Digital Records Arrive at Health Centre IVs, and the Paper Register Refuses to Leave
Clinicians are entering data twice, which is the clearest sign a rollout has outpaced its training budget.
By Dr Ivan Mukisa..Central Uganda.5 min read
Central Uganda. 25 June 2026.
MixedPublic Health
The system works. That is not in dispute at the facilities running it. The dispute is about who has time to use it during a clinic that sees two hundred patients.
Double entry is the symptom
Staff continue to fill the paper register because reporting upward still asks for it, and because a power cut mid-clinic has no paper equivalent of a crash.
"
Give us the tablets and also give us one person whose job is the data. Otherwise it is the nurse's third job.
Clinical officer, health centre IV
Where a dedicated records assistant exists, data quality improves within weeks, which is a staffing finding rather than a software one.
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A staffing gap dressed as a technology rollout
The electronic medical records systems now installed at a growing number of health centre IVs were bought and deployed with training budgets calculated per facility, but clinicians say the training covered software use rather than workflow redesign, leaving staff to fit data entry into a clinic day that was already full before the tablets arrived.
Facilities that have assigned a dedicated records or data assistant, rather than expecting clinical staff to enter data between patients, report noticeably better data completeness within a matter of weeks, according to district health information officers who review facility submissions.
"
Nobody trained us to stop keeping the paper register. So we kept both, and both take time.
Nurse, health centre IV, central Uganda
Ministry of Health officials say the eventual goal is to phase out parallel paper reporting once electronic systems show consistent uptime, including through power interruptions, but district officers say that transition cannot happen responsibly until backup power and offline data capture are reliable at every participating facility.
The rollout's next phase, according to ministry planning documents, includes budgeting for records assistant positions at a wider set of facilities, a change health workers describe as the single adjustment most likely to make the system worth the disruption it has caused so far.
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