Understanding the introduction and use of a mobile device-supported health information system in Nigeria

Copyright @ 2014 The Authors.This paper presents an in-depth analysis of efforts to introduce a mobile health information system in Nigeria as part of a development initiative aimed at improving maternal and child health. Specifically, it examines the use of mobile devices to facilitate maternal health information accessibility and exchange among health practitioners in order to reducing maternal, newborn and child mortality. Further, it also looks at the challenges raised while introducing mobile devices into work practices in the healthcare sector. The study adopts a case study approach, relying on semi-structured interviews and document analysis as its main methods for collecting data. The specific case examined is a mobile phone-based information system introduced to support a national government effort in Nigeria, known as the midwives service scheme. The findings of this study show that this integrated approach of using mobile phones to support (health) information systems has vast potential; for instance increasing the timeliness of (health) data available to stakeholders for monitoring and planning purposes. However, we also find that over time, attaining the potential of development efforts such as this remains difficult as initiatives involving the use of mobile devices is not just about getting the technical aspect right. It is equally dependent on deep seated social-cultural influences such as poor political and financial commitment. These two mutually reinforcing influences have been identified in this study as significant impediments to efforts of this kind. Therefore, this paper argues for, first a strong political commitment across all levels of government whereby their words are backed with action. Second it is important that the government maintains financial integrity by releasing the funds budgeted to support the smooth running of these efforts, for such initiatives to thrive and ultimately contribute to development

Information support for health information management in regional Sri Lanka: health managers' perspectives

Good management, supported by accurate, timely and reliable health information, is vital for increasing the effectiveness of Health Information Systems (HIS). When it comes to managing the under resourced health systems of developing countries, information-based decision making is particularly important. This paper reports findings of a self-report survey that investigated perceptions of local health managers (HMs) of their own regional HIS in Sri Lanka. Data were collected through a validated, pre-tested postal questionnaire, and distributed among a selected group of HMs to elicit their perceptions of the current HIS in relation to information generation, acquisition and use, required reforms to the information system and application of information and communication technology (ICT). Results based on descriptive statistics indicated that the regional HIS was poorly organised and in need of reform; that management support for the system was unsatisfactory in terms of relevance, accuracy, timeliness and accessibility; that political pressure and community and donor requests took precedence over vital health information when management decisions were made; and use of ICT was unsatisfactory. HIS strengths included user-friendly paper formats, a centralised planning system and an efficient disease notification system; weaknesses were lack of comprehensiveness, inaccuracy, and lack of a feedback system. Responses of participants indicated that HIS would be improved by adopting an internationally accepted framework and introducing ICT applications. Perceived barriers to such improvements were high initial cost of educating staff to improve computer literacy, introduction of ICTs, and HIS restructure. We concluded that the regional HIS of Central Province, Sri Lanka had failed to provide much needed information support to HMs. These findings are consistent with similar research in other developing countries and reinforce the need for further research to verify causes of poor performance and to design strategic reforms to improve HIS in regional Sri Lanka