Factors Affecting Generic HIS Extensibility in Resource-Limited Settings: DHIS2 Android Tracker App Implementation in Zimbabwe

Abstract

This thesis investigates the factors that affect the adoption, extension and implementation processes involving generic open source software systems in the health information systems domain of developing country contexts. The study aims at unravelling what the factors are and how they enable or constrain the extensibility of these generic systems in resource-limited settings. The study was conducted as ‘Action-Case’ involving the development and implementation of an Android-based version of the Tracker Capture module in the DHIS2 system. The implementation context was a national malaria control program in Zimbabwe between the period of 2015 and 2016. Qualitative methods were used for data gathering and analysis informed by an interpretive paradigm of in-context IS field research. A theoretical model inspired on the Fit-Viability framework was used to frame the investigative and analysis processes. Factors were broadly identified as: 1)technological factors inherent in the software tools, 2)availability of technical expertise to implement the system, 3)the state of supporting ICT infrastructures, and 4)socio-economic conditions. These factors were assessed based on how they were perceived to impact on the system implementation process and the overall program performance. The major themes emerging from the findings were that extensibility of generic software systems do not depend on their design alone but also on other environmental factors. These factors have the ability to enable or constrain the realization of the systems extensions sought and have consequent implications in the wider implementation context. Practically, the research suggests that a system implementation approach that emphasizes project management practices when adopted could help curtail potential problems that may arise from the factors identified. Additionally, other points were discussed looking at how project risks may be minimized when considering technology adoption and sustainability in the public health sector of developing countries. Theoretically, the study hopes to contribute to enriching the Fit-Viability framework that was used to frame this research. Also it is hoped that the findings would add to the discourse on the emerging phenomena involving the adoption and repurposing of generic software systems to serve new use functions in the health information systems domain.