Johan Ivar Sæbø

University of Oslo · Department of Informatics

This article describes the efforts to reform the Health Management Informa-tion System (HMIS) of Tajikistan. The authors were involved in proposing and piloting a computerized HMIS based on a complete overhaul of the current data collection tools, as well as in planning for the scaling up of the system. One of the recommendations was to support loc...

This paper addresses one of the major obstacles of reaching the Millennium Development Goals (MDG): inefficient and unreliable information systems. Leading international organizations have called for integrated data warehouses as one of the solutions, but this remains hard to achieve. This paper presents four country cases of standardizing and inte...

Scaling of information systems is a field of research with growing importance. This paper presents the story of scaling of an artifact (called District Health Information Software — DHIS) and associated principles and practices around a health information system that has taken place over 15 years, both within and between multiple developing countri...

Participatory Design (PD) has traditionally been committed to extensive interaction between developers and situated users to mitigate the disempowering consequences of computerization, such as the deskilling of labour workers. However, the widespread adoption of off-the-shelf software and the emergence of complex information system architectures wi...

Objectives This paper looks at the effects on transparency and accountability of introducing league tables in the health sector in Sierra Leone and Malawi. Methods Drawing on long-term action research in the two countries, we have supported development of league tables at district levels. Our practical aim of this work has been to design and devel...

Development planning is key to the attainment of global and national goals, especially in low-and middle-income countries where diverse sectors leverage each other's capacities to maximize limited resources. In this paper, we discuss approaches to digitalizing monitoring of national development plans in Uganda along a two-phase timeline where the f...

To date, there is little insight into how digital platforms might be governed towards the creation of social value. We argue that digital platforms can contribute to the creation of social value by enabling social options. Thus, we are concerned about how digital platform ecosystems may be governed towards the enablement of social options. We repor...

Background During the COVID-19 response in Norway, many municipalities used the Fiks contact tracing tool (FiksCT) to register positive individuals and follow-up contacts. This tool is based on DHIS2, an open source, web-based platform. In this study we examined if data completeness in FiksCT improved after integration with national registers betwe...

Journal hijacking, which refers to the attempted brand takeover of a journal by a third party, is a nascent threat confronting the information systems (IS) community, as evidenced by cybercriminals having established an online presence, masquerading as the Scandinavian Journal of Information Systems (SJIS). The SJIS hijacking damages the journal's...

This paper contributes to the nascent debate in the information systems (IS) field on liminal innovation by focusing on how tensions can be resolved during crisis. Liminal innovation is used by scholars to describe iterative processes of experimentation and implementation of IS during crisis. We draw on the concepts of communitas and anti-structure...

The importance of partnerships is established in the ICT4D academic and practitioner literature as a success factor contributing towards achievement of development outcomes. However, it is also recognised that the failure of partnerships is a common occurrence and there is limited knowledge about the reasons for these failures. International develo...

Digital public goods (DPGs) for development is a relatively new discourse in the field of information technology for development (ICT4D). DPGs are currently portrayed by international organisations and donors as key enablers towards the accomplishment of the Sustainable Development Goals (SDGs). However, there is a paucity of research that establis...

Globally, health information security and associated topics have received considerable attention from both professionals and the academic community. The literature on the threats and mitigations when it comes to developing countries is scarce, and tends to focus on issues such as cryptographic techniques for secure safe data transmission or patient...

The COVID-19 pandemic challenged countries to protect their populations from this emerging disease. One aspect of that challenge was to rapidly modify national surveillance systems or create new systems that would effectively detect new cases of COVID-19. Fifty-five countries leveraged past investments in District Health Information Software versio...

Background In regard to health service planning and delivery, the use of information at different levels in the health system is vital, ranging from the influencing of policy to the programming of action to the ensuring of evidence-informed practices. However, neither ownership of, nor access to, good quality data guarantees actual use of these dat...

The purpose of this paper is to explore digital global public goods (DGPG) as a foundation for theorizing platforms for development. Global public goods (GPG) are widely accepted as fundamental for socio-economic development due to non-rivalry, non-exclusivity and global relevance. However, the challenges of extending the ideals of GPG to the digit...

Online training has been gaining popularity for its flexibility and cost-efficiency. Its introduction challenges existing practices of in-service training which are mostly in the form of onsite training. Based on a participative, interpretive case study, we conceptualized in-service training as an institution, examining how the introduction of onli...

Online training has been gaining popularity for its flexibility and cost-efficiency. Its introduction challenges existing practices of in-service training which are mostly in the form of onsite training. Based on a participative, interpretive case study, we conceptualized in-service training as an institution, examining how the introduction of onli...

