Barriers in health information systems and technologies to support maternal and neonatal referrals at primary health centers

Objectives: This study explored health workers’ perceptions and experiences regarding the maternal and neonatal referral system, focusing on barriers of health information systems and technologies (IS/IT) at primary health centers (PHCs) in South Tangerang, Indonesia. Methods: This qualitative study was conducted using semi-structured interviews, which were conducted at the South Tangerang District Health Office and three PHCs. Interviews were conducted with nine participants responsible for maternal and neonatal referrals in their organizations. The data were analyzed using qualitative content analysis. Results: In South Tangerang, the Primary Health Care Information System (SIMPUS) is used to register patients and record data on medical treatment. To facilitate referrals, the PHCs currently use the Integrated Referral Information System (SISRUTE), P-Care, and the Integrated Emergency Management System (SPGDT). The following four IS/IT barriers to support maternal and neonatal referrals were found: technology, human resources, organizational support, and the referral process and implementation. Conclusions: The barriers in technology, human resources, and organizational support cause problems in the maternal and neonatal referral process and in the implementation of referrals. Barriers to referrals can influence patients’ ability to receive appropriate care in a timely fashion and lead to inefficiency in maternal and neonatal referrals. This study contributes knowledge about IS/IT implementation in maternal and neonatal referral systems and provides recommendations to health regulators and application developers for the implementation of IS/IT in Indonesia.