Paper published: Understanding HMIS Implementation in a Developing Country Ministry of Health Context – an Institutional Logics Perspective

This Public Health Informatics research paper discusses the institutional aspects of HMIS implementation in the real world setting of a developing country Ministry of Health. It highlights the complexity of such an endeavor, in a context that, as HMIS implementers generally agree, can often be contested, dysfunctional and/or simply put, a hard nut to crack.

I generated the paper’s word cloud (see below) – a word cloud is a visual representation of the paper’s text data, highlighting the most used words or keywords.

The paper’s abstract

Globally, health management information systems (HMIS) have been hailed as important tools for health reform (1). However, their implementation has become a major challenge for researchers and practitioners because of the significant proportion of failure of implementation efforts (2; 3). Researchers have attributed this significant failure of HMIS implementation, in part, to the complexity of meeting with and satisfying multiple (poorly understood) logics in the implementation process.

This paper focuses on exploring the multiple logics, including how they may conflict and affect the HMIS implementation process. Particularly, I draw on an institutional logics perspective to analyze empirical findings from an action research project, which involved HMIS implementation in a state government Ministry of Health in (Northern) Nigeria. The analysis highlights the important HMIS institutional logics, where they conflict and how they are resolved.

I argue for an expanded understanding of HMIS implementation that recognizes various institutional logics that participants bring to the implementation process, and how these are inscribed in the decision making process in ways that may be conflicting, and increasing the risk of failure. Furthermore, I propose that the resolution of conflicting logics can be conceptualized as involving deinstitutionalization, changeover resolution or dialectical resolution mechanisms. I conclude by suggesting that HMIS implementation can be improved by implementation strategies that are made based on an understanding of these conflicting logics.

Keywords: Social issues in Public Health Informatics; developing countries; health management information systems; institutional logics; institutional aspects of information systems; action research; Nigeria; Ministry of Health; change management

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Writing up thesis on mHealth…Scaling mHealth in Low-Resource settings

Scaling is a central concern in public health. More so, it is an underlying assumption because it is largely concerned with the health of the entire populace. The motivation to scale health services and its associated components including health information networks is underpinned by everything ‘public’ about public health. It is a basis for WHO’s mission and was well captured in its landmark ‘Health for All’ conference in Alma Ata 40 years ago (WHO, 1978). It is also the basis for spreading evidence-based and scientifically proven small-scale interventions to the populace (Black 1986, Taylor 2010). Scaling up global health initiatives and packages, rolling them to the lowest levels is thus a core strategy in reaching for the Millenium Development Goals targets by 2015 (United Nations, 2010).

Despite considerable increases in funds directed at scaling health services in low-resource settings and their associated information systems (Ravishankar et al 2009), reaching the lowest levels of care and the populace in targeting the MDGs have been largely unsuccessful (United Nations, 2010).

In this regard, mHealth, the application of mobiles for health is promising. Mobile technology is transforming healthcare by increasing access to healthcare and health-related information including hard-to-reach populations, improving the ability to track diseases, providing timlier and more actionable public health information and expanding access to health education as well as training (VitalWave, 2009). From a mass media perspective, it is also regarded as the fastest scaling media technology in history compared with how long it took print, recordings, cinema, radio, television and internet to scale (Ahonen, 2008).

In this research, the role of mHealth in scaling health information networks is investigated. Is mHealth the magic bullet it is envisioned to be? Are they any constraints – technical, strategic, organizational? What are the key lessons for architectural and implementation design?

Research aims and objectives coming…

Climate change will erode foundations of health

Scientists tell us that the evidence the Earth is warming is “unequivocal.” Increases in global average air and sea temperature, ice melting and rising global sea levels all help us understand and prepare for the coming challenges. In addition to these observed changes, climate-sensitive impacts on human health are occurring today. They are attacking the pillars of public health. And they are providing a glimpse of the challenges public health will have to confront on a large scale, WHO Director-General Dr Margaret Chan warned today on the occasion of World Health Day.

http://www.who.int/mediacentre/news/releases/2008/pr11/en/index.html