Framework for the preservation of medical records in selected public healthcare facilities in Malawi

Abstract

The purpose of this study was to investigate the preservation strategies of medical records at selected public healthcare facilities in Malawi with a view to proposing a framework for the preservation of these records. Through a pragmatic research paradigm, the investigation integrated quantitative and qualitative methodologies, employing a mixed methods approach, to comprehensively comprehend the subject matter. The study targeted 415 healthcare staff from five public healthcare facilities in Malawi. Additionally, documents such as policies, standards, and budget documents were sourced from healthcare facilities as primary data for document analysis. The study employed stratified and purposive sampling techniques, with a sample size of 200 healthcare staff. Data collection methods consisted of questionnaires, interviews, observations, and document analysis. Quantitative data was analysed using IBM’s Statistical Package for Social Sciences, and results were presented through frequencies, percentages, and tables. Qualitative data was analysed using ATLAS.ti, and results were presented through verbatim extracts. This multifaceted approach enabled a nuanced analysis of diverse facets of preservation. The overall significance of the study is in its potential to offer a reshaping policy direction on the preservation of medical records in healthcare facilities in Malawi. By examining the aspects of preservation, the research offered practical insights for policy formulation, institutional strategies, standards and best practices, thereby steering healthcare facilities towards evidence-based medical practice. The study showed that implementation of preservation strategies was inadequate with a lack of metadata for preserving records; lack of relevant policies, standards, procedures, guidelines, and legislation; lack of robust technologies for storage of medical records such as cloud storage, blockchain technology, artificial intelligence, and Deoxyribonucleic acid storage; and low level ofknowledge and skills of staff handling records. The study concluded that the preservation of medical records in the public healthcare facilities in Malawi was somewhat poor. Based on the findings, the study recommends the development of specific policies, standards, guidelines and procedures for preserving records; the Ministry of Health and all relevant stakeholders such as Malawi Liverpool Wellcome Trust and Lighthouse should support healthcare facilities in Malawi in improving its ICT infrastructure; and healthcare facilities in Malawi should support staff to attend short courses, seminars, and workshops on preservation of records.