E-Government Policy and Health Information Systems Implementation in Andhra Pradesh, India: Need for Articulation of Linkages Between the Macro and the Micro

In recent years, many different types of e-government projects have been implemented across the developing world. One important application area, especially following the Millennium Development Goals, is the introduction of health information systems to improve the management of health care for development. Despite significant investments in these projects, experience reveals a disjuncture between macro-level policy priorities and micro-level implementation of these programmes. We use a broad conceptualization of evaluation to synthesize priorities at different levels during the implementation of an e-government project—the Health Information Systems Project (HISP) in Andhra Pradesh, India. This enables us to identify important enabling processes and conditions which serve to connect policy and implementation priorities. Our findings suggest that evaluation does help us to understand the disjuncture between policy at the macro level and implementation at the micro level and to identify linkages between the two. Finally, we discuss some of the key institutional issues that need to be addressed to translate the learning derived from the field into policy actions.

[1]  Jørn Braa,et al.  Networks of Action: Sustainable Health Information Systems Across Developing Countries , 2004, MIS Q..

[2]  Richard Heeks Most eGovernment-for-Development Projects Fail: How Can Risks be Reduced? , 2003 .

[3]  Krister Andersson,et al.  From policy lessons to policy actions: motivation to take evaluation seriously , 2004 .

[4]  Michael L. Best,et al.  Impact and Sustainability of E-Government Services in Developing Countries: Lessons Learned from Tamil Nadu, India , 2006, Inf. Soc..

[5]  Sundeep Sahay,et al.  Counter Networks, Communication and Health Information Systems , 2003 .

[6]  R. Kaplan,et al.  The Balanced Scorecard: Translating Strategy into Action , 1996 .

[7]  Shirin Madon,et al.  Governance lessons from the experience of telecentres in Kerala , 2005, Eur. J. Inf. Syst..

[8]  K. Legge,et al.  Evaluating Planned Organizational Change , 1984 .

[9]  E. Guba,et al.  Fourth Generation Evaluation , 1989 .

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

[11]  Gilbert A. Clark,et al.  Evaluating the Arts in Education: A Responsive Approach , 1976 .

[12]  A. Kellerman,et al.  The Constitution of Society : Outline of the Theory of Structuration , 2015 .

[13]  Wanda J. Orlikowski,et al.  Information Technology and the Structuring of Organizations , 2011 .

[14]  Tom M. van Engers,et al.  Measuring e-government impact: existing practices and shortcomings , 2004, ICEC '04.

[15]  D. Silverman Qualitative research : theory, method and practice , 2004 .

[16]  A. Giddens Central Problems In Social Theory , 1979 .

[17]  Basil E. Cracknell,et al.  Knowing is all: or is it? Some reflections on why the acquisition of knowledge, focusing particularly on evaluation activities, does not always lead to action , 2001 .

[18]  S. Alkire Valuing Freedoms: Sen's Capability Approach and Poverty Reduction , 2002 .

[19]  Michael Quinn Patton,et al.  Utilization-Focused Evaluation , 1979 .

[20]  Antonio Cordella,et al.  The Role of Information and Communication Technology in Building Trust in Governance: Towards Effectiveness and Results , 2005 .

[21]  Geoff Walsham,et al.  Implementing public information systems in developing countries: Learning from a success story , 2005 .

[22]  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.

[23]  Rahul De Two Readings of a Land Records Management E-Government System: A Case Study in India , 2005 .

[24]  Shirin Madon Evaluating e-governance projects in India: a focus on micro-level implementation , 2005 .

[25]  Sundeep Sahay,et al.  Counter Networks, Communication and Health Information Systems: A Case Study from Mozambique , 2003, Information Systems Perspectives and Challenges in the Context of Globalization.

[26]  Ralph W. Tyler,et al.  Basic Principles of Curriculum and Instruction , 1969 .

[27]  Pär J. Ågerfalk,et al.  Setting the Scene for Actability Evaluation : Understanding Information Systems in Context , 2002 .

[28]  Geoff Walsham,et al.  Information technology in developing countries: A need for theory building∗ , 1995 .

[29]  Gerardine DeSanctis,et al.  Capturing the Complexity in Advanced Technology Use: Adaptive Structuration Theory , 1994 .

[30]  Michael Scriven Prose and Cons about Goal-Free Evaluation: , 1991 .

[31]  Rudy Hirschheim,et al.  Analysing information systems evaluation: another look at an old problem , 1998 .

[32]  Richard Heeks Information and Communication Technologies, Poverty and Development , 1999 .

[33]  J. Kooiman,et al.  Modern Governance: New Government-Society Interactions , 1993 .

[34]  J. Kooiman,et al.  Governing as Governance , 2003 .

[35]  Frank F. Land,et al.  Evaluation in a Socio-technical Context , 2000, Organizational and Social Perspectives on IT.

[36]  Atanu Garai,et al.  Taking ICT to Every Indian Village: Opportunities and Challenges , 2006 .

[37]  Theo Lippeveld,et al.  Design and Implementation of Health Information Systems , 2000 .

[38]  Suprateek Sarker,et al.  Understanding Virtual Team Development: An Interpretive Study , 2003, J. Assoc. Inf. Syst..

[39]  U. Reinhardt,et al.  The world health report 2000 - Health systems: improving performance , 2000 .

[40]  Subhash Bhatnagar,et al.  E-Government: From Vision to Implementation - A Practical Guide With Case Studies , 2004 .

[41]  J. Clapp,et al.  Development as freedom , 1999 .

[42]  Goran Hyden,et al.  Making sense of governance : empirical evidence from sixteen developing countries , 2004 .