Digitalization mechanisms of health management information systems in developing countries. Issue 1 (March 2019)

• Record Type: Journal Article
• Authors: Gebre-Mariam, Mikael; Bygstad, Bendik
• Is Part Of: Information and organization. Volume 29:Issue 1(2019)
• Page Start: 1
• Page End: 22
• Publication Date: 2019-03
• Subjects: Information resources management -- Periodicals; Organizational change -- Periodicals; Information technology -- Social aspects -- Periodicals; Accounting -- Data processing -- Periodicals; Management information systems -- Periodicals; Comptabilité -- Informatique -- Périodiques; Systèmes d'information de gestion -- Périodiques; Electronic journals; 658.4
• DOI: 10.1016/j.infoandorg.2018.12.002
• Languages: English
• ISSNs: 1471-7727

Abstract

Abstract: The developmental potential of IT in developing countries continues to be confronted by enduring problems that hamper both the sustainability of digitalization initiatives and the realization of their expected benefits. Using a critical realist perspective, this paper examines the underlying causal chain of health management information system (HMIS) digitalization in a developing country. The study develops a mechanism-based explanation of the digitalization process drawing on Archer's morphogenetic approach (1995). Four generative mechanisms of HMIS digitalization were identified: projectification, informatization, embedded inscription and scaling. Theoretically, the paper demonstrates the joint value of Archer's structurational theory and the dynamics of interrelated causal mechanisms of digitalization. We offer three insights for ICT4D practice: First, projects as primary modalities for digitalization have created partnership asymmetries between NGO and local institutions hindering sustainable development. Second, lack of formalized arrangements around multi-stakeholder collaboration has led to poor accountability and regulatory environments. Finally, total dependency on external partners as NGO assumes a gap-filling role thereby replacing rather than building local institutional capacity. Highlights: The paper identified four generative mechanisms that provide causal explanation of unfolding events and how they shaped the HMIS digitalization process. The study demonstrates the analytical and explanatory capacity of critical realism and the morphogenetic approach for studying the complex process of digitalization. Approaches for tackling key theoretical challenges in ICT4D, namely; developing contextual contingency and linking ICT4D projects to their developmental outcomes by concatenating macro-micro causal mechanisms. The study offers practical insights into strategic and management priorities of digitalization in the developing country context.