Background: Health information systems (HIS) are considered a vital tool to strengthen Low- and Middle-Income Countries’ (LMIC) health systems. Unfortunately, little is known about the technical factors of HIS in LMIC. Objective: This study aimed to make an empirical contribution, using the case of Kosova to find out about HIS development, trying to identify dysfunctional areas and opportunities for improvement. Methods: Technical factors of the PRISM framework were analyzed via document analysis, and semi-structured interviews were held with 15 respondents from the Ministry of Health, the National Institute of Public Health of Kosova, and the Hospital Clinical University Services of Kosova. Interviews were transcribed and coded deductively, using the defined theoretical framework to guide the content analysis. Results: The results indicate that MoH considered technical factors while developing HIS in Kosova. Nevertheless, HIS fulfills only some of the essential functions. Barriers to efficient HIS among technical factors are lengthy, time-consuming manual HIS forms, inadequate data from HIS forms for NIPHK analysis, difficulties when changing software and HIS economic operators, and the complexity of HIS functioning. Conclusion: Kosova still faces technical difficulties with an efficient and sustainable HIS system. Complex processes of extensive efforts have yet to produce the desired results, which prevent evidence-based health analysis and informed decision-making in Kosovar healthcare. More research is needed into organizational and behavioral factors influencing HIS efficiency in LMIC.
Key words: Health information systems, technical factors, developing countries, Kosova.
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