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Exploring the role of health management information systems in improving accountability arrangements for primary health care delivery in less developed countries: a case of Northern Nigeria

Anifalaje, Adebusoye (2012) Exploring the role of health management information systems in improving accountability arrangements for primary health care delivery in less developed countries: a case of Northern Nigeria. PhD thesis, The London School of Economics and Political Science.

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Abstract

Health management information systems (HMIS) are implemented in less developed countries (LDCs) with the expectation that they will contribute to improving primary health care (PHC) delivery. Information generated through these systems is conceived as an imperative for better decision making processes and strengthening accountability arrangements that underpin the delivery of PHC. Despite strong rhetoric and significant investments to support these systems, most HMIS implementation in LDCs face challenges of poor data quality and weak accountability arrangements that limit their impact on health status. This constitutes a divergence from the instrumentality of predetermined indicators measuring health status performance that do not necessarily reflect the complex reality underlying how poor communities define their health priorities. We therefore highlight that accountability for performance management may indeed detract from the objective of improving the health of the poor and needs to be understood more broadly. This study illuminates the challenges and potential of HMIS implementation through accountability arrangements that are socially embedded in institutions, interactions and interpretations of global and local actors. As such, our primary research question is, “To what extent can HMIS improve accountability arrangements of PHC delivery?” Employing an interpretivist research methodology, we provide perceptions of how interactions between citizens, service providers, bureaucratic and political agents dynamically construct, contest and navigate accountability arrangements underpinning the provision of health care. This understanding has hitherto been limited in the HMIS literature. As a central theme in ICT for Development literature, illuminating these interactions furthers our understanding regarding the potential of HMIS in improving the lives of the poor. National governments, donors and HMIS practitioners will benefit from the practical insights derived from this study especially in relation to reconceptualising HMIS analysis to incorporate contextual and developmental notions of PHC. With relatively limited HMIS research, Northern Nigeria as the empirical context of this study also constitutes a useful contribution to the body of knowledge.

Item Type: Thesis (PhD)
Additional Information: © 2012 Anifalaje Adebusoye
Library of Congress subject classification: R Medicine > RA Public aspects of medicine
Sets: Departments > Management
Supervisor: Madon, Shirin
URI: http://etheses.lse.ac.uk/id/eprint/384

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