Sustainability of computer-based health information systems especially in less-developed countries is crucial because of its importance in empowering health care managers at different levels to provide effective and efficient health care services to the neediest in a resource constrained setting. However, sustainability and adequate use of newly implemented health information systems in the context of developing countries depends up on wide range of context sensitive factors.
The purpose of this study was to investigate the challenges that may exert influence on the sustainability of a computer-based health information system in Ethiopia. Specifically, the study was carried out at different levels of the Addis Ababa health bureau, which is authorized by the central government to manage and administer public health institutions in Addis Ababa, the capital city. The purpose of this study was done as part of a broader Health Information System program (HISP) research initiative in Ethiopia.
The study followed the qualitative research tradition using an interpretive research perspective in order to gain deeper understanding of the health information system in the context it operates. Consequently, data was collected through interviews, observation and documents/artifacts analysis. The empirical data obtained as a result of the qualitative techniques were analyzed using contemporary literatures drawn from the information systems field.
From the empirical data, practical challenges and opportunities for the sustainability have been identified and possible suggestions to overcome the challenges are discussed. The challenges and opportunities for sustainability are multiple and are categorized in terms of (1) human resource related (2) Technological infrastructure related and (3) managerial/organizational related and (4) information related factors. Some of the specific challenges identified include; from a human resource dimension issues such as lack of perception about the connection between information and managerial action, lack of motivation among HIS workers and lack of adequate technical staff; from infrastructure related issues such as emergence of new data elements and reporting forms which are not included in the existing software; from managerial/organizational dimension such as lack of top-level support and lack of data quality controlling mechanisms; from information related dimension issues such as presence of poor quality data due to several factors in the health information system it self.
It is concluded that sustainability of computer-based health information systems is a phenomenon influenced by a multiplicity of factors. These factors exert their influence directly and, or indirectly. It is also noted that sustainability of computer-based health information systems can be improved by understanding and managing possible difficulties and which will eventually contribute to the improvement of health care delivery.
The study also contributed to information system research by emphasizing: how the identified factors can exert influence on sustainability of health information systems.