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Top1. Introduction
In recent years, many developing countries are increasing the use of information and communication technology (ICT) solutions to improve service delivery (Ponelis & Holmner, 2015). This include e-governance (Dasgupta, 2013) and e-health system (Shaanika, 2016). E-health refers to medical services that are provided and received electronically including over the Internet (Eysenbach, 2001). It is applied regionally and globally to promote the use of ICT solutions and to advance healthcare services. The e-governance entails the use of ICT to design a more effective government-to-consumer (G2C) or consumer-to-government (C2G) systems, which encompasses committed leadership, accountability, and evaluation mechanism (Kalsi & Kiran, 2013).
The e-health entails all health-related services that are delivered through ICT systems, that is, health information systems, data capturing and analytics as well as electronic health records (Barbabella et al., 2017). Ariani et al. (2017) highlight that e-health systems are intended to help healthcare professionals in achieving improvement of healthcare quality that they provide to the citizen. Bhatia (2014) suggests that the use of ICT solutions in health sector focuses on improving three main areas, namely, healthcare information systems for better access and management of information related to health; better diagnosis for improved treatment; and communication for better interaction among health workers and the general public. A successful implementation of e-health leads to improvements in healthcare areas such as enhanced healthcare services, availability and access, improved health quality and safer outcomes, and enables better evidence-based decisions in health planning (Odhiambo, 2015). E-health has been beneficiary to many countries particularly the developed countries (Mugo & Nzuki, 2014). However, the same cannot be said about developing countries (Luna et al., 2014), such as Namibia (Iyamu & Hamunyela, 2014).
Namibia is faced with fragmented e-health system (Dlodlo & Hamunyela, 2017). Nengomasha et al. (2018) reported that the fragmentation of the e-health system in Namibia results to duplication of diagnoses, medical tests, and treatments of health conditions. Subsequently, this has led to poor service delivery by health facilities to the communities. This is a major issue being faced by most developing countries. Owing to similarities of many countries in Africa, they can benefit from successful case studies, which do not seem to exist currently. Fanta and Pretorius (2018) state that e-health implementation efforts in developing countries are fragmented because of pressure from donors, economic and political factors. This is a challenge that could be addressed through e-health integration with the e-governance, by first understanding the influencing factors.
Due to the premise of the e-governance, many countries in Africa such as Ghana, Nigeria, Rwanda, South Africa, and Zambia have either proposed or deployed the concept (Kyem, 2016; Twinomurinzi, Phahlamohlaka & Byrne, 2012; Bwalya, 2009). Singh et al. (2010) explored how the concept of e-governance can be employed to improve service delivery. One of the advantages of e-governance is that it enables citizens’ better and ease of access to government services in the shortest time (Gupta et al., 2018). Also, it increases response time to citizens, and creates opportunity for responsibility and accountability, which ultimately, promotes transparency (Dhindsa et al., 2013). In addition, the e-governance removes the physical barrier of citizens travelling long distances to access government services.