Integrated Health Information Systems in Tanzania: Experience and Challenges

Health is a serious development issue. The perceived link between health and development has been articulated in much of the policy and academic literature resulting in many initiatives to introduce integrated health information systems at the local level. Despite huge investments made in this direction, these systems have not made any radical impact on the delivery of healthcare for local communities. Drawing on empirical work in Tanzania, we argue that this has been because of the adoption of a narrow, managerialist perspective of “integration”. We propose instead an interpretation of integration from a variety of standpoints; development studies, management, and sociology. According to this approach, it is not just data that is integrated, but ways of working and the social relations which support the health information systems at global, national and local levels. In our discussion section, we broaden the scope of integrated health information systems to consider the integration of not just management information but also epidemiological data.

[1]  Jean-Pierre Unger,et al.  Integrated care: a fresh perspective for international health policies in low and middle-income countries , 2006, International journal of integrated care.

[2]  J. Unger,et al.  Disintegrated care: the Achilles heel of international health policies in low and middle-income countries , 2006, International journal of integrated care.

[3]  Edoardo Jacucci,et al.  Standardization of health information systems in South Africa: The challenge of local sustainability , 2006 .

[4]  Richard Heeks,et al.  Health information systems: Failure, success and improvisation , 2006, Int. J. Medical Informatics.

[5]  H. Kimaro,et al.  Analyzing the problem of unsustainable health information systems in less-developed economies: Case studies from Tanzania and Mozambique , 2005 .

[6]  Elaine Byrne,et al.  The role of identity in health information systems development: A case analysis from Mozambique , 2005 .

[7]  González Cl Mass campaigns and general health services: conclusions. 1965. , 2005 .

[8]  Margunn Aanestad,et al.  Negotiating Multiple Rationalities in the Process of Integrating the Information Systems of Disease‐Specific Health Programmes , 2004, Electron. J. Inf. Syst. Dev. Ctries..

[9]  M. Cueto,et al.  The origins of primary health care and selective primary health care. , 2004, American journal of public health.

[10]  M. Masaiganah Primary Health Care for the People: Health policy in Tanzania , 2004 .

[11]  J. Ehiri,et al.  Comprehensive versus selective primary health care: lessons for global health policy. , 2004, Health affairs.

[12]  Ross Upshur,et al.  Evidence-based health policy: context and utilisation. , 2004, Social science & medicine.

[13]  S. Thacker,et al.  Strengthening capacity in developing countries for evidence-based public health: the data for decision-making project. , 2003, Social science & medicine.

[14]  J. Unger,et al.  A code of best practice for disease control programmes to avoid damaging health care services in developing countries. , 2003, The International journal of health planning and management.

[15]  E Monteiro,et al.  Integrating Health Information Systems: A Critical Appraisal , 2003, Methods of Information in Medicine.

[16]  Margunn Aanestad,et al.  VERTICAL OR INTEGRATED HEALTH PROGRAMMES? The consequences for the laboratory information system in Mozambique , 2003 .

[17]  Hugh Preston,et al.  Information Systems and Global Diversity , 2002, Eur. J. Inf. Syst..

[18]  S. Atkinson Political cultures, health systems and health policy. , 2002, Social science & medicine.

[19]  Kristin Braa,et al.  The control devolution: ERP and the side effects of globalization , 2001, DATB.

[20]  C. Avgerou,et al.  Information Technology in Context: Studies from the Perspective of Developing Countries , 2001 .

[21]  Olivier Burki SECTOR-WIDE APPROACH IN TANZANIA The Health Sector Example OBSERVATIONS FROM A BI-LATERAL , 2001 .

[22]  J. Harriss,et al.  Depoliticizing development: The World Bank and social capital , 2001 .

[23]  M. Mapunda Tanzania health sector reform: the current position , 2001 .

[24]  C. Comoro Health Sector Reforms: Hope in the horizons , 2001 .

[25]  B. Cooke From Colonial Administration to Development Management , 2001 .

[26]  G. Cornia Globalization and health: results and options. , 2001, Bulletin of the World Health Organization.

[27]  Jeremy Rose,et al.  EVALUATING THE CONTRIBUTION OF STRUCTURATION THEORY TO THE INFORMATION SYSTEMS DISCIPLINE , 2001 .

[28]  P. Oliveira,et al.  Going down to the local: incorporating social organisation and political culture into assessments of decentralised health care. , 2000, Social science & medicine.

[29]  J. Domingues Social Integration, System Integration and Collective Subjectivity , 2000 .

[30]  Jørn Braa,et al.  Developing District-based Health Care Information Systems : The South African Experience , 2000 .

[31]  Jacky Swan,et al.  Information systems and strategic change: a critical review of business process re-engineering , 1999 .

[32]  J. Sachs,et al.  Malaria climate and poverty. , 1999 .

[33]  T. Bossert Analyzing the decentralization of health systems in developing countries: decision space, innovation and performance. , 1998, Social science & medicine.

[34]  T. Davenport Putting the enterprise into the enterprise system. , 1998, Harvard business review.

[35]  Stephen B. Peterson Saints, demons, wizards and systems: why information technology reforms fail or underperform in public bureaucracies in Africa , 1998 .

[36]  Jeremy Rose Evaluating the contribution of structuration theory to the IS discipline , 1998, ECIS.

[37]  N. Mouzelis Social and System Integration: Lockwood, Habermas, Giddens , 1997 .

[38]  M. Archer,et al.  Realist Social Theory: The Morphogenetic Approach , 1997 .

[39]  The World Health Report 1997--conquering suffering, enriching humanity. , 1997, World health forum.

[40]  M. Archer Social Integration and System Integration: Developing the Distinction , 1996 .

[41]  J. Bransen The Philosophy of Social Science. An Introduction , 1996 .

[42]  Margaret S. Archer,et al.  Culture And Agency: ‘Social integration and System integration’ , 1996 .

[43]  Leslie P. Willcocks,et al.  IT-enabled business process reengineering: organizational and human resource dimensions , 1995, J. Strateg. Inf. Syst..

[44]  Geoff Walsham,et al.  Decentralised information systems for development planning in India: context/process interaction , 1995 .

[45]  P Sandiford,et al.  The management of health services in Tanzania: a plea for health sector reform. , 1994, The International journal of health planning and management.

[46]  Geoff Walsham,et al.  Structuration Theory and Information Systems Research , 1990, ICIS.

[47]  Douglas V. Porpora,et al.  Four Concepts of Social Structure DOUGLAS V. PORPORA , 1989 .

[48]  Dennis A. Rondinelli,et al.  Development Projects as Policy Experiments: An Adaptive Approach to Development Administration , 1985 .

[49]  R. Bhaskar,et al.  The Possibility of Naturalism: A Philosophical Critique of the Contemporary Human Sciences , 1979 .

[50]  L. J. Cole,et al.  MASS CAMPAIGNS AND GENERAL HEALTH SERVICES. , 1965, WHO chronicle.

[51]  C. González Mass campaigns and general health services. , 1965, Public health papers.

[52]  Walter Ray Phillips United Nations Educational, Scientific and Cultural Organisation , 1949, Nature.