Browsing by Author "Kimaro, Honest C."

Now showing 1 - 18 of 18
  • Thumbnail Image
    Item
    Adoption of Free Open Source Geographic Information System Solution for Health Sector in Zanzibar Tanzania
    (JHIDC, 2014) Bakar, Abubakar D.; Kimaro, Honest C.; Sultan, Abu Bakar; Hamiar, Sleiman
    The study aims at developing in-depth understanding on how Open Source Geographic Information System technology is used to provide solutions for data visualization in the health sector of Zanzibar, Tanzania. The study focuses on implementing the health visualization solutions for the purpose of bridging the gap during the transition period from proprietary software to the Free Open-Source Software using Key Indicator Data System. The developed tool facilitates data integration between the two District Health Information Software versions and hence served as a gateway solution during the transition process. Implementation challenges that include outdated spatial data and the reluctance of the key users in coping with the new Geographical Information System technologies were also identified. Participatory action research and interviews were used in understanding the requirements for the new tool to facilitate the smooth system development for better health service delivery.
  • Thumbnail Image
    Item
    Analysing the Hindrance to the Use of Information and Technology for Improving Efficiency of Health Care Delivery System in Tanzania
    (2005-09) Kimaro, Honest C.; Twaakyondo, Hashim M.
    Information Technologies (IT) have been described as offering tremendous opportunity to improve health services as well as in meeting broader developmental goals which have an impact on health. Through the use of IT, healthcare sectors can potentially plan, monitor and evaluate health services as well as communicate more effectively within and across organizational hierarchies. However, a number of studies suggest several hindrances where the use of IT to bring critical change in the health sector of Tanzania has been problematic. Despite the lack of appropriate use of the existing IT resources in the health sector, donors and government have continued helping the health sector to acquire up-to-date IT resources while however placing little emphasis on long term IT training, data management and effective utilization of information resulting into wasted of such resources hence little improvement in health services delivery. This study is based on the Health Information System Programme (HISP), an action research project aimed at improving health information system in developing countries with the use of IT and information for local action. Under the project, the district health information software which is customizable, open source and freely distributed has been implemented in five pilot districts in Tanzania. The lessons learned from HISP project and other levels of the health sector in general indicate the lack of skills for data interpretation and utilisation, policy guidelines on information and human capacity building as well as a lack of flexible system.
  • Thumbnail Image
    Item
    ANALYSIS OF THE ACCEPTANCE PROCESS OF DISTRICT HEALTH INFORMATION SYSTEMS (DHIS) FOR VERTICAL HEALTH PROGRAMMES
    (Electronic Journal of Information Systems in Developing Countries, 2015) Kiwanuka, Achilles; Kimaro, Honest C.; Senyoni, Wilfred
    District Health Information System (DHIS) is used in many parts of the world to report aggregated data at the district level. Tanzania is one of the countries where the ministry of health endorsed DHIS for such use. Although the system has been rolled out recently throughout the country, Vertical Health Programmes (VHPs) are on their way to fully adopting the system. The objective of this study was to analyse the acceptance process of DHIS by three VHPs so as to examine the facilitating conditions and the challenges that they face. Data was collected through interviews, document review and observation. Analysis of the data showed the facilitating conditions to be having a consensus on which VHP indicators to include in the DHIS, existence of infrastructure including the routine Health Information System (HIS), and support from development partners. Challenges of acceptance process of DHIS include inadequate human resource for HIS, data quality and information flow issues, and existence of separate monitoring and evaluation systems for the VHPs. The study recommends integration or interoperation of DHIS with VHP systems, creating a pool of resources for HIS, training and motivating human resource for HIS.
  • Thumbnail Image
    Item
    Analyzing the Problem of Unsustainable Health Information Systems in Less-Developed Economies: Case Studies from Tanzania and Mozambique
    (Wiley Online Library, 2005-01-29) Kimaro, Honest C.; Nhampossa, José L.