The importance of partnerships is established in the ICT4D academic and practitioner literature as a success factor contributing towards achievement of development outcomes. However, it is also recognised that the failure of partnerships is a common occurrence and there is limited knowledge about the reasons for these failures. International develo...

Digital public goods (DPGs) for development is a relatively new discourse in the field of information technology for development (ICT4D). DPGs are currently portrayed by international organisations and donors as key enablers towards the accomplishment of the Sustainable Development Goals (SDGs). However, there is a paucity of research that establis...

Globally, health information security and associated topics have received considerable attention from both professionals and the academic community. The literature on the threats and mitigations when it comes to developing countries is scarce, and tends to focus on issues such as cryptographic techniques for secure safe data transmission or patient...

BACKGROUND: In terms of health service planning and delivery the use of information at different levels in the health system is vital, from influencing policy, to program action, and to evidence informed practices. However, having good data or access to good data does not necessarily imply data use. For information to be used relevant data needs to...

COVID-19 represented a major shock to global health systems, not the least to resource-challenged regions in the Global South. We report on a case of digital, information system resilience in the response to data needs from the COVID-19 pandemic in two countries in the Global South. In contrast to dominant perspectives where digital resilience enab...

The purpose of this paper is to define and conceptualize digital global public goods (DGPGs) and illustrate the importance of contextual relevance in ICT4D projects. Recent studies have examined the importance of digital artefacts with public goods traits, emphasizing the significant potential for socio-economic development. However, we know little...

With rising numbers of COVID-19 positive patients in March 2020, Norwegian municipalities, who are responsible for contact tracing, struggled to register all the infected and their close contacts. This was partly due to the scale of the pandemic and partly because the only tools they had were pen and paper and in some cases spreadsheets. To address...

The purpose of this paper is to define and conceptualize digital global public goods (DGPGs) and illustrate the importance of contextual relevance in ICT4D projects. Recent studies have examined the importance of digital artefacts with public goods traits, emphasizing the significant potential for socioeconomic development. However, we know little...

COVID-19 represented a major shock to global health systems, not the least to resource-challenged regions in the Global South. We report on a case of digital, information system resilience in the response to data needs from the COVID-19 pandemic in two countries in the Global South. In contrast to dominant perspectives where digital resilience enab...

Background Policymakers need regular high-quality coverage data on care around the time of birth to accelerate progress for ending preventable maternal and newborn deaths and stillbirths. With increasing facility births, routine Health Management Information System (HMIS) data have potential to track coverage. Identifying barriers and enablers face...

Objective The aim of the study is to analyse an initiative from the World Health Organisation (WHO) to facilitate the dissemination of global standards and guidelines through digital health packages, which can strengthen the capacity of countries to monitor the SDGs. Digital health packages include data standards, guidance on data analysis, specif...

Indicators are foundational for planning, monitoring, and evaluating health services in developing countries. Most health indicators use population-based data, to enable comparison across geographical areas and over time. This paper is based on an interpretative case study on health indicators and how they are calculated and used at health faciliti...

The COVID-19 pandemic has highlighted the need for good quality data. The World Health Organization (WHO) has published recommended data standards for managing information about the pandemic, and in this paper we study an initiative to rapidly disseminate and implement these standards at the national level. A common challenge in standardisation ini...

The COVID-19 pandemic has highlighted the need for good quality data. The World Health Organization (WHO) has published recommended data standards for managing information about the pandemic, and in this paper we study an initiative to rapidly disseminate and implement these standards at the national level. A common challenge in standardisation ini...

In March 2020 the number of confirmed COVID-19 cases in Norway increased rapidly, and the efforts to trace contacts of positive cases were under severe pressure. Contact tracing in Norway is the responsibility of the municipalities, and no standardized or coordinated contact tracing practices were at the time in place on the national level. The aff...

The purpose of this paper is to explore digital global public goods (DGPG) as a foundation for theorizing platforms for development. Global public goods (GPG) are widely accepted as fundamental for socioeconomic development due to non-rivalry, non-exclusivity and global relevance. However, the challenges of extending the ideals of GPG to the digita...

The Health Information Systems Programme (HISP) is a sustainable and scalable research project enabling and supporting health information systems implementation in more than 100 developing countries. In this paper, we present the historical roots, the status, and discuss the future of HISP and its software (DHIS2). We also reflect on factors contri...

The Health Information Systems Programme (HISP) is a sustainable and scalable research project enabling and supporting health information systems implementation in more than 100 developing countries. In this paper, we present the historical roots, the status, and discuss the future of HISP and its software (DHIS2). We also reflect on factors contri...

Background: The proliferation of siloed community-based reporting systems in developing countries has been observed to be inadequate in supplying communi-ty stakeholders and governments with the information they desire. There is a clear need for community-based reporting systems to feed into a single centralized, government owned information system...

