| dc.description.abstract | This study was conducted in Kakuma Refugee Camp, Kenya, where the adoption of Electronic
Medical Records (EMRs) in humanitarian healthcare settings is increasingly recognized as a
strategic intervention for improving clinical quality, operational efficiency, and system
accountability. However, implementation in resource-limited environments like Kakuma
remains challenged by infrastructural constraints, limited digital capacity, and workforce
turnover. This study assessed the influence of EMR adoption on four core operational
domains—drug inventory tracking, quality of patient care quality, data security, and report
generation—and their impact on patient recovery outcomes within International Rescue
Committee (IRC) health facilities. Anchored in the Diffusion of Innovations (DOI) Theory,
the Technology-Organization-Environment (TOE) Framework, and Donabedian’s Quality-of-
Care Model, the study employed a quantitative explanatory research design, using structured
questionnaires administered to 53 healthcare workers. Multiple linear regression was used to
determine the predictive effect of each EMR functionality on self-reported clinical outcomes,
including treatment adherence, diagnostic turnaround time, and overall recovery. Findings
revealed that all four EMR functionalities had a statistically significant and positive impact on
patient recovery outcomes. Patient care quality was the strongest predictor (β = 0.881, p =
0.000), followed by drug tracking efficiency (β = 0.640, p = 0.000), data security (β = 0.625,
p = 0.017), and report generation (β = 0.539, p = 0.001). The model explained 62.1% of the
variance in recovery outcomes (R2 = 0.621), indicating a robust model fit. These results
underscore that EMRs are most effective when fully integrated into clinical, pharmaceutical,
administrative, and reporting workflows. Chapter Five concludes that while all functionalities
contribute significantly, their collective value is maximized through alignment with day-to-
day practices, policy support, and user-centered system design. The study contributes to theory
by extending digital health adoption frameworks to fragile healthcare environments and to
practice by identifying functionality-specific priorities for EMR implementation.
Methodologically, it demonstrates the utility of frontline perception data in evaluating digital
system performance where objective health indicators are limited. Policy recommendations
include role-specific training, participatory system refinement, and public–private partnerships
to ensure scalable and sustainable EMR deployment. Future research should incorporate
objective clinical metrics, longitudinal designs, and a broader scope of system functionalities.
Qualitative studies are also encouraged to explore user experiences and support EMR
alignment with operational realities in complex humanitarian contexts. | en_US |
