José Leopoldo Nhampossa

Analyzing the problem of unsustainable health information systems in less-developed economies: case studies from Tanzania and Mozambique

Most of donor-supported information technology (IT)–based projects developed or implemented in less-developed economies (LDEs) end up as complete or partial failures or unsustainable. Notably, a number of intra-organizational and external factors are associated with this problem, including inadequate infrastructure and human resource capacity, fragmented donor policy, and lack of policies to manage the sustainability problem. Accordingly, IT initiatives are often donor-driven, top-down, and hijacked by top managers who (normally) do not have adequate skills, but have enormous power to enforce such initiatives across organizational hierarchies. In analyzing the concepts from sustainability and institutionalization, key insights towards a better understanding of the problem of unsustainability are developed. It is argued that health information systems (HISs) become sustainable if they are institutionalized in the sense of being integrated into the everyday routine of the user organization. However, a sustainable HIS should also be flexible enough to allow changes as the user needs change. Moreover, introduction of a new HIS is not only a technical change, but requires the cultivation and institutionalization of a new kind of culture. Through a comparative case analysis of the HIS development and implementation processes in Tanzania and Mozambique, we have identified two sets of relationships, between the Ministry of Health (MoH) and donor agencies and between the MoH and software development agencies as critical and contributing factors to the unsustainability of a HIS. Given this setting, we highlight three key strategies for dealing with the problem of unsustainability in LDEs: (a) integration of a HIS, (b) local shaping of new cultures, and (c) cultivation approach to systems development.

Contextuality of participation in IS design: a developing country perspective

Participatory approaches to information systems design have evolved over approximately the last three decades, mainly in Scandinavia, Europe, and lately in the US. However there has been limited and peripheral research and debates over participatory design approaches and techniques in developing country settings. This paper explores three case studies in developing countries where participatory approaches have been used in the design and implementation of health information systems. The investigation reveals the politics of design, the nature of participation, and the methods, tools and techniques for carrying out design projects are shaped with respect to the diversity of the socio-economic, cultural and political situations faced in each of these settings. Though common strategies, such as capacity development, could be found that cut across the three case studies it is the importance of the contextual nature of participatory design that emerges most strongly. There is no single algorithmic best practice regarding participatory design in information systems which is applicable to all situations.

A Study of the Actual and Potential Usage of Information and Communication Technology at District and Provincial Levels in Mozambique with a Focus on the Health Sector

This article presents results from a study on the use and appropriation of information and communication technologies (ICT) in Mozambique with a focus on the health sector. The three provinces of Gaza, Inhambane and Niassa were surveyed and two questionnaires addressing 1) computer users and their ability to manage ICT, and 2) health workers and their handling of health information, were used. Based on this study appropriate strategies for developing an ICT‐infrastructure with the needs of the health sector as points of departure are discussed. The study is born out of a program to strengthen and further develop the health information and management systems at district and provincial levels as part of a process to support decentralisation of the health system in Mozambique. The study shows that computers and Internet are rapidly being spread to the provincial capitals and major districts in Mozambique. A main problem identified is the lack of ICT‐skills and education and poorly developed infrastructure and networks of support. There are very few formal ICT companies providing hardware, and even less, software support. Maintenance and learning about ICT are to a large extent going on within informal networks of computer users in the provinces.

Wiki content evaluation framework

Allowing anyone to edit content is the philosophy of most wikis. Such approach does not ensure that the editor is a specialist in the topic and is well-meaning. Poor quality of the content and vandalism can be a major problem. We did a literature review on quality of information and criteria and examined a number wiki applications seeking to understand the process of authorship being used in larger wiki sites, such as those run by the Wikimedia Foundation and present a conceptual model to enforce quality in Wiki content. In this model, we suggest that each article should have an evaluation resulting from voting a pool of reviewers and that a historical record of the evaluation should be keep and available to users.

Audit of e-commerce process

E-Commerce is growing and having an important role in the international economy. In this paper we discuss broadly the importance of having adequate tools to support e-commerce auditing. Specifically to support internal control, we suggest the use of process mining. We also suggest an approach to support audit of e-commerce process.

Producers and evaluators of information

Research work reported in this paper has as main purpose contributing to discussion about how to obtain quality and credibility in the information of wiki projects. We want to learn what tools we should produce. In this perspective, we intent to answer the following questions: Who is the best evaluator of an information resource? Who is the most trustful information resource producer? In order to answer to those questions, we developed an empirical research. In this empirical research we identified not only the best evaluator and producer but also the best evaluator and producer for specific type of information resource.