Factors Influencing Electronic Health Record Adoption in Rural Hospitals in Borno State

Electronic health record (EHR) adoption in rural hospitals in Borno State, North East Nigeria, is complicated by infrastructure deficits, conflict-related disruptions, and distinct healthcare workforce characteristics. This study investigates the factors influencing EHR adoption in Borno State rural hospitals, drawing on an extended Technology Acceptance Model incorporating infrastructure readiness, perceived security, management support, and training quality as additional constructs. A quantitative survey was administered to 120 healthcare workers at eight rural hospitals in Borno, Gwoza, and Kukawa local government areas, processed using Structural Equation Modelling via AMOS. Results confirm that management support (beta = 0.41, p < 0.001) and infrastructure readiness (beta = 0.38, p < 0.001) are the two strongest predictors of adoption intention. The study documents unique contextual factors in Borno's post-conflict rural hospitals, including data loss anxiety stemming from prior facility displacement and staff reluctance to create digital records that could expose patient identities in insecure environments. Recommendations target Borno State Ministry of Health investment in reliable power infrastructure and offline-capable EHR systems designed for intermittent connectivity. The study contributes an extended TAM model grounded in conflict-affected health system contexts. Keywords: electronic health records, Borno State, rural hospital, TAM, SEM