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The e-Kohort application was developed to digitize maternal and child health records, enabling healthcare providers to monitor pregnancies, childbirth, infants, and toddlers more efficiently. By replacing paper-based reporting with electronic records, the system supports faster decision-making and more accurate health monitoring. However, despite its nationwide implementation, challenges such as incomplete data entry, delayed reporting, and inconsistent records continue to limit its effectiveness in primary healthcare facilities. These issues prompted researchers to investigate what determines successful adoption of the application in community health centers across Jambi City.
The study also reflects Indonesia's broader public health challenge. According to the World Health Organization (WHO), most maternal and infant deaths are preventable when healthcare systems are supported by accurate, complete, and timely health information. Although reducing maternal and infant mortality remains one of Indonesia's national priorities under the Sustainable Development Goals (SDGs), Jambi Province continues to report maternal mortality rates above the SDG target, underscoring the importance of strengthening digital health information systems.
To evaluate the factors influencing healthcare workers' acceptance of the e-Kohort application, the researchers employed the Human, Organization, and Technology Fit (HOT-Fit) framework. This internationally recognized evaluation model examines the success of health information systems by considering three dimensions: technology, human factors, and organizational support.
The research adopted a quantitative cross-sectional design involving 78 healthcare workers from all community health centers (Puskesmas) in Jambi City who actively use the e-Kohort application. Data were collected through validated and reliable questionnaires and analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) with WarpPLS version 8.0.
Technology Emerges as the Strongest Driver
The findings reveal that technology-related factors are the strongest determinants of healthcare workers' acceptance of the e-Kohort application.
Key findings include:
Technology factors significantly influenced application acceptance (β = 0.500; p = 0.001).
Human factors, including perceived usefulness and user satisfaction, also had a significant positive impact (β = 0.430; p = 0.001).
Organizational factors showed no statistically significant direct effect on application acceptance (β = 0.027; p = 0.404).
The researchers also found that their model explained 74% of the variation in healthcare workers' acceptance of the e-Kohort application, indicating that technology quality and user-related factors account for most of the success in implementing the digital health system.
Accurate Information Is the Most Valued Feature
Among all measured indicators, information quality received the highest average score (4.12), suggesting that healthcare workers consider the e-Kohort application capable of producing accurate, complete, and relevant information for maternal and child healthcare services.
Other indicators also received positive evaluations:
Information Quality: 4.12
User Satisfaction: 4.09
Organizational Environment: 4.07
Service Quality: 4.05
Organizational Structure: 4.05
Perceived Benefits: 4.04
System Quality: 3.97
Overall, respondents expressed positive perceptions of the application across all evaluated dimensions.
According to Ghinanissa Azzahra Dustar and Bella Dwisiswanarum of Universitas Adiwangsa Jambi, high-quality information increases healthcare workers' confidence in the application while improving the accuracy of recording, reporting, and clinical decision-making. Users also reported that the application enhances work efficiency and simplifies maternal and child health data management.
Organizational Support Alone Is Not Enough
One of the study's most interesting findings is that organizational support alone does not directly influence healthcare workers' willingness to use the e-Kohort application.
Although respondents acknowledged support from health center management, leadership commitment, organizational policies, and workplace resources, these factors did not significantly increase application acceptance. The researchers suggest that because e-Kohort has become a routine component of maternal and child healthcare services, users evaluate it primarily based on its usefulness, ease of use, and technical performance rather than organizational conditions.
Nevertheless, the study emphasizes that continuous training, technical assistance, monitoring, and regular evaluation remain essential to ensure the long-term sustainability of digital health information systems.
Implications for Indonesia's Digital Health Transformation
The findings provide valuable insights for Indonesia's Ministry of Health, regional health offices, and community health center administrators seeking to strengthen digital healthcare services.
The researchers recommend prioritizing:
Continuous improvement of system and information quality.
Responsive technical support for healthcare workers.
User-centered training programs.
Strategies to improve user satisfaction.
Regular monitoring and evaluation to ensure long-term system sustainability.
By focusing on these priorities, Indonesia can maximize the effectiveness of the e-Kohort application, improve the quality of maternal and child health data, and support national efforts to reduce maternal and infant mortality through evidence-based healthcare services.
Author Profile
Ghinanissa Azzahra Dustar is a researcher at Universitas Adiwangsa Jambi whose research focuses on health information systems, digital health transformation, and healthcare technology evaluation.
Bella Dwisiswanarum is an academic at Universitas Adiwangsa Jambi specializing in public health, health information management, and digital healthcare system development.
Research Source
Article Title: Determinants of Healthcare Workers' Acceptance of the e-Kohort Application
Authors: Ghinanissa Azzahra Dustar, Bella Dwisiswanarum
Journal: International Journal of Education and Psychological Science (IJEPS)
Volume: 4, Issue 4 (2026)
DOI: https://doi.org/10.59890/ijeps.v4i4.24
Journal Website: https://journalijeps.my.id/index.php/ijeps
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