Abstract
Abstract
This study investigated the factors contributing to unsustainable health information systems
and low level of use. Approaches to development and implementation of an integrated
district-based health information system focusing on sustainability and use as well as the
challenges are studied. This action research was carried out in Tigray Region, Ethiopia, at
all levels of the health structure in two pilot districts: Hintalo-Wajirat and Wukro.
The intervention was undertaken using an action research approach with an interpretive
case study. Interviews with observations of the information management activities at
Region, district and facility levels, and document analysis were the chosen methods of data
collection. The empirical findings were analyzed in relation to the existing knowledge in
the relevant domain area and concepts from structuration theory.
The researchers found that centralization, fragmented structure and the low capacity of the
health information system were the root causes of its very limited contribution to the
performance of the Region’s health system. The introduction of an integrated district-based
health information system was the action proposed by the researchers to change the
situation and put into action. The initial phases of the implementation of the redefined
routine data flow and introduction of DHIS in order to create a unified health information
system and facilitate decentralization were undertaken during the period of the research.
The pilot implementation process is still ongoing in the Region under the technical
assistance and follow-up from the Health Information System Project (HISP) in Ethiopia.
We believe that this intervention is believed to contribute to the realization of optimal
usability and sustainability of the Region’s health information system.
Key words: Health Information Systems, Sustainability, Information use, Integration,
Decentralization, Action research, Developing countries.