The Challenges of Sustainability of Health Information Systems in Developing Countries: Comparative Case Studies of Mozambique and Tanzania

The introduction of Information Technology (IT) typically comes with the promise of helping to manage scarce resources, increase efficiencies, reduce workload, and increase work productivity. In the context of developing countries, the lure of these promises is magnified given the existing conditions and inefficiencies. International donors for example the World Bank, or the World Health Organization play an important role in shaping this promise because developing countries are dependent on them for both technical and financial aspects. Given that IT projects may take a long time to be fully institutionalized, sufficient resources are required to build the local capacity to support and sustain the project after the withdrawal of donors. Inadequate donor support often contributes to weakening rather than strengthening human resource capacity and effective system design, since it emphasizes the technology itself in the expense of the needs of the users. These factors contribute to the design and implementation of unsustainable health information systems (HIS) in developing countries. Through a comparative case analysis of the HIS in Mozambique and Tanzania, we have identified three sets of relationships as crucial in shaping the sustainability of HIS. The relationships between the Ministry of Health (MoH) and the software development agency, between the MoH and the donors, and between the donors and the software development agency. The reasons for the lack of alignment between the relationships, although possibly different in the two cases, are identified and some specific recommendations are made to support their alignment, and with it, we argue, the sustainability of the system

Adoption of Free Open Source Geographic Information System Solution for Health Sector in Zanzibar Tanzania

\ud The study aims at developing in-depth understanding on how Open Source Geographic Information System technology is used to provide solutions for data visualization in the health sector of Zanzibar, Tanzania. The study focuses on implementing the health visualization solutions for the purpose of bridging the gap during the transition period from proprietary software to the Free Open-Source Software using Key Indicator Data System. The developed tool facilitates data integration between the two District Health Information Software versions and hence served as a gateway solution during the transition process. Implementation challenges that include outdated spatial data and the reluctance of the key users in coping with the new Geographical Information System technologies were also identified. Participatory action research and interviews were used in understanding the requirements for the new tool to facilitate the smooth system development for better health service delivery.\u

Disentangling participatory ICT design in socioeconomic development

Participatory design in socioeconomic development is an invariably political activity fraught with both political as well as ethical entanglements. ICT for development (ICTD) - often involved in contexts of great inequality and heteogeneity - places these in especially sharp relief. This paper draws attention to these entanglements as well as what they mean for the role and practice of designer-researchers practicing PD. We then draw upon our experiences in an active PD project to highlight approaches that serve as a partial response to these entanglements. These presents both limitations as well as orientations for our role as designer-researchers in engaging with and organising PD work in ICTD - providing a starting point for answering the question “who participates with whom in what and why?