Background To achieve Sustainable Development Goals and Universal Health Coverage, programmatic data are essential. The Every Newborn Action Plan, agreed by all United Nations member states and >80 development partners, includes an ambitious Measurement Improvement Roadmap. Quality of care at birth is prioritised by both Every Newborn and Ending Pr...

Purpose: This paper analyses an initiative led by WHO within the health information domain to standardise analysis of health information through the use of analytical dashboards, using the concept of flexible standards. We focus on the implementation of these standards within existing, working information systems, analysing the implementation strat...

The purpose of this paper is to explore tensions in global public goods (GPG), based on the case of digital platforms for innovation. GPG designs promise normative ideals of non-rivalry and non-exclusivity, which in practice are challenged in reality and fraught with tensions. This paper draws on theory of contradictions to illustrate some of these...

Health information dashboards, which are collections of relevant indicator visualizations for management, have become a common feature and strategy for improved information use in the health sector. They should provide any manager with quality information in a format that points out the perfor- mance of health service provision, and thus necessitat...

With adherence to treatment, HIV positives can live a normal life. Accordingly, investments are made and health systems are expanded to reach those at risk in developing countries, where HIV is reported to be most endemic. At the same time, many developing countries still rely heavily on paper-based tools which are found to be inefficient when larg...

Background: To achieve Sustainable Development Goals and Universal Health Coverage, programmatic data are essential. The Every Newborn Action Plan, agreed by all United Nations member states and >80 development partners, includes an ambitious Measurement Improvement Roadmap. Quality of care at birth is prioritised by both Every Newborn and Ending...

Substantial investments are made in ICTs to support socioeconomic growth in developing countries. As a side-effect of this, the public health sectors in developing countries are commonly challenged by the proliferation of multiple and parallel information systems. Investments are made, but not in a coordinated manner. Based on a case study of OpenH...

Substantial investments are made in ICTs to support socioeconomic growth in developing countries. As a side-effect of this, the public health sectors in developing countries are commonly challenged by the proliferation of multiple and parallel information systems. Investments are made, but not in a coordinated manner. Based on a case study of OpenH...

Efforts to promote evidence-informed health policy in low-resource settings face persistent challenges in acquiring the necessary data. Inconsistent and fragmented data collection processes impede efforts to evaluate needs and monitor impacts. Recently, however, technical solutions have offered opportunities to overcome these challenges. Implementa...

Since its inception in 1948, the World Health Organization (WHO) has been instrumental in setting standards for monitoring and evaluation of public health interventions and health service delivery. This paper focuses on the way in which these standards are operationalized through health indicators and analytical tools. We describe and discuss a con...

New technologies have been implicated in various forms of mobilities creating new realities and questioning normative categories and the order in contexts where they are applied. Our study argues that through understanding technology mobilities, we uniquely bring to light new forms of social phenomena that materialize with interactions between mHea...

Indicators are foundational for planning, monitoring and evaluating of health services in developing countries. Most health indicators use population-based data, to enable comparison across geographical areas and over time. This paper is based on an interpretative case study on health indicators and how they are calculated and used at health facili...

Uninterrupted supply of health commodities is a prerequisite for a well-functioning healthcare system. Establishing and maintaining effective supply chains is at the same time challenging in developing countries. A key part of this chain and the focus of this paper are the information systems supporting the communication and distribution of commodi...

Health sectors in developing countries are commonly struggling with disarrayed health information architectures, where multiple vertical, disease-specific programmes have implemented their isolated information systems. A consequence is parallel and overlapping systems where information is stored at different locations and in different formats. To a...

Background and Purpose: The purpose of this paper is to describe the state of HMIS in Cameroon, with particular emphasizes on the organisational factors affect integration, routinization and use of information for decision-making for the achievement of UHC goals. Methods: This paper is based on an interpretative case study on the implementation of...

Objectives: With the increased attention to transparency and accountability in health sector management, this paper looks at how this can be promoted at district levels in two developing countries, Sierra Leone and Malawi. Using league tables for ranking districts and facility performance, the effects on transparency and accountability is examined....

League tables are used to compare the performance of different entities in the health systems in developing countries. The aim of this paper is to study the implementation process and its effects related to a computerized league table application in Malawi. Focusing on the health district and using a field experiment research approach, the focus is...

The ability of a health information exchange to consolidate information, collected in multiple, disparate information systems, into a single, person-centric health record can provide a comprehensive and longitudinal representation of an individual’s medical history. Shared, longitudinal health records can be leveraged to enhance the delivery of ind...

