Improving Developing Countries’ Health Information Systems Capacity for Infectious Disease Pandemic Responses: A Case Study of the Ebola Virus Disease and the Coronavirus Disease Pandemics

There is increasing evidence to demonstrate that current information system theoretical models meant to assess the success of the health information systems (HIS) lack the applicable theoretical underpinning suitable for developing countries. This stems partly from a theory-evidence gap where theoretical models developed in the West are applied in developing country contexts but lack tailoring to localized, contextual realities. Therefore, this study addresses this gap by enhancing the DeLeon and McLean\u27s information system success model with six contextual factors peculiar to the infectious disease HISs in a developing country context. This study took place in two developing countries, Liberia and Nigeria. It applied a triangulation convergence mixed-method study design, involving a quantitative descriptive, cross-sectional, and qualitative study design to collect data from participants in three decision-making levels. For the quantitative component of the study, multistage sampling guided the selection of the primary level decision makers randomly selected from 200 primary health care clinics 100 each from Liberia and Nigeria. For the qualitative component of this study, a judgemental non-probability sampling approach selected the secondary and tertiary level decision-makers involved in Liberian and Nigeria’s infectious disease response. Descriptive, structural equation modelling (quantitative) and inductive and deductive thematic analysis (qualitative) formed the core of the data analysis methods for this study. Taken together, the data revealed that 13 of the 21 hypothesized relationships extending the DeLeon and McLean’s information system success model were supported. The difference in the number and type of hypothesized relationships supported in Nigeria and Liberia also attest to the enhanced model’s sensitivity to determine context-specific challenges in different developing countries. The results also revealed that human resources for health competency (HRHC) had the strongest predictive influence on information, system and service quality in the two countries, while external partner support negatively predicts some quality measures in the two countries. This study demonstrates the value of applying context-specific theoretical models in HIS research in developing countries. The results from the study also demonstrate that investing in HRHC and improving donor engagement has the potentials to improve developing country\u27s ability to make responsive evidence-based decisions during the next infectious disease pandemic