Adoption of Electronic Medical Records Among Health Workers in Selected Public Health Facilities in Banaadir, Somalia

Background Electronic Medical Records (EMRs) have emerged as vital tools for enhancing the quality and coordination of healthcare services worldwide. By providing convenient access to patient history, reducing medical errors, and streamlining workflow, these digital systems can significantly improve overall patient outcomes. However, in many developing countries—including Somalia—adoption of EMRs remains slow and inconsistent. Specifically, public health facilities in regions like Banaadir continue to face structural, technical, and organizational barriers that inhibit the rapid and widespread utilization of these technologies. Objectives The broad objective of this study was to assess the level of adoption of EMRs among health workers in selected public health facilities in Banaadir. The specific objectives of the study were: To determine the socio-demographic characteristics, technological factors and health system factors associated with adoption of EMRs. Methodology A descriptive cross-sectional research design was adopted to provide a snapshot of EMR use in selected Banaadir public hospitals. The study population comprised doctors, nurses, laboratory technicians, and administrative staff who regularly handle patient records. A sample of 150 respondents was drawn using stratified random sampling to ensure representation from each professional cadre. Quantitative data was collected through structured questionnaires. Descriptive statistics were used to determine frequencies, means, and standard deviations. As for inferential statistics, χ2 test was used to determine the association between independent variables and EMR adoption. Key Findings The study achieved a high response rate of 88.9% (n=80). EMR adoption was significantly influenced by age (p=0.001; Cramer’s V=0.284), with younger health professionals more likely to adopt the systems. Educational level also played a crucial role (p=0.001; Cramer’s V=0.292), as those with higher academic qualifications exhibited higher usage. Furthermore, the frequency of software usage showed a strong positive correlation with adoption (p=0.001; Cramer’s V=0.284), demonstrating that routine interaction with digital systems promotes familiarity and integration into clinical workflows. Regarding institutional factors, the extent of EMR implementation within hospitals significantly impacted adoption (p=0.013; Cramer’s V=0.328). Facilities with complete or partial EMR systems reported higher staff uptake compared to those without implementation. Notably, 61.3% of respondents indicated that their hospitals operated under a hybrid model combining paper-based and electronic systems, signalling ongoing digital transition. Most respondents (82.5%) reported basic computer literacy, while 81.3% had previous exposure to EMR systems. However, technological barriers persist. Limited availability of EMR software (Mean=2.44, SD=1.20), concerns over data privacy and internet connectivity (Mean=2.57, SD=1.18), and inconsistent technical support were highlighted as major impediments. Despite these challenges, a majority expressed positive perceptions of EMRs, particularly in enhancing data management and patient care. Conclusion This study highlights a critical disconnect between the recognized benefits of EMRs and their actual implementation in routine healthcare practice within Banaadir’s public hospitals. While health workers acknowledge the value of digitized records, widespread adoption is constrained by systemic issues such as limited ICT infrastructure, insufficient technical support, and individual challenges like digital illiteracy and resistance to change. As a result, the full potential of EMRs to improve patient care, streamline clinical workflows, and support data-driven decisions remains largely untapped. Addressing these challenges will require coordinated, multi-level strategies—strengthening infrastructure, investing in capacity-building, and cultivating a policy environment that actively supports digital transformation. Without these efforts, EMRs will continue to fall short of delivering their intended impact on Somalia’s healthcare system. Recommendations To improve EMR adoption in Banaadir’s public health facilities, key actions are needed. First, provide regular digital literacy training tailored to different professional and age groups to build user confidence and competence. Second, invest in reliable ICT infrastructure, including stable internet, hardware, and on-site technical support. Full implementation of EMR systems in all hospitals should be prioritized, as partial or no implementation limits adoption. Additionally, policies that promote digital acceptance and accountability should be introduced. Collaboration between government, health institutions, and partners is essential to create a supportive environment for sustained EMR integration.