This paper is about the production of the health information system in Rwanda. It is a critical account which situates the ongoing architectural process historically and spatially. We have drawn on the ideas of Henri Lefebvre to pay particular attention to the often underplayed spatial dimension of information systems architecture. We draw some con...

We describe an effort to build an information system in West Africa, spanning the 15 countries of the West African Health Organization (WAHO). This is an environment where there is no central authority, and we have labeled these efforts as federated architecting. For this regional health information system to function, standards and routines need t...

One of the challenges of health management in developing countries is the existence of weak accountability and feedback practices. This paper assesses the conditions for introducing performance league tables for promoting accountability and feedback in health management. A qualitative approach with an interpretive perspective has been adopted in th...

Health systems in developing countries are commonly struggling with multiple and overlapping information systems (IS). There is a need to move away from this to reduce the burden of parallel reporting it creates and enable coordinated information collection and sharing. However, this is not straightforward as it prompts intricate functional archite...

In this paper we discuss the emergence of architecture, understood as the structured relationship between components in suites of software systems. We aim to formulate a processual perspective on architecture, implying that we emphasize the process of emergence over time as opposed to the usual time-invariant, static views that dominate architectur...

This paper is based on a critical perspective on the coordination of information systems in the health sector in developing countries. Two stories of health information system implementations in West Africa are presented. These are stories of integration, interoperability and architecting processes unfolding in a space where different actors pursue...

The article highlights the contradictory role per diem payments play in swiftly attracting local participation in ICT for Development (ICT4D) projects, while undermining long-term capacity building and sustainability with such efforts. We discuss sustainability challenges endemic to ICT4D projects in light of our case study findings from a mobile p...

The paper aims to identify, through an institutionalist analysis, the interplay between institutional logics pertaining to a prolonged and ongoing HMIS restructuring process in Malawi. In doing so the paper highlights important contestations between interpretations of the HMIS function, efforts aimed at its restructuring, and the meaning of the hea...

The aim of this thesis, and the research behind it, is to shed some light on the topic of scaling of IS, specifically scaling of Health Information Infrastructures (HII). There are both theoretical and practical motivations behind this. Theoretically, scaling has been treated as a linear process of expansion, though there remains little consensus a...

Health service provision is a public concern that mostly takes place at community level, through primary health care. Using cases from Sierra Leone and Kenya, this study shows how country health information systems, producing simple information products such as quarterly bulletins and league tables being distributed widely, have enabled the communi...

This paper draws upon an institutional entrepreneurship perspective to analyse the relationship between development and technological change, specifically within the context of public health information systems in developing countries. Firstly the development context is analysed in terms of the changing landscape and also institutions reflecting bo...

The challenge of scale and sustainability in health information systems development, especially in resource-poor settings, is well known. Earlier studies have argued for organizing such development in networks to increase the chances of success, as well as the heterogeneity leading to better understanding and thus better products. This paper looks...

Many poor countries developing health information systems face huge challenges of uneven infrastructural development. This relates both to the physical infrastructure such as internet, and even electricity, but also of skilled people and organizational maturity. While cities can offer the latest in technology, there can easily be a wide range of di...

We address the problem of how to integrate health information systems in low-income African countries in which technical infrastructure and human resources vary wildly within countries. We describe a set of tools to meet the needs of different service areas including managing aggregate indicators, patient level record systems, and mobile tools for...

Cases from an international network, active in health information systems development and implementation in “developing countries”, are presented in order to show a variety of interplays between the same IT agency and varying local settings. By using the same institutional lens, a theoretically informed view of empirical data is provided. Trajector...

This paper presents an ongoing project in Sierra Leone to integrate health information systems at district and national level through a novel approach. Employing solar-powered low-energy computers running Linux, a wide consortium of local and international actors have tried to counter the severe problems of electricity supply breakdowns and compute...

This paper describes an ongoing project in Botswana to improve monitoring and evaluation (ME) of HIV/AIDS programs using a bundle of different software. The National AIDS Coordination Agency and the Ministry of Local Government in Botswana was using a software package whose main strength was an existing support base and a large international data r...

The organizational complexity of health service provision is fairly high, given the many actors and the rapid evolution of both treatment methods and disease picture. Due to a dysfunctional health information system, the various actors in Botswana had created their own, independent information systems, leading to duplication of work and inaccessibi...

There has been a high rate of failure in the implementation of information systems in developing countries. Participative approaches have received a lot of attention as a way to ensure more appropriate systems with a greater rate of success. The authors of this paper spent 4 months working on designing and implementing a health information system a...

This paper will address issues of user participation in a large centralistic organization. It is based on one year experience of developing a computerized health information system within the Cuban health services. Relevant literature suggests that participative methods may be less feasible in centralistic environments. This paper confirms this by...