There is currently an ongoing process in Tanzania to strengthen the health management information system of the country. A consortium of several partners, including the Ministry of Health and Social Welfare have decided on the way forward being based on the implementation of the District Health Information System (DHIS) in all regions. Tanzania is one of the least developed countries in the world, and there are many donor agencies involved in the country. The likely way forward for the DHIS to be implemented in all regions of the country is based on the support of these donors.
This thesis looks at the process and results of a donor-supported, and (partly) initiated, implementation of the DHIS in the two regions Mtwara and Lindi in Tanzania. The study is concerned with finding what were the results of such a project, and what can be learned from it. It seeks to answer the research objectives “What is the current situation of the implementation of the District Health Information System in Mtwara and Lindi regions?” and, “What are the main conditions and actions taken contributing to the current situation?”.
In order to analyze and understand my findings I build theoretically on perspectives from social informatics, the concept of design-actuality gaps, organizations as multivariate systems, and a conflict perspective. Qualitative research methods have been employed, in an interpretive case study approach.
Main findings of this study indicate that although many efforts have been made, and positive outcomes have been reached, some challenges are still left for the project to face. The main conditions contributing to the current situation were found to be practical issues, ownership, and the need for a focus on the health facility workers. The study suggests that there are differences between the two regions due to how the project was initiated in each region.
Key words: Implementation of health information systems, Tanzania, donor agency involvement, ownership, a conflict perspective