This paper addresses work practices and organizational culture as situated actions and the implications for information systems innovation uptake. It reports research being conducted in Tanzania that brings an ethnographic research approach to understanding relations between local health care practices and health information systems development, by asking how health workers’ practices and everyday actions are influenced by the context of their specific situation. The research is being conducted in the context of a globally distributed open source software project to introduce and enhance health information systems in developing countries. Drawing on cultural historical activity theory, the study highlights the need for understanding each information system user's and each organization's specific and detailed work processes, and how situational and organizational factors may come together with the health information systems innovation processes in meeting the challenges discussed. In order to establish fully the potential of activity theory to innovation processes, situatedness of work practices focusing on the organization context is emphasized.

This chapter reviews the origins, approaches and roles associated with the use of cultural historical activity theory (CHAT) in information systems (IS) research. The literature is reviewed and examples are discussed from IS and related fields of human-computer interaction (HCI), computer supported cooperative work (CSCW) and computer supported collaborative learning (CSCL), to illustrate the power of CHAT in IS research as well as its link to appropriate research methods. After explicating the value of its use, the chapter concludes by discussing theoretical and methodological implications of applications of CHAT in examining real-world problems in IS research.

This article addresses the historical dimension of the relation between information systems innovation and organizational transformation. We analyse findings from a study of ongoing transformations in the healthcare sector in Zanzibar, Tanzania. The process is described with a particular focus on instances where some contradictions in the old activity system were not resolved but inherited by the new activity system. To address this we complement the activity theory framework with the notion of "installed base" from studies of information infrastructures. This helps to illuminate the theme of unresolved and continuing contradictions, and thus contribute to the concept of historicity in CHATinformed studies.Information systems (IS) innovation and organizational transformation is arguably the key challenge facing designers, implementers and users of IS and information technologies (IT) in organization (Sarker & Lee, 1999). Observed challenges include, among other things; uncoordinated communication between the top management and employees about the innovation initiatives at hand and inadequate understanding of the complexities associated with the development and implementation of IT as well as the formal and informal organizational functional areas and procedures.Furthermore, researchers have challenged approaches to IS innovation and organizational transformation that tended to put emphasis on discrete processes, such as productivity, systems quality, and development costs. These approaches neglect the intentions and actions of key players, the process by which IS tools are adopted and used, and the organizational context within which Correspondence should be sent to

The need for integration of health information systems as realised in the 90s by the developing countries resulted into deliberate standardisation initiatives. Software systems, human resources, procedures, and data collection tools were all subjected to standardisation. This standardisation, however, has been so absolute that the local and permanent variations were not taken into consideration. This study sought to find out how the local variations within the health care provision units can be taken into consideration in the design of health care data collection processes and tools. It employed qualitative, case study design and had 3 data collection techniques: observations, semi‐structured interviews, and documents review. The study found out that success in standardising data collection tools and processes in health care settings can be achieved if standards are put into clusters as it is unrealistic to subject the different health facility types into the same standards. The study proposes 3 clusters of standards. The dispensary cluster which accounts for the majority of all health facilities and the hospital cluster which accounts for all advanced diagnosis and treatment facilities and the third, specialised hospital cluster which accounts for specialised services.

In this paper we discuss two Participatory Design (PD) projects, one in Tanzania-Zanzibar and the other one in Sweden. In both countries the design process was done through the analysis of work practices involving both designers and users. The discussion focuses on a number of factors such as location, time and scene. We also ask how different projects can be that it is still possible to talk about PD as an overall participation and design approach. If PD is not a singular, definite, closed and fixed approach on the explicit layers, so how do these projects relate to each other when focusing on methods embracing the ambiguities of participation? The paper ends with a discussion of differences and similarities considering participation in the projects.