| dc.description.abstract | This thesis provides a distinct perspective on the implementation of a national Health Management Information System (HMIS) over a span of 20 years in Mozambique. The historical analysis presented here traces the country’s journey from the aftermath of colonial rule and a subsequent devastating civil war to the establishment of a robust and effective national HMIS. This was not a straightforward process but filled with successes and setbacks, which my historical study aims to trace and analyse through the lens of institutional theory. The analytical approach involved following the trajectory of a specific technological artefact, the District Health Information Software (DHIS2), over this period, during which it was first introduced, discontinued, and subsequently reintroduced, to gradually evolve and become the national system. This remarkable process was delineated into three empirical phases, each of which was retrospectively analysed using thematic analysis first and later, following a multilevel analysis drawing upon the rich concepts of institutional theory. The three key concepts identified (contradictions, entrepreneurship and institutionalisation) from the thematic analysis were synthesised using Seo and Creed's (2002) integrated framework, which was duly adapted to my research context. My thesis contributes broadly to the Information and Communication Technology for Development (ICT4D) field with implications for Information Systems (IS) research, specifically to better understand the phenomenon of HMIS/IS implementation and the interactions between Health and IT. Theoretically, my analysis depicts socio-political and technological dynamics influencing the implementation of DHIS2 and related processes over time in a public sector within an LMIC context. Thus, it contributes to understanding the mutual influences between institutional and organisational contexts, human agency, and technology. This analysis counters the dominant failure discourses which characterise ICT4D projects in LMIC contexts. Practically, it highlights how integrated approaches combining health and informatics skills development may raise awareness and action. Thus, contributing towards the development of sustainable capacity within health systems to further advance HMIS strengthening in the country. | en_US |