Organizational Capacity Building for Sustainable Health Information Systems: A Case Study from Ghana
DOI:
https://doi.org/10.12856/JHIA-2015-v3-i2-127Abstract
Abstract
Background and Purpose:
Implementing ICT innovations especially in low resourced countries has been documented in the information systems (IS) literature as a very challenging feat because of the existence of weak organizational structures leading to manifestations of silos of fragmented country ICT projects lacking the basic organizational structures to scale and become sustainable over time [31, 11, 33]. In 2010 Ghana adopted the DHIS2 software as a replacement of the existing and challenged health information system (HIS) to enable it track progress on the health related millennium development goals (MDG).
The outcome has been a successful nation-wide implementation of HIS in all public health facilities. This paper looked at the factors that enabled the successful implementation and sustenance of the adopted software in Ghana.
Methods: Concepts from information infrastructure theory and the notion of the installed base were used as lenses to collect and analyse the empirical data. Data collection and analysis was qualitative using participant observation, focused group discussions, semi-structured interviews and document analysis.
Results: This has been possible because of realignment of selected elements of the installed base necessary for achieving set objectives. For Ghana the elements identified were manpower development, resource mobilization, strengthening of institutions and networking with stakeholders to leverage on available resources and technology.
Conclusions: Sustainability of HIS in resource constrained contexts requires selection of elements of the installed base necessary for effective organizational capacity building. And these elements must be interdependent otherwise the objective of sustainability might not be accomplished. Effective capacity building efforts of an organization therefore involves combining strategies synergistically to ensure long-term sustainability.
Key words: Organizational Capacity Building, Installed Base, DHIS2
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References
AbouZahr, C. & Boerma, T. (2005). Health Information Systems: the foundations of public health, Bulletin of the World Health Organization, 83(8).
Adam T. & de Savigny D., 2012. Systems thinking for strengthening health systems in LMICs:
need for a paradigm shift. Health Policy and Planning. 2012;27(suppl 4):iv1-iv3.
Adaletey, D. L., Poppe, O, Braa, J., (2013). Cloud Computing for Development –Improving the Health Information System in Ghana, IST-Africa 2013 Conference Proceedings.
Adaletey, D. L., Jolliffe, B., Braa, J., Ofosu, A., 2014. Peer-Performance Review as a Strategy for Strengthening Health Information Systems: A Case Study from Ghana. Journal of Health Informatics in Africa.
Adaletey, D. L., 2015. Leveraging on Cloud Computing for HIS to Support Maternal and Child Health Services at the Community Level in Ghana. (forth coming)
Adindu, A., 1995. Quality of Health Information System. Incongruity and Health System Dysfunction. Lambert Academic Publishing,PhD Thesis, 1995.
Avison, D., Lau, F., Myers, M. D., & Nielsen, P. A. 1999. Action Research. Communications of the ACM,42(1), 94-97
Barker, A., 2005. Capacity building for sustainability: toward community development in coastal Scotland, Journal of Environmental Management 75
Blaya, J., Fraser, H., & Holt, B., 2010. E-Health Technologies Show Promise In Developing Countries. Health Affairs 29, NO. 2 (2010): 244–251.
Baskerville, R. L., & Wood-Harper, A. T. (2002). A Critical Perspective on Action Research as a Method for Information Systems Research In M. D. Myers & D. Avison (Eds.), Qualitative Research in Information Systems (pp. 129-145): Sage Publications.
Braa, J., Monteiro, E., & Sahay, S. (2004). Networks of Action: Sustainable Health Information Systems Across Developing Countries. MIS Quarterly,28(3), 337-362.
Braa, J., & Hedberg, C. (2002). The Struggle for District-Based Health Information Systems in South Africa. The Information Society, 18, 113-127.
Braa, J., & Sahay, S. (2012). Integrated Health Information Architecture: Power to the Users. New Delhi: Matrix Publishers.
Bygstad, B., Hanseth, O., Truong, O., 2015. From IT Silos to Integrated Solutions: A Study in E- Health Complexities. Proceedings of European Conference of Information Systems (ECIS), 2015.
Charbel, Jose´, Chiappetta Jabbour and Fernando Ce´sar Almada Santos, 2008. The central Role of Human Resource Management in the Search for Sustainable Organizations.
Chan, M, Kazatchkine, M, Lob-Levyt, J, Obaid, T, Schweizer, J, Sidibe, M, Veneman, A, Yamad, T, 2010. Meeting the Demand for Results and Accountability: A Call for Action on Health Data from Eight Global Health Agencies. PLoS Medicine | www.plosmedicine.org 1 January 2010 | Volume 7 | Issue 1
Cooke, J., 2005. A framework to evaluate research capacity building in health care, BMC Family Practice 2005, 6:44 doi:10. 1186/1471-2296-6-44
Crisp Beth, Hal, R.,Swerissen and Stephen J. Duckett, 2000. Four Approaches to Capacity Building in Health: Consequences for Measurement and Accountability in Australian Institute for Primary Care, Faculty of Health Sciences, La Trobe University, Bundoora, Victoria 3083, Australia.
Carl, F., Steve Carpenter, Thomas Elmqvist, Lance Gunderson, C. S. Holling, and Brian, 2002. Resilience and Sustainable Development: Building Adaptive Capacity in a World of Transformations Walker AMBIO:A Journal of the Human Environment, 31(5):437-440.2002.
