Health information systems implementation: Weaving alliances in East African Community

Abstract

This paper addresses the problem of fragmentation and lack of coordination in the context of health information systems. Drawing on a longitudinal action research study of implementing a regional database in East African Community; a process model is developed illustrating forms of institutional work in weaving alliance through three non-linear phases: standardisation, evolving and stabilisation. The study first contributes by conceptualising weaving alliance as a process whereby novel Information and Communication Technologies (ICT) capabilities such as the implementation and use of dashboards emerge and co-evolve with intentional actions by actors aligning stakeholders with diverse interests. The second contribution concerns how dashboards emerge and co-evolve with existing work practises facilitating a common understanding among multi-stakeholders. Collectively, the study broadens our understanding of introducing and sustaining ICT4D solutions in settings characterised by fragmented information systems.