    Most of donor-supported information technology (IT)–based projects developed or implemented in less-developed economies (LDEs) end up as complete or partial failures or unsustainable. Notably, a number of intra-organizational and external factors are associated with this problem, including inadequate infrastructure and human resource capacity, fragmented donor policy, and lack of policies to manage the sustainability problem. Accordingly, IT initiatives are often donor-driven, top-down, and hijacked by top managers who (normally) do not have adequate skills, but have enormous power to enforce such initiatives across organizational hierarchies. In analyzing the concepts from sustainability and institutionalization, key insights towards a better understanding of the problem of unsustainability are developed. It is argued that health information systems (HISs) become sustainable if they are institutionalized in the sense of being integrated into the everyday routine of the user organization. However, a sustainable HIS should also be flexible enough to allow changes as the user needs change. Moreover, introduction of a new HIS is not only a technical change, but requires the cultivation and institutionalization of a new kind of culture. Through a comparative case analysis of the HIS development and implementation processes in Tanzania and Mozambique, we have identified two sets of relationships, between the Ministry of Health (MoH) and donor agencies and between the MoH and software development agencies as critical and contributing factors to the unsustainability of a HIS. Given this setting, we highlight three key strategies for dealing with the problem of unsustainability in LDEs: (a) integration of a HIS, (b) local shaping of new cultures, and (c) cultivation approach to systems development.
  • Thumbnail Image
    Item
    Challenges in Implementing a Computerized Name-based Information Tracking System: Practical Experiences from Maternal Health Care
    (2012) Ngoma, Caroline A.; Kimaro, Honest C.; Igira, Faraja T.; Mukulu, John; Kaasbøll, Jens J.; Yona, Alice; Mkabara, Naza; Sarikoki, Siaeli; Sangu, Immaculata; Njau, Cecilia; Mnaya, Adili; Mpoyo, Sofia; Mlongakweli, Zaina; Mwaga, William; Pilyimo, Rehema
    This paper presents challenges encountered in implementing a computerized name-based system for tracking information of pregnant women and children in rural clinics. Results indicate that the implementation of a computerized name-based system faces potential challenges that include; understanding the complexity of local healthcare practices within the community as well as correlating standardised and improvised data collection tools used in health facilities. Other challenges are; application of localised and standardised procedures in healthcare provision, replacing the paper-based system and lastly gradual learning curve during the implementation. These are initial findings drawn from a qualitative research study conducted in the Coastal region of Tanzania. This study intends to improve data reporting and utilisation of health facility services for pregnant women, children and other key community members.
  • Thumbnail Image
    Item
    Challenges of Sustainability of Health Information Systems in Developing Countries: Comparative Case Studies of Mozambique and Tanzania
    (JHIDC, 2007) Kimaro, Honest C.; Nhampossa, José L.
    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 and implementation of unsustainable health information systems (HIS) in developing countries. Through a comparative case analysis of the HIS in Mozambique and Tanzania, we have identified three sets of relationships as crucial in shaping the sustainability of HIS. The relationships between the Ministry of Health (MoH) and the software development agency, between the MoH and the donors, and between the donors and the software development agency. The reasons for the lack of alignment between the relationships, although possibly different in the two cases, are identified and some specific recommendations are made to support their alignment, and with it, we argue, the sustainability of the system.
  • Thumbnail Image
    Item
    Challenges of user participation in the design of a computer based system: the possibility of participatory customisation in low income countries
    (JHIDC, 2008-01) Kimaro, Honest C.; Titlestad, Ola Hodne
    Participatory design is generally regarded as an effective approach in systems evelopment to overcome challenges such as changing contexts, difficulties of capturing users’ needs and problems of achieving systems’ acceptance. However, user participation is associated with certain contextual assumptions or beliefs from its origin in the West that are not always applicable in the context of Low Income Countries (LICs). The initial technical capability of users, motivation and desire to participate, availability of resources and long-term support mechanisms are often taken for granted in the West, but in many cases not present in the context of LICs. In the Western setting, due to favourable socio-economic and political conditions and the presence of skilled users, an approach to design of systems from scratch with user participation tend to give quality systems. However, in a LIC setting where the intended users have limited computer skills, there is a need to put an extra effort into training and to find alternative approaches to achieve participation in system design. In such a setting, we argue that participatory customisation, a process where the users in collaboration with the developers adapt an already developed or partly developed system to meet the needs of their own workplace, can be a better approach. In this paper we approach participatory customisation in LICs by looking in detail at the customisation of the District Health Information Software (DHIS) in two pilot health districts in Tanzania. The Tanzanian project is part of a global research initiative (the HISP), and in order to put forward more general approaches for LICs, we compare our findings from Tanzania with similar customisation processes in Cuba, India, Mozambique and South Africa.
