The challenges of sustainability of health information systems in developing countries: comparative case studies

The introduction of Information Technology (IT) typically comes with the promise of helping to manage scarce resources, increase efficiencies, reduce workload, and increase work productivity. In the context of developing countries, the lure of these promises is magnified given the existing conditions and inefficiencies. International donors for example the World Bank, or the World Health Organization play an important role in shaping this promise because developing countries are dependent on them for both technical and financial aspects. Given that IT projects may take a long time to be fully institutionalized, sufficient resources are required to build the local capacity to support and sustain the project after the withdrawal of donors. Inadequate donor support often contributes to weakening rather than strengthening human resource capacity and effective system design, since it emphasizes the technology itself in the expense of the needs of the users. These factors contribute to the design an