Analysing the Challenges of IS implementation in public health institutions of a developing country: the need for flexible strategies

Shegaw Anagaw Mengiste


This paper explores the challenges of introducing computer-based health information systems in the context of the Ethiopian public health care system. Drawing empirical examples from the process of introducing computer-based health information system(HIS) in two regional states (Amhara and Benishangul-Gumuz) of Ethiopia, this paper analyses the socio-technical challenges influencing the transition towards a new computerised system and suggested the importance of developing context-sensitive strategies to tackle different challenges in different contexts. Building on the notions of installed base and cultivation the paper examines the socio-technical issues and factors that influenced the process of developing, customizing, and implementing computerised HIS in different settings. The findings of this paper revealed that contextual differences in terms of access to infrastructural reources, availability of adaquate and qualified manpower, and managerial commitment and support would significantly influence the implementation process. I argue that, such context-senitive challenges need to be dealt through flexible startegies that took in to account the specific context. In this paper, four diffferent flexible strategies: the strategy of gateways, top-down vs bottom-up approaches, flexible essential data sets and clustering have beed identified as being useful in implementing computer-based systems in different settings of the Ethiopian public health care system.


Health Information systems; implementation; flexible strategies; Ethiopian health care system