  • Thumbnail Image
    Item
    Factors Affecting Utilization of Evidence Based Health Information System for Effective Supply Chain of Essential Medicine in Tanzania: A Case Study from Mbeya Region
    (JHIDC, 2011) Kagaruki, Gibson; Kimaro, Honest C.; Mboera, Leonard
    Background: Essential Medicines (EMs) are medicines that satisfy the priority health care of the population. They are selected with due regard to public health relevance, evidence on efficacy and safety, and comparative cost-effectiveness. While Health Information System (HIS) is a system that integrates data collection, processing, reporting and use of the information necessary for improving health service effectiveness and efficiency through better management at all levels of health services. Method: A cross sectional study was conducted from April to June 2009 in Mbeya Region and at the national level to assess the factors affecting utilization of evidence based health information system for effective supply chain of EMs in Tanzania so as to develop strategies for valuable procurement at the facility and national levels. Quantitative data was collected from 33 health facilities (HFs) and qualitative data was collected from two focus group discussions and 23 different key informants from different levels of the EMs supply chain. Results: This study revealed the following main factors that affect utilisation and management of information system (IS): lack of strong IS at Medical Store Department and Ministry of Health and Social Welfare to manage the organization, suppliers and clients needs; lack of compliance to the national ordering and deliveries guideline and procedures; inadequate funds; low capacity in implementing integrated logistic system; lack of national representative data during annual budgeting and forecasting of EMs requirements; and political interests. Conclusion: In this study the supply chain of EMs at the HFs and central levels in Tanzania is not evidence-based. For effective utilization of HIS in the supply chain of EMs there is need to strengthen the capacity in the management and utilisation of HIS at facility, district and national levels.
  • Thumbnail Image
    Item
    A Framework for the Acceptance Process of District Health Information System for Vertical Health Programmes
    (IST-Africa 2015 Conference Proceedings, 2015) Kiwanuka, Achilles; Kimaro, Honest C.; Senyoni, Wilfred; Thobias, Joseph
  • Thumbnail Image
    Item
    HIS Standardization in Developing Countries: Use of Boundary Objects to Enable Multiple Translations
    (2015-12) Nyella, Edwin E; Kimaro, Honest C.
    Standardization and integration of Health Information Systems (HIS) in most developing countries has been reported as a complex undertaking due to poverty, multiplicity of diseases and diverse actors working in various initiatives within the healthcare context. The need for collaborative investments in HIS strengthening is highlighted by major actors such as WHO, as significant to achieve an integrated HIS. However, despite the fact that involvement of multiple partners is desirable as a vehicle to attain an integrated HIS, entailed challenges should be understood and well managed. By drawing on the concept of translation from actor network theory supplemented by the notion of boundary objects, we examine the HIS standardization challenges and the strategies to curb them in the context of multiple divergent actors engaging in HIS integration process in Tanzania. The article stresses the need to coordinate the standardization process through circulation of boundary objects across the involved multiple actors.
  • Thumbnail Image
    Item
    An Information Infrastructure and Institutional Theory Perspective: On Decentralization and Sustainability of ICT Based Health Information Systems in Developing Countries: A Case Study from Tanzania
    (VDM Verlag Dr. Müller, 2010-01-05) Kimaro, Honest C.
    This book presents an in-depth theoretically informed and empirically based studies of the efforts to introduce, use, and sustain the computer based Health Information Systems (HIS) in the local setting of Tanzania. Theoretically, the aim is to understand the relationship between processes of decentralization and sustainability of computer based HIS. I argue in this book that the key to achieving a sustainable HIS is to address the complexities and challenges of the decentralization processes of health services and HIS and their inter- linkages. In analyzing the case study through various concepts drawn from institutional theory and information infrastructure perspective, the book develops key insights towards addressing this paradox. The various implications developed from this work have implications for use in the study of decentralization and sustainability of IS generally and HIS more specifically in similar contexts.
