Abstract
Background
Ghana has over the years implemented interventions to improve on its medicines supply chain. This notwithstanding, significant gaps exist in access to affordable and quality medicines in general, and for non-communicable diseases in particular. The study examined the level and antecedents of use continuance of a digital medicines supply chain system (Med4All) implemented by selected health facilities in Ghana.Methods
Data (sample of 124 survey respondents reinforced with 56 respondents for qualitative interviews) on perceived usefulness, perceived ease of use, expectation confirmation, satisfaction, and attitudes toward use and use continuance intention of the Med4All were analysed via descriptive statistics and structural equation modelling for the survey data and thematic analysis for the qualitative interviews.Results
Results indicate a high level of use continuance intention (3.94 out of 5), perceived usefulness, perceived ease of use, expectation confirmation, satisfaction with, and positive attitudes towards the Med4All system. In addition, perceived usefulness, perceived ease of use, satisfaction, and attitudes toward the use of the Med4All system were key factors associated use continuance intention. More importantly, the speed of transaction turnaround and availability of interest-free loans to health facilities constituted key features that can increase and sustain use continuance. There are however challenges, including delays in deliveries, poor communication between medicines suppliers and health facilities, payment challenges, delays in conducting post-supply surveillance of medicines, and in some cases, the unwillingness of health facility staff to use the Med4All system to procure medicines.Conclusion
Although the level of satisfaction and use continuance intentions are high, failure to address identified challenges can result in increased dissatisfaction and consequently threaten the sustainability and survival of the Med4All system. Stakeholders are encouraged to address existing challenges as a matter of urgency. Additionally, the fast transaction turnaround and availability of interest-free loans, can be used as a major lever to further improve the Med4All system to speed-up adoption by new users and sustain use continuance.