Managing information systems for health services in a developing country: a case study using a contextualist framework

Investments in information technology (IT) have been escalating in the heal th sector in both developed and developing countries. However, the failure rate of applications is of concern especially for countries with scarce res ources. There is insufficient understanding of factors that lead to such fa ilures in developing countries. A case study of implementing a computerised information system (IS) for health services in the Philippines is analysed using a contextualist framework. Factors that led to the failure included ambiguity in the organisation and in responsibility for the project, lack o f capacity to undertake large information systems development projects and inability to retain appropriate staff. However, when the historical and con textual issues were revealed and the interplay between the content, process and context of the change was analysed it was revealed that the content of the IS was not responsive to the changes in the wider health system. The c ase study confirms the need to analyse and understand organisational, envir onmental and cultural issues in adopting models and procedures used elsewhe re when managing information systems in developing countries. (C) 1999 Else vier Science Ltd. All rights reserved.