A framework for integrating traditional medicine into Uganda’s national health care system

Abstract

Traditional Medicine (TM) remains a critical component of healthcare in Uganda, with over 60% of the population, particularly in rural areas, relying on TM as a primary source of care. Despite this, TM data has largely been excluded from national health information systems, including UgandaEMR—the most widely used electronic medical records (EMR) platform covering approximately 1,900 health facilities across the country. This exclusion has resulted in incomplete health data, limited integration of culturally relevant care practices, and challenges in regulating traditional health services. The study identified multiple barriers that hinder the integration of TM data into UgandaEMR. These include gaps in policy and governance, lack of standardized data collection tools, infrastructure constraints, limited technical capacity, and socio-cultural resistance among practitioners and communities. To overcome these challenges, a practical framework for integrating TM data into HMIS was developed. The framework consists of four layers: strategic governance and planning, system assessment and development, deployment and operationalization, and change management. It emphasizes modular system design, standardization of TM data elements, interoperability with UgandaEMR, and targeted capacity-building for health facility staff and TM practitioners. These design elements ensure that the integration is scalable, contextually relevant, and technically feasible. Validation of the framework was conducted with 62 stakeholders including TM practitioners, health facility staff, EMR administrators, and policymakers confirmed the framework’s relevance and practicality. Stakeholders highlighted the adaptability of UgandaEMR, cost effective integration strategies using mobile and open-source platforms, willingness to adopt reporting tools, and moderate institutional support as key enablers. Participatory governance and culturally sensitive approaches were deemed essential to foster trust, enhance adoption, and ensure accurate documentation of TM practices. Overall, the study demonstrates that integrating TM data into UgandaEMR, supported by a structured framework and stakeholder engagement, can improve data completeness, strengthen evidence-based policy formulation, and promote equitable healthcare delivery