Data Warehousing for Optimizing Healthcare Resource Allocation in Botswana
Abstract
Healthcare resource allocation remains a persistent challenge in Botswana, primarily due to inefficiencies in data management that obstruct equitable distribution and evidence-based decision-making. Traditional allocation approaches in Botswana exhibit severe fragmentation, low interoperability, and an absence of real-time data analytics factors that contribute to service delivery disparities, especially in rural and underserved areas. In contrast, developed countries have leveraged data warehousing to optimize healthcare resource planning, offering Botswana a proven yet untapped strategic opportunity. This study designs and validates a context-sensitive data warehouse methodology, applying the Kimball Lifecycle model as the guiding framework. A mixed-methods design was adopted, incorporating qualitative interviews with 24 healthcare practitioners and administrators across public and private health facilities, along with quantitative surveys assessing the state of 12 existing health data systems. Results reveal systemic shortcomings in data accuracy (average error rates of 22%), timeliness (with a median data update lag of 14 days), and accessibility (only 38% of facilities had centralized access). Post-implementation of the prototype data warehouse, significant improvements were noted: data accuracy increased by 47%, data accessibility across departments rose to 85%, and decision turnaround time was reduced by 33%. The warehousing also demonstrated cost-effectiveness, reducing redundant data handling expenses by an estimated 18% over six months. In conclusion, this study presents a robust, scalable, and locally adaptable data warehousing framework that effectively addresses Botswana’s systemic challenges in healthcare resource allocation.
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O. Seitio-Kgokgwe, R. D. Gauld, P. C. Hill, and P. Barnett, “Development of the National Health Information Systems in Botswana: Pitfalls, prospects and lessons,” Online J. Public Health Inform., vol. 7, no. 2, Jul. 2015, doi: 10.5210/ojphi.v7i2.5630.
A. Mabina, B. Seropola, N. Rafifing, and K. Kalu, “Leveraging MANETs for Healthcare Improvement in Rural Botswana,” J. Inf. Syst. Inform., vol. 6, no. 4, pp. 3185–3206, Dec. 2024, doi: 10.51519/journalisi.v6i4.968.
A. B. Nassoura, “Navigating Data Warehousing Implementation in Jordanian Healthcare Sector: Challenges and Opportunities,” South East. Eur. J. Public Health, pp. 85–97, Aug. 2024, doi: 10.70135/seejph.vi.676.
E. P. Kansiime, J. M. Ondulo, and C. O. Odoyo, “Navigating the Interoperability Landscape of Electronic Medical Record Systems in Developing Countries: A Narrative Literature Review,” J. Sci. Innov. Creat., vol. 3, no. 2, pp. 18–25, Sep. 2024, doi: 10.58721/jsic.v3i2.733.
A. Nambiar and D. Mundra, “An Overview of Data Warehouse and Data Lake in Modern Enterprise Data Management,” Big Data Cogn. Comput., vol. 6, no. 4, p. 132, Nov. 2022, doi: 10.3390/bdcc6040132.
O. Seitio-Kgokgwe, R. D. Gauld, P. C. Hill, and P. Barnett, “Assessing performance of Botswana’s public hospital system: the use of the World Health Organization Health System Performance Assessment Framework,” Int. J. Health Policy Manag., vol. 3, no. 4, pp. 179–189, 2014, doi: 10.15171/ijhpm.2014.85.
J. H. Ledikwe et al., “Improving the quality of health information: a qualitative assessment of data management and reporting systems in Botswana,” Health Res. Policy Syst., vol. 12, no. 1, p. 7, Dec. 2014, doi: 10.1186/1478-4505-12-7.
E. AbuKhousa, J. Al-Jaroodi, S. Lazarova-Molnar, and N. Mohamed, “Simulation and Modeling Efforts to Support Decision Making in Healthcare Supply Chain Management,” Sci. World J., vol. 2014, pp. 1–16, 2014, doi: 10.1155/2014/354246.
O. Seitio-Kgokgwe, R. D. Gauld, P. C. Hill, and P. Barnett, “Development of the National Health Information Systems in Botswana: Pitfalls, prospects and lessons,” Online J. Public Health Inform., vol. 7, no. 2, Jul. 2015, doi: 10.5210/ojphi.v7i2.5630.
M. Naeem, W. Ozuem, K. Howell, and S. Ranfagni, “A Step-by-Step Process of Thematic Analysis to Develop a Conceptual Model in Qualitative Research,” Int. J. Qual. Methods, vol. 22, p. 16094069231205789, Oct. 2023, doi: 10.1177/16094069231205789.
S. Seuring, T. Stella, and M. Stella, “Developing and Publishing Strong Empirical Research in Sustainability Management—Addressing the Intersection of Theory, Method, and Empirical Field,” Front. Sustain., vol. 1, p. 617870, Feb. 2021, doi: 10.3389/frsus.2020.617870.
M. Elgeddawy and M. Abouraia, “Pragmatism as a Research Paradigm,” Eur. Conf. Res. Methodol. Bus. Manag. Stud., vol. 23, no. 1, pp. 71–74, Jun. 2024, doi: 10.34190/ecrm.23.1.2444.
V. Kaushik and C. A. Walsh, “Pragmatism as a Research Paradigm and Its Implications for Social Work Research,” Soc. Sci., vol. 8, no. 9, p. 255, Sep. 2019, doi: 10.3390/socsci8090255.
R. Andrews, K. Goel, P. Corry, R. Burdett, M. T. Wynn, and D. Callow, “Process data analytics for hospital case-mix planning,” J. Biomed. Inform., vol. 129, p. 104056, May 2022, doi: 10.1016/j.jbi.2022.104056.
