Assessing The Role Of Electronic Procurement Adoption In The Ghanaian Public Hospitals

The last decade has witnessed significant changes in the public procurement operations and management of public hospitals in Ghana.The public hospitals rank among the top public sectors regarding revenue generation and employment.The healthcare industry is one of the fastest growing industries in Ghana with an estimated market contribution of nearly GHC 6.5 billion.With respect to the exponential growth in demand for safe management and treatments of diseases at an economical price or overestimating cost of running healthcare services,the sector needs to gear up to support growth that matches both local and international demands.As a result,procurement specialists have legitimized the relevance of the public procurement law and practices in Ghana.The procurement analysts have also given ample evidence and assessment on the level of compliance of the public procurement act 2003(Act 663)by public hospitals in Ghana.It is worthwhile,that this evidence has led to an outline of proposals to enhance speed,compliance and relevance of the public procurement Act 663(2003).However,there is dearth of studies on the nature of public procurement of goods and services in specific organizations,sectors and industries in the context of information technology(IT)or information systems(IS)on the role they play on the performance of public hospitals in Ghana.The lack of an e-procurement system in public hospitals have affected public procurement performance for the effective delivery of healthcare services to their customers.Nevertheless,most public procurement studies have scanty information concerning public hospitals in Ghana and thus they omitted the provision of public knowledge on the use of e-procurement in the public hospitals,particularly for products or services that require the use of information systems(IS)for the speedy delivery of hospital items,and for better products procurement performance in the public healthcare sector.In ensuring effective and efficient delivery of healthcare to the public hospital's customers,the adoption of an e-procurement system is essential for the ten regional public and teaching hospitals in Ghana.This study explored the extent to which the e-procurement system could support the elimination of some core challenges confronting the ten regional public and teaching hospitals in Ghana.Some of the extant literatures reviewed in the course of the study were full of models that promotes the use of information technology systems on decision adoption on e-procurement in others regions of the world.However,studies on e-procurement adoption in the public hospitals in the developing countries milieu have not been explored.To bridge this gap in the current literature,this study applied the theories of technology acceptance model(TAM)and technology organization&environment(TOE)to investigate the role of e-procurement adoption in the ten regional public and teaching hospitals in Ghana.The TAM was extended by incorporating trust,compatibility and technical support and training on user's intention to adopt e-procurement technology.Whilst,the TOE model was also employed to assess the adoption decision of e-procurement in Ghanaian public hospitals.The study explored the use of e-procurement system and procurement practices on the perceived performance of the ten regional public and teaching hospitals using SMART PLS.The proposed models used in the study were tested through quantitative methods.In order to investigate the causal relationship between independent variables on the dependent variable(e-procurement adoption),a structural equation modeling and logistic regression were employed to analyze the data.A sample size of 490 respondents were selected across the ten regional public and teaching hospitals in Ghana.A survey questionnaire was administered to procurement professionals in the ten regional public and teaching hospitals.The study focused on the procurement professionals/IT specialists operating in the ten regional public and teaching hospitals in Ghana who plays key roles in the procurement of goods and services for the ten regional public and teaching hospitals.The respondents also consist of departments such as procurement,stores and supply chain managers.The study used a questionnaire as an instrument for the primary data collection.Random and purposive sampling methods were also employed in order to achieve a wide coverage for the data collection.The measurement of the items in the questionnaires were adapted from the TAM and TOE models with slight wordings to the constructs for this study.All scales were measured based on a 5-point Likert scale according to the following response choices,1=strongly disagree,2=disagree,3=indifferent 4=agree and 5=strongly agree.The study also adopted an open-ended questions in the study questionnaire.The findings of the study showed that the employment of e-procurement system indicated a positive relationship with hospital procurement practices.Hence,the top managers should pay attention to the use of e-procurement system in the ten regional public and teaching hospitals.Additionally,taking a cursory look at the indicators such as the gathering of information,the supplier contract,the contracting,the requisitioning,the intelligence and analysis,reaffirmed the ten regional public and teaching hospitals'preparedness and commitment to support in-service training programs on the current procurement practices for the employees.The findings from the public hospital procurement practices had a positive relationship with hospital procurement performance,hence this is consistent with the existing findings that hospital procurement practices had a positive correlation with hospital procurement performance.However,this implies that increase in the flexibility of the managing of supply chains by internet technologies enabled logistic managers to encourage the introduction of customization and integration of these new technologies into the ten regional public and teaching hospitals'supply chain management systems.Findings revealed that the benefits of using e-procurement had a positive influence on e-procurement's adoption than the barriers to e-procurement adoption.This also implies that easy access to market data and improved intelligence were the most significant benefits among the independent variables of barriers and benefits to e-procurement's adoption.Therefore,easy access to market data and improved intelligence conveyed other benefits to the ten regional public and teaching hospitals.Furthermore,the ease of access to market data supported the efforts of supply chain trading partners with well integrated information sharing across the actors in the ten regional public and teaching hospitals.The findings enhanced the better management and control of the key actors and saves time during procurement processes in the public healthcare organizations.The findings of the barriers to e-procurement adoption were not supported.However,among the variables of barriers to e-procurement adoption,the inadequate legal issue was the most important barrier to the adoption of e-procurement.The other barriers to e-procurement adoption were lack of employee competency,inadequate skilled labor,inadequate IT infrastructure,and the security concern of e-procurement transaction data were not observed as the most barriers to the adoption of e-procurement systems.This suggested that,the inadequate legal issue buttresses why the rules and regulations of the National Communication Authority and their role in the public procurement issues should be addressed by liaising with the agency before e-procurement system could be adopted by the ten regional public and teaching hospitals in Ghana.The management of the ten regional public and teaching hospitals should educate employees on competencies and skills training and development in order to improve employee's awareness and preparedness on the integration of new technologies in the ten regional public and teaching hospitals.Also,no significant differences in terms of age groups in influencing adoption decision on the e-procurement system were observed.Furthermore,the findings of TAM showed that the hypothesized impacts of trust,compatibility and technical support were on a higher-order cognitive mechanism within the TAM.The R~2 of these explanatory variables were considered as PU 0.77and PEOU 0.42 that symbolizes the essence of the factors of e-procurement in driving employee's acceptance of e-procurement.In the case of the TOE framework,the study revealed the positive role influenced by the relative advantage,external pressure,top management support and the technology readiness of the TOE factors in investigating the determinants of e-procurement on adoption decision by the ten public and teaching hospitals.In summary,this study has contributed to the theory of e-procurement studies by investigating the factors affecting the role of e-procurement adoption by public hospitals in Ghana.The study offers a critical factor peculiar to public hospitals,which can influence e-procurement adoption in Ghana.Furthermore,this study also provided strategies for transitioning from conventional to paperless procurement for effective and efficient procurement of goods and services for the public hospitals in Ghana.The study makes significant contribution to theory of e-procurement to stimulate the overriding performance of e-procurement in the purchasing process in a developing country context.Strategies for improving e-procurement adoption development in Ghana are presented in addition to the managerial implications of the study findings.