In this thesis I have participated in an action research project in South Africa and Mozambique within their respective public health care. The “replication” of a system from one country to another, presents a wealth of problems. In this thesis a research is done in the context of the transfer of a routine health information reporting system from South Africa to Mozambique. This process requires adaptation of the system to the new context. Part of this context is the already existing legacy systems as entangled parts of a larger information infrastructure. The existing legacy systems consist of institutionalized routines in existence, and an objective of the new system is to deinstitutionalize these, and institutionalize new organizational routines. This effort is in conflict with the installed base that includes the old legacy systems. To understand the tensions that arise as part of the effort necessary to align the new systems to the installed base, legacy theory will be used and evaluated.
Legacy systems theory has several methods for connecting the old to the new. One method is target database population, which consists of populating the new system with data from existing legacy systems by importing. As part of this thesis, a tool was developed to automate parts of the import process. The import process was highly complex and time consuming due to several legacy properties found in the existing systems; primarily lack of documentation, lack of interfaces and the general poor state of the existing systems. Data stored in the existing systems were found to be redundant, inconsistent, non-uniform and ambiguous. The tool is evaluated as a change tool in the context of legacy systems and information infrastructure theories. There are two steps in the use of the tool; import of data, enabling data previously hidden and unavailable to become visible, and analysis of the imported data to analysis and evaluate the existing systems. However, the tool was not found to act as a gateway, this due to lack of sustainability and support for continuous data import.
The existing systems and infrastructure is after completion of the import process evaluated by analyzing the data in the new system. The objective of the evaluation is to show the need for change of the health information systems within the organization. Several shortcomings of the existing systems emerged, including lack of flexibility, lack of integration, extensive fragmentation, problems in data collection, analysis and the use of data. There were also lack of conditions to enable new routines, sharing of information, and support for the heterogeneous user community.