors showing no direct influence. Conclusion The study finds that current digital health initiatives only modestly improve the user-friendliness, reliability, and usefulness of data systems, partly due to fragmented, non–interoperable platforms that burden data management. However, compatibility, usability, reliability, and usefulness of digital tools significantly enhance access to quality data and data-driven decisions. The study recommends strengthening and integrating existing systems and providing continuous digital health training to institutionalize data-informed decision-making.