IT enactment of new public management in Africa: the case study of health information systems in Kenya

In the last twenty years most African Governments have embarked on public sector reforms sponsored by international partners. Conceived under the New Public Management, the majority of these reforms leverage information technology to decentralise hierarchical structures into more information efficient organizations. The research analyses how the enactment of information technology influences the organisational outcome of New Public Management reforms in Africa. This question has been addressed through the case study of the Ministry of Health in Kenya. The case study provides the longitudinal account of how the usage of information technology within two health management information systems of the Ministry has given way to misalignments between NPM discourses and their enactment. Data collection and analysis have been framed within a multivocal and multilevel institutionalist perspective viewing different actors acting under the pressure of competing rationalities (New Public Management and Old Public Administration) at three main levels of action: the macro or policy level (e.g., formal policies), the meso or organisational level (e.g., professional norms of medical field) and the user or agentic level (e.g., IS users' routines). The case study has shown that the clashing between institutional discourses and their enactments caused the mobilisation of different legitimating resources underpinning different enactments of IT-enabled change leading to a partial implementation of reforms. Findings point to the rhetoric behind certain reform discourses by the main actors involved, particularly, at the macro-policy level. The paper calls for a stronger source of socio-political legitimacy to support these discourses around public sector reforms so that through the right competences and systems of values at the meso level information technology can be used as a catalyst for a more consistent implementation of the reforms. New discourses around the potential of IT should be more aligned with certain cultural-cognitive institutions underpinning the intention of policy makers at the macro level inducing Government echelons to legitimize IT at the macro-policy level