Abstract

The successful adoption of Health Information Systems is fundamental to improving efficiency, accountability, and decision-making in public healthcare, particularly in low and middle income countries. This study investigates the determinants influencing the implementation of the Government of Tanzania Hospital Management Information System. Drawing on an integrated theoretical framework comprising the Unified Theory of Acceptance and Use of Technology, the DeLone and McLean IS Success Model, and the Diffusion of Innovations theory a cross sectional survey was conducted involving 406 healthcare professionals from four public hospitals in Tanzania. Using Exploratory Factor Analysis and Structural Equation Modeling, the study validated 7 out of 13 hypothesized relationships. Information quality, service quality, system use, communication, compatibility, behavioral intention, and trialability emerged as significant predictors of system implementation. In contrast, constructs such as effort expectancy, user satisfaction, and facilitating conditions showed no statistical significance. The study concludes that institutional and infrastructural enablers outweigh individual perceptions in influencing HIS adoption. Recommendations include enhanced investment in ICT infrastructure, structured pilot testing, continuous user training, and policy reinforcement to support nationwide Health Information Systems integration in public healthcare delivery.

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