Abstract
The study argues that state-led development reforms are the preconditions necessary for structural transformation and long-term, large-scale health information systems (HIS) digitalization in developing countries. However, the context and practice of development projects and the socio-political nature of partnership between NGOs and government institutions remains a barrier to such reforms. Drawing on a donor-funded national HIS project in Ethiopia, theoretical and practical insights are outlined in this thesis. Theoretically, the findings and analytical approaches offer relevant insights to ICT4D and development management researchers. Combining Margaret Archer’s morphogenetic approach and social interface analysis from the sociology of development, the study constructs an analytical narrative to explain the digitalization trajectory by identifying the conjecture of four causal mechanisms. Practically, the study highlights key strategic priorities in digitalization. These include; cultural shifts from project-based development arrangements towards locally integrated development initiatives, formalization of state-NGO accountability and collaborative environments, and a renewed engagement with institutional capacity development instead of gap-filling. To drive these aims, the study proposes guidelines on how governance reforms around IT initiatives can be implemented in the developing country HIS context.
List of papers
Paper I: Mikael Gebre-Mariam, Bendik Bygstad. Digitalization mechanisms of health management information systems in developing countries. Information and Organization, Volume 29(1), 2019, 1-22.DOI: 10.1016/j.infoandorg.2018.12.002. The manuscript is available in the thesis. The published version is available at: https://doi.org/10.1016/j.infoandorg.2018.12.002 |
Paper II: Mikael Gebre-Mariam. Navigating Socio-politics and Governance in ICT4D Projects: A Social Interface Analysis. To be published. The paper is not available in DUO awaiting publishing. |
Paper III: Mikael Gebre-Mariam & Elisabeth Fruijtier (2018) Countering the “dam effect”: the case for architecture and governance in developing country health information systems, Information Technology for Development, 24:2, 333-358, DOI: 10.1080/02681102.2016.1214808. The paper is not available in DUO due to publisher restrictions. The published version is available at: https://doi.org/10.1080/02681102.2016.1214808 |
Paper IV: Gebre‐Mariam, M. Governance lessons from an interorganizational health information system implementation in Ethiopia. E J Info Sys Dev Countries. 2018; 84:e12045. DOI: 10.1002/isd2.12045. The article is included in the thesis. Also available at: https://doi.org/10.1002/isd2.12045 |