SCALING OF HEALTH INFORMATION SYSTEMS IN NIGERIA AND ETHIOPIA - CONSIDERING THE OPTIONS

This paper addresses the IFIP 9.4 conference theme for papers that take stock of the development of ICT in the health sector, and in particular how infrastructure and human resource factors influence the implementation of e-development initiatives. Using case studies from the Health Information Systems Programme in Nigeria and Ethiopia, the interdependencies between three spheres are identified as being important in scaling health information systems. The three spheres that are explored are the volume of data collected, human resource factors and access to technology. We draw on concepts from mindful innovation with technology to illustrate that a cultivation approach is appropriate to bringing about change. We suggest that a balance needs to be achieved between the three spheres if scaling initiatives are to succeed, and identify a number of factors that can be used to achieve and maintain the balance. Three flexible standards are identified as being critical strategies to global health information scaling initiatives, namely an essential data set, a scalable process of information systems collection and collation consisting of gateways between paper based systems and hardware and software which can be interfaced with one another, and a cultivation approach.