Assessing the Long-Term Impact and Sustainability of the Zambia Electronic Perinatal Record System (ZEPRS) in Strengthening Maternal and Neonatal Healthcare

Abstract

This study evaluated the sustainability and long-term impact of the Zambia Electronic Perinatal Record System (ZEPRS) on enhancing maternal and neonatal health service delivery in the Lusaka District. The study aimed to determine the impact of ZEPRS on clinical outcomes, the improvement of healthcare workflows, and whether it can be scaled up and sustained. Through inferential and descriptive statistics such as chi square tests and logistic regression, the study revealed that ZEPRS has enhanced patient monitoring significantly, improved clinical practice, and informed decision-making by practitioners. Extensive system use was strongly associated with perceived effectiveness, confirming the potential of electronic health tools to support service delivery if effective implementation into daily work.

Despite these challenges, the study identified challenges facing long-term sustainability. These include limited digital infrastructure, power disruptions, access problems with the internet, lack of training, and over-reliance on donors. These were found to be statistically significant predictors of sustainability problems among users of the system. Endorsement by stakeholders for replication of ZEPRS across the country is general but qualified in terms of stronger domestic investment, improved infrastructure, continued capacity development, and institutional ownership.

The studies recommend the inclusion of ZEPRS in the national health budget, digital infrastructure investments, institution-based training of users, and interoperability with other health systems. Public-private partnerships, user-centered design, and robust data protection policies are also recommended. Additional studies will have to target the adoption of ZEPRS in rural areas, a comparison of costs and benefits with paper-based systems, and community opinions on adopting digital health. Overall, the findings suggest that ZEPRS can be scaled and sustained across Zambia by a coordinated, multi-sector effort that combines technology, policy, finance, and human capacity.