Introducing a complex health information system in a developing country : Case: The Gambia

Abstract

The District Health Information System, version 2 (DHIS 2) is a complex health information system for collecting, analyzing and reporting health related data. DHIS 2 is free and open source and is implemented in many developing countries, such as Sierra Leone, Zanzibar, India and Vietnam. The Gambia implemented DHIS 2 autumn 2009/spring 2010 and is the case I’ve used for my research. It was the decided that DHIS 2 should be the official reporting tool for health data from January 2010. I had two field trips to the country during the spring 2010 and helped the Ministry of health in the implementation process.

The research goal of this thesis is to explore how a complex health information system can successfully be implemented, maintained and used in a context with poor ICT knowledge. In this thesis I show that conception-reality gaps when implementing a health information system play a vital role. Extensive training of health workers and computer technicians is also important to secure sustainability of the system.

I also show that data quality has been significantly increased after the implementation of DHIS 2 and that quality can be further increased. DHIS 2 has proved more user-friendly than previous reporting tools and thus contributed to ease the data entry task.