District Health Information System (DHIS) is used in many parts of the world to report aggregated data at the district level. Tanzania is one of the countries where the ministry of health endorsed DHIS for such use. Although the system has been rolled out recently throughout the country, Vertical Health Programmes (VHPs) are on their way to fully adopting the system. The objective of this study was to analyse the acceptance process of DHIS by three VHPs so as to examine the facilitating conditions and the challenges that they face. Data was collected through interviews, document review and observation. Analysis of the data showed the facilitating conditions to be having a consensus on which VHP indicators to include in the DHIS, existence of infrastructure including the routine Health Information System (HIS), and support from development partners. Challenges of acceptance process of DHIS include inadequate human resource for HIS, data quality and information flow issues, and existence of separate monitoring and evaluation systems for the VHPs. The study recommends integration or interoperation of DHIS with VHP systems, creating a pool of resources for HIS, training and motivating human resource for HIS.

The article is addressing the problem posed by fragmented and poorly coordinated Health Information Systems (HIS) in developing countries within the framework of complexity. HISs that can provide quality data for monitoring, management and health services provision are important for countries, which requires a sensitive understanding of complexity and how they can be managed. Using a case from Indonesia, we discuss the challenges of integrating HIS using the concept of attractor for change from the field of Complex Adaptive Systems (CAS). The dashboard is positioned as such an attractor as a means to get different stakeholders to discuss and reach a consensus on how to integrate and share data without disturbing the underlying systems too much. A more generic model to manage complexity is proposed.As a general rule we say that the higher the complexity, and the more embedded in the social context the systems are, the less easy it is to handle complexity. In the following model, we analyse complexity along two dimensions: more or less contextsensitive, and more or less networked or interdependent of other systems. The context-sensitive vs context-free dichotomyComplexity is a function of the nature of interaction of the system with local business processes, their levels of formalization, or standardisation, and the rate of change of the different components. The stronger the interaction and lower the levels of formalisation, the more unique features the system will need to include, making it more context-sensitive. This links with the web model [1] presented earlier, where the social systems model represents the context-sensitive end of the continuum and the discrete entity model the context-free end.

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This paper addresses the problem of fragmentation and lack of coordination in the context of health information systems. Drawing on a longitudinal action research study of implementing a regional database in East African Community; a process model is developed illustrating forms of institutional work in weaving alliance through three non‐linear phases: standardisation, evolving and stabilisation. The study first contributes by conceptualising weaving alliance as a process whereby novel Information and Communication Technologies (ICT) capabilities such as the implementation and use of dashboards emerge and co‐evolve with intentional actions by actors aligning stakeholders with diverse interests. The second contribution concerns how dashboards emerge and co‐evolve with existing work practises facilitating a common understanding among multi‐stakeholders. Collectively, the study broadens our understanding of introducing and sustaining ICT4D solutions in settings characterised by fragmented information systems.

This paper problematizes the way ICT4D projects are rarely equipped to anticipate for the longitudinal and organic nature of ICT4D processes. As such, it aims to explore how these ever-evolving processes may be met with adaptive solutions that are responsive to their changing environments. Our analysis concentrated on uncovering the change processes of a particularly successful ICT4D implementation over time. Based on these findings, we developed a process perspective of bricolage-driven change in ICT4D in which bricolage practices move through 3 different stages we identify to be 'opportunity based', 'locally owned' and 'locally driven' in nature. These insights are aimed at aiding researchers as well as practitioners in the ICT4D domain in the implementation of long term ICT4D solutions.