A. Melder, T. Robinson, I. Mcloughlin, R. Iedema, and H. Teede, “Integrating the complexity of healthcare improvement with implementation science: a longitudinal qualitative case study,” BMC Health Serv. Res., vol. 22, no. 1, p. 234, Dec. 2022, doi: 10.1186/s12913-022-07505-5.
R. Gonzales, J. Wareham, and J. Serida, “Measuring the Impact of Data Warehouse and Business Intelligence on Enterprise Performance in Peru: A Developing Country,” J. Glob. Inf. Technol. Manag., vol. 18, no. 3, pp. 162–187, Jul. 2015, doi: 10.1080/1097198X.2015.1070616.
P. Kaur, J. Stoltzfus, and V. Yellapu, “Descriptive statistics,” Int. J. Acad. Med., vol. 4, no. 1, p. 60, 2018, doi: 10.4103/IJAM.IJAM_7_18.
C. Lochmiller, “Conducting Thematic Analysis with Qualitative Data,” Qual. Rep., Jun. 2021, doi: 10.46743/2160-3715/2021.5008.
S. Campbell et al., “Purposive sampling: complex or simple? Research case examples,” J. Res. Nurs., vol. 25, no. 8, pp. 652–661, Dec. 2020, doi: 10.1177/1744987120927206.
M. Hennink and B. N. Kaiser, “Sample sizes for saturation in qualitative research: A systematic review of empirical tests,” Soc. Sci. Med., vol. 292, p. 114523, Jan. 2022, doi: 10.1016/j.socscimed.2021.114523.
K. Vasileiou, J. Barnett, S. Thorpe, and T. Young, “Characterising and justifying sample size sufficiency in interview-based studies: systematic analysis of qualitative health research over a 15-year period,” BMC Med. Res. Methodol., vol. 18, no. 1, p. 148, Dec. 2018, doi: 10.1186/s12874-018-0594-7.
A. H. Amirullah and Y. Anis, “Design and Development of a Data Warehouse for PT. CMS Using the Nine-Step Kimball Method,” Int. J. Softw. Eng. Comput. Sci. IJSECS, vol. 5, no. 1, pp. 141–153, Apr. 2025, doi: 10.35870/ijsecs.v5i1.3453.
P. M. D. D. C. Innecco, “The Implications of Cloud Computing and Big data on the Roadmap towards Business Intelligence,” 2015, doi: 10.13140/RG.2.2.23198.84803.
J. Bisbey, S. H. H. Nourzad, C.-Y. Chu, and M. Ouhadi, “Enhancing the efficiency of infrastructure projects to improve access to finance,” J. Infrastruct. Policy Dev., vol. 4, no. 1, p. 27, Mar. 2020, doi: 10.24294/jipd.v4i1.1175.
G. M. Raj, S. Dananjayan, and N. Agarwal, “Inception of the Indian Digital Health Mission: Connectin. the Dots,” Health Care Sci., vol. 2, no. 5, pp. 345–351, Oct. 2023, doi: 10.1002/hcs2.67.
M. Coube, Z. Nikoloski, M. Mrejen, and E. Mossialos, “Persistent inequalities in health care services utilisation in Brazil (1998–2019),” Int. J. Equity Health, vol. 22, no. 1, p. 25, Feb. 2023, doi: 10.1186/s12939-023-01828-3.
J. Sreedharan et al., “Key Performance Indicators: A Framework for Allied Healthcare Educational Institutions,” Clin. Outcomes Res., vol. Volume 16, pp. 173–185, Mar. 2024, doi: 10.2147/CEOR.S446614.
A. Mabina, N. Rafifing, B. Seropola, T. Monageng, and P. Majoo, “Challenges in IoMT Adoption in Healthcare: Focus on Ethics, Security, and Privacy,” J. Inf. Syst. Inform., vol. 6, no. 4, pp. 3162–3184, Dec. 2024, doi: 10.51519/journalisi.v6i4.960.
A. Babili, S. Nsanzimana, E. Rwagasore, and R. T. Lester, “SMS-based digital health intervention in Rwanda’s home-based care program for remote management of COVID-19 cases and contacts: A qualitative study of sustainability and scalability,” Front. Digit. Health, vol. 4, p. 1071790, Jan. 2023, doi: 10.3389/fdgth.2022.1071790.
E. U. Chika et al., “Digital Healthcare Tools in Nigeria: Strengthening Public Health and Pandemic Preparedness - Insights from the COVID-19 Crisis,” Telehealth Med. Today, vol. 9, no. 1, Art. no. 1, Feb. 2024, doi: 10.30953/thmt.v9.445.
K. G. Chuma and M. Ngoepe, “Policy framework for integrating data interoperability at public hospitals in South Africa,” J. Infrastruct. Policy Dev., vol. 8, no. 15, p. 9200, Dec. 2024, doi: 10.24294/jipd9200.
E. Uwambajimana et al., “Assessment of the use of electronic medical records system and barriers in Rwanda,” Aug. 26, 2024, In Review. doi: 10.21203/rs.3.rs-4763866/v1.
K. Ndlovu, K. L. Mauco, S. Chibemba, S. Wanyee, and T. Oluoch, “Assessment of Stakeholder Perceptions and Attitudes Toward Health Data Governance Principles in Botswana: Web-Based Survey,” JMIR Form. Res., vol. 7, p. e41408, Mar. 2023, doi: 10.2196/41408.
S. Nair, K. Tshabalala, N. Slingers, L. Vanleeuw, D. Basu, and F. Abdullah, “Feasibility of Provision and Vaccine Hesitancy at a Central Hospital COVID-19 Vaccination Site in South Africa after Four Waves of the Pandemic,” Diseases, vol. 12, no. 6, p. 113, May 2024, doi: 10.3390/diseases12060113.
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