Abstract:
Background: The electronic community health information system is a mobile platform for
Health Extension Workers in Ethiopia, consisting of a mobile app and a web-based
performance monitoring dashboard. It was introduced to improve data collection and service
provision. However, the level of its utilization remains unknown, particularly among Health
Extension Workers in the East Shewa Zone.
Objective: The aim of the study was to assess the level of utilization and associated factors of
electronic community health information systems among health extension workers in East
Shewa Zone, Oromia, Ethiopia, 2025.
Methods: A facility-based cross-sectional study was conducted from June 30 to August 30,
2025. The study covered all 11 woredas, with 243 HEWs chosen proportionally using simple
random sampling. Quantitative data were collected from HEWs using structured
questionnaires via Kobo Collect, and qualitative data were gathered through 11 in-depth
interviews with supervisors and managers. Data were analyzed using SPSS version 26.
Descriptive and inferential statistics were performed. Variables with p < 0.25 in bivariate
analysis were included in multivariable logistic regression. Adjusted odds ratios (AOR) with
95% confidence intervals (CI) were computed, and p < 0.05 was considered statistically
significant.
Results: Of the 243 HEWs who participated (95% response rate), 70.8% (95% CI: 64.2
75.8%) reported frequent and always use of eCHIS. About 17% reported rare or occasional
use, and 7% had never used the system. Factors significantly associated with higher
utilization included residing in urban areas while working in rural posts (AOR = 0.19, 95%
CI: 0.07–0.51), receiving adequate supervisory support (AOR = 4.88, 95% CI: 1.83–12.98),
and positive perceptions of eCHIS usefulness (AOR = 4.167, 95% CI: 3.642-22.721) and
improved output (AOR =28.059, 95% CI:5.578-141.144) were significantly associated with
higher utilization.
Conclusion: The level of eCHIS utilization among HEWs is high in east shewa. Factor
associated with eCHIS utilization were residence, getting enough support, perception of
eCHIS has improved work output, eCHIS usefulness for their work and continue to use
eCHIS
