Healthcare Providers’ Experiences and Perspectives on the Use of Electronic Health Record System-ULTRA for Maternal and Perinatal Care in Kilimanjaro, Tanzania. A qualitative study

Introduction: Sub-Saharan Africa faces challenges in collecting maternal and perinatal data due to poor documentation in paper-based systems and inadequate infrastructure for digital utilization. An electronic health record system (EHRS)-ULTRA was developed and piloted in the Kilimanjaro region from October 2022 to August 2024 to improve data management. This study explores experiences, perceived utility, barriers, and facilitators among healthcare providers. Methods: The study used a qualitative, exploratory, descriptive design to examine healthcare providers’ experiences and perceived utility of using EHRS-ULTRA in Kilimanjaro, Tanzania. Data were collected through key informant interviews (KIIs) and focus group discussions (FGDs). Participants were purposively selected from two districts representing urban (Moshi Municipal) and rural (Moshi District), including reproductive and child health coordinators, facility managers, and healthcare professionals from Antenatal Care, Labor and Delivery, and Postnatal Care departments. Data were analyzed using reflexive thematic analysis.Result: A total of 35 participants took part, including 29 healthcare providers (FGDs) and 6 health managers (KIIs). The study identified four themes related to EHRS-ULTRA in maternal and perinatal healthcare services: user experience, clinical decision-making, factors encouraging adoption, and challenges making adoption harder. User experience is crucial for exploring and delivering timely services, improving care, streamlining processes, and enhancing data quality. Clinical decision-making is supported by access to patient history, care tracking, and notification of potential danger signs. Leadership participation and compliance with the Mfumo wa Taarifa za Uendeshaji wa Huduma za Afya (MTUHA) book are key factors in promoting the rollout of EHRS-ULTRA. However, challenges such as electricity, unstable internet, human resource capacity, and government preparedness for scaling hinder the adoption of EHRS-ULTRA.Conclusion: Healthcare professionals have identified EHRS-ULTRA as a valuable tool to support clinical decision-making, continuum of care, and timely service delivery, thereby improving the quality of maternal and perinatal healthcare services. Client data continuity, referral management, and effective scale-up are all enhanced by interoperability and integration of the current EHRS platform technologies. However, resource constraints and health system readiness continue to pose significant challenges.