Abstract
BACKGROUND: The integration of digital technologies into healthcare systems can significantly improve human resource management, especially in low- and middle-income countries (LMICs) like Bangladesh. Despite policy-level efforts such as the rollout of the Human Resource Information System (HRIS), adoption remains uneven and under-studied. This study aimed to identify barriers to HRIS adoption and propose strategies to strengthen digital transformation in human resource management within Bangladesh’s healthcare sector. METHODS: A cross-sectional mixed-methods study was conducted from March to June 2023 across five districts- Lakshmipur, Feni, Noakhali, Comilla, and Cox’s Bazar- selected for their varying levels of digital readiness. Quantitative data were gathered from 320 h and IT professionals using a structured questionnaire. Qualitative insights were obtained through 10 in-depth key informant interviews with hospital directors, researchers, and policymakers. Quantitative analysis was performed using SPSS version 26, and qualitative data were analyzed thematically using Braun and Clarke’s method. RESULTS: Despite widespread awareness and positive perceptions of HRIS, several critical barriers impeded adoption. These included inadequate training in digital systems, insufficient digital literacy among HR personnel, unreliable internet connectivity, lack of uninterrupted power supply, and limited funding. Furthermore, centralized decision-making, weak inter-ministerial coordination, and lack of motivation among senior leadership emerged as institutional obstacles. Participants emphasized the need for hands-on training, need-based resource allocation, infrastructure investment, and stronger leadership engagement. The convergence of quantitative and qualitative findings underscored the systemic and multidimensional nature of the challenges. CONCLUSION: Despite progress in digital infrastructure, systemic and organizational barriers continue to hinder the full-scale adoption of HRIS in Bangladesh. Addressing these through targeted interventions is critical for optimizing human resource efficiency and strengthening the health system. CLINICAL TRIAL NUMBER: Not applicable. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-025-13549-0.