Damtew, Z. A., Miscione, G., Mekonnen, S., Østmo, E., Staring, K., Sæbø, J. I., & Sun, V. (2010). Globetrotting health information systems. Journal of Health Informatics in Developing Countries, 4(1), 27-38.
Franks, T, 1999. Capacity Building and Institutional Development: Reflections on Water, DPPC, University of Bradford, UK
Fuchs, Lynn S;Fuchs, Douglas, 2006. A Framework for Building Capacity for Responsiveness to Intervention School Psychology Review; Winter 2006; 35, 4; ProQuest Psychology Journals pg. 621-626
GHS, 2011, Standard Operation Procedures for Data Management
GHS CHPS, 2005. Community-based Health Planning and Services (CHPS). The Operational Policy. Ghana Health Service Policy Document No. 20. May 2005.
GHS CHPS Manual, 2013. Strengthening Community-based Health Planning and Services. Manual for Community Health Management Committee. USAID|Ghana|JICA Project.
GHS DRP, 2013. Disaster Recovery Plan for Health Information System.
GHS SOP, 2011. Standard Operating Procedures. 2nd Edition, 2011
Giuse, DA, Kuhn KA, 2003. Health information systems challenges: The Heidelberg conference and the future. International Journal of Medical Informatics 2003, 69:105-114.
Hanseth, O., and Lyytinen, K., 2010. Design theory for dynamic complexity in information infrastructures: the case of building internet. Journal of Information Technology, 25, 1-19. doi: 10.1057/jit.2009.19
Health Metrics Network (HMN). 2008. Framework and Standards for Country Health Information Systems. Second Edition. Geneva: Second Edition
Heeks, R. (2002). Information Systems and Developing Countries: Failure, Success, and Local Improvisation. The Information Society, 18, 101-112.
Heward S., Hutchins C., & Keleher, H., 2007. Organizational Change, key to Capacity Building and Effective Health Promotion Vision 2020 Australia, ACT Health Promotion Authority (Healthpact), Australia and Department of Health Science, Monash University, Australia.
Honest C. Kimaro; José L. Nhampossa, 2010. Analyzing the problem of unsustainable health information systems in less-developed economies: Case studies from Tanzania and Mozambique. Information Technology for Development.
Jones, M., 2001. Sustainable Organizational Capacity Building: Is Organizational Learning a Key? International Journal of Human Resource Management 12:1 February 2001 91–98
Kuipers, Humphreys, Wakerman, Wells, Jones and Entwistle, 2008. Collaborative review of pilot projects to inform policy: A methodological remedy for pilotitis? Australia and New Zealand Health Policy 2008:http://www.anzhealthpolicy.com/content/5/1/17
Kvale, S., (2009). Learning the Craft of Qualitative Research Interviewing. Sage Publication Inc.
Lengnick-Hall, C A, Tammy E. Beck, T E, Lengnick-Hall, M L, 2011. Developing a capacity for organizational resilience through strategic human resource management. Human Resource Management Review 21 (2011) 243–255
Matavire , R., Chidawanyika, H., Braa, J., Nyika, P.,Katiyo, J., 2013. Shaping the Evolution of the Health Information Infrastructure in Zimbabwe. . 8thHELINA 2013 Conference.
Mekonnen, S, M, Sahay, S, Lewis, J, 2015. Understanding the Role of Social Capital in Integrating Health Information Systems. Journal of Health Informatics in Developing Countries.Vol. 9 No. 2, 2015
Miles, M.B. & Huberman, A.M. (1994). Qualitative Data Analysis. Thousand Oaks: Sage Publications.
Myers, M. D., 1997. Qualitative Research in Information Systems. MISQ Discovery.
North, D. C. (1990). Institutions, institutional change and economic performance. Cambridge: Cambridge University Press.
Nu’Man, Jeanette, Winifred King, Amee Bhalakia, and Shaniece Criss, 2007; A Framework for Building Organizational Capacity Integrating Planning, Monitoring, and Evaluation. Journal of Public Health Management Practice, 2007, January (Suppl), S24–S32 Lippincott Williams & Wilkins, Inc.
Poppe, O., Jolliffe, B., Adaletey, D. L., Braa, J., Manyaa, A., 2013. Cloud Computing for Health Information in Africa. Comparing the Case of Ghana to Kenya. 8th Health Informatics in Africa Conference (HELINA 2013).
researchICTafrica.net: Annual Report 2010-2011
Scott, W. R., 2001. Institutions and Organizations. Second Edition. Sage, USA
Star, S. L. and Ruhleger, K, 1996. Steps toward an ecology of infrastructure: design and access for large information spaces. Information Systems Research 7(1), 111–134.
Sæbø, J. I., Braa, J., Sahay, S., Kossi, E. K., & Settle, D. (2011). Networks of Networks - Collaborative Efforts to Develop Health Information Systems Across Developing Countries. Paper presented at the Ifip WG 9.4 Social Implications of Computers in Developing Countries, Kathmandu, Nepal.
UN MDG Report, 2013. The Millennium Development Goals Report
Wilkinson, A., Hill, M., Gollan, P., 2001. The Sustainable Debate; International Journal & Production Management. Vol. 21, No. 12, pp. 1492-1502.
