Standardization of health information systems in South Africa: The challenge of local sustainability

Abstract

The implementation and development of routine health information systems continue to provide a number of challenges for managers-the more so in developing countries where resources are scarce and human resource and technical skills limited. This article conceptualizes the interdependence between the local adaptation and appropriation of global standards, and the value that this adds to the global standard through improved quality of data. These processes reinforce one another in the creation of sustainable information systems. The article draws upon a case study of a rural hospital in South Africa. A successful change process is documented, wherein the organization, through innovative management and leadership, actively and successfully appropriated the national standard. The case study is used to highlight three main messages, namely, that standards should be able to be locally appropriated, that the creation of networks helps to support the local adaptation of standards, and that the layering of information systems is important to encourage the use of information and helps to improve data quality. C 2006 Wiley Periodicals, Inc.

Health information systems, decentralisation and democratic accountability

“…As a result, studies have shown how many rural health workers pay lip service to the exercise of filling forms manually and inputting data into the HIS. Other scholars have argued that while part of the health reform agenda requires overall standardisation of indices for reporting, the actual implementation of standards at the local level often demands flexibility and adaptation according to the local situation (Jacucci et al, 2006;Sahay and Latifov, 2009). Some studies have brought evidence to show that in reality there is a high dependency of local health planners on soft data obtained from informal information sources outside the formal information system (Mutemwa, 2006;Miscione, 2007;Williamson and Kaasboll, 2009).…”

Evaluation of Two Programs Supporting Global Family Planning Data Needs: Assessing Achievements, Informing Future Directions

“…Based on such findings, all users need to be able to effectively use the system in question, but the design should be a flexible one that evolves over time to meet the specific needs of the country in question-ideally, the HMIS should be simple, of high quality, responsive, scalable, adaptable, stable, and robust (Kimaro and Nhampossa, 2007). Furthermore, local networks should conform to national standards or templates in terms of data usage and input and should expand on existing frameworks where necessary (Jacucci, Shaw, and Braa, 2006).…”

Challenges and Strategies for Standardizing Information Systems for Integrated TB/HIV Services in Tanzania: A Case Study of Kinondoni Municipality

“…Yet Jacucci et al (2006) argued that there is a need for local adaptation and appropriation of global standards so as to have quality data. A locally appropriated standard usually meets user requirements hence reducing the risk of multiple standards.…”