1 PRAGMATISM OR POLICY: IMPLICATIONS ON HEALTH INFORMATION SYSTEMS SUCCESS

The most fundamental issue for any information system is to produce information that is relevant to organisational goals. A number of research studies have reported failures in information systems, especially in health information systems (HIS) in developing countries. The challenges of success lie in the heterogeneity of the players, the requirements, the practices and some of the policies in place. In some cases, national policies affect the success of the information systems. This paper describes and analyses some of the factors that affect HIS success in developing countries. The aim of this research was to identify, within the environment where the information systems are implemented and used, issues that could be stumbling blocks to their success. Although the use of HIS is seen as a satisfactory outcome of health sector reform, there are certain social aspects, both internal and external to the organisation and system that influence its success or failure. We highlight the factors affecting HIS using a case study from Malawi. Specifically, we examine the extent to which Sexual Reproductive Health and Rights (SRHR) policy, which includes stopping traditional birth attendants from assisting in births, affects the maternal and child data flow from communities to health facilities and hence into HIS. The SRHR policy was introduced as a way of curbing maternal mortality in a bid to attain the fifth Millennium Development Goal. The findings from an interpretive study reveal that external factors, such as SRHR policy implementation, can affect the quality of data that is input into HIS. We recommend a more pragmatic approach when implementing SRHR policy and provide a new angle to value judgements of environmental context