  • Thumbnail Image
    Item
    An institutional perspective on the process of decentralization of health information systems: A case study from Tanzania
    (Wiley Online Library, 2007-10-15) Kimaro, Honest C.; Sahay, Sundeep
    Attempts to decentralize Health Information Systems (HISs) are ongoing in various developing countries as a part of health sector reforms. Donor communities in particular have often insisted on decentralization of health care systems as a mechanism to encourage quality and sustainability of health services and availability of timely resources at local levels by removing layers of bureaucracy. The decentralization of HISs along with the system of health care delivery is emphasized to support the efficiency and management of health services by incorporating local use of information in decision making and planning. However, these goals of decentralization are not easily achieved because of the complexity of the institutional context in which the decentralization is being carried out. Drawing from institutional theory, we study the process of decentralizing HIS in Tanzania. We identify three key sets of institutional influences on the HIS originating from the political administrative, health management, and health service delivery systems. Through an ongoing empirical analysis, we identify the gaps between the formal rules that govern the reform process and the informal constraints that operate on the ground and “keep the show going.” The existence of these gaps contributes to the ineffective results obtained through the reform process. The need for both vertical and horizontal alignment is emphasized as an approach to addressing these gaps in the future
  • Thumbnail Image
    Item
  • Thumbnail Image
    Item
    Redesigning health information systems in developing countries: The need for local flexibility and distributed control
    (Wiley Online Library, 2008-01-29) Kimaro, Honest C.; Mengiste, Shegaw; Aanestad, Margunn
    Despite widespread aims to strengthen the Health Information System (HIS) as a tool for decentralised health care, there is a strong tendency in most developing countries that the HIS continues to reflect the central level's needs and requirements. The traditional design approach with little or no end user involvement results in a centralised HIS with an extensive, somewhat inappropriate, but also inflexible set of standards. Consequently, the HIS is not very useful for the wished-for decentralisation of health services, and there is an urgent need to redesign the existing HIS in order to make it locally relevant and appropriately decentralised. Based on a comparative case analysis of the HIS in Tanzania and Ethiopia, we offer practical recommendations on the way to achieve this redesign. A central design goal should be to achieve a balance between centralised control and local autonomy. Some degree of control over a decentralised HIS, including budgets and the use of resources, should be delegated to the district administration. In order to achieve the aim of a locally relevant, well-working HIS, it is necessary that appropriate authority, capacity and decentralised allocation of resources for HIS will be developed at the district and sub-district levels.
  • Thumbnail Image
    Item
    Strategies for Developing Human Resource Capacity to Support Sustainability of ICT Based Health Information Systems: A Case Study from Tanzania
    (The Electronic Journal of Information Systems in Developing Countries., 2006) Kimaro, Honest C.
    Information and Communication Technologies (ICTs) are typically introduced in organizations with the promise to help manage resources, increase efficiency, increase work productivity and reduce workload. In the context of developing countries, the lure of these promises is magnified given the existing conditions and inefficiencies. International aid agencies play an important role in shaping this promise. However, introduction and use of ICTs in developing countries has proven problematic due to failures or unsustainability resulting from many factors. One important factor is the lack of appropriate human resources both with respect to quantity and quality. This paper emphasizes that human resource capacity building in developing countries is an urgent issue of concern for the sustainability of ICTs. Drawing on concepts of sustainability, ICT literacy, and human capacity building, this paper analyzes challenges related to human resources in health information systems (HISs) and ICTs in the health sector of Tanzania and suggests some strategies to address the problem. Specifically, the paper focuses on initiation of ICT based HIS in the context of the health sector and argues for human resources with a mix of skills to understand the meaning of data, information, and the use of computers.
  • Thumbnail Image
    Item
    Strategies for Development and Integration of Health Information Systems: Coping With Historicity and Heterogeneity
    (2005) Aanestad, Margunn; Monteir, Eric; Kimaro, Honest C.; Macombe, Esselina; Macueve, Gertrudes; Mukama, Faraja; Muquingue, Humberto; Nhampossa, Jose Leopoldo; Lungo, Juma
    Health is crucial for development, and well-working health information systems are required for sound decision making and effective use of resources. However, establishing working information systems in developing countries is truly a challenge. Moreover, strategies for the development and integration of large and growing collections of information systems escape simplistic recipes. This is a pressing practical problem globally, as well as analytically under-researched within the IS field. We aim to contribute to the understanding and development of such strategies by underscoring two core dilemmas: (i) the conservative influence of historically accumulated and institutionalized practices, technologies and perceptions (dubbed the ‘historicity’ of information systems) and (ii) the lacking integration and increasing fragmentation across the collection of information systems (dubbed the ‘heterogeneity’ of information systems). The empirical underpinning for our analysis is an action research project, the Health Information Systems Program (HISP), which aims at improving existing suboptimal health information systems in developing countries. HISP provides a particularly poignant illustration of the challenges related to historicity and heterogeneity of information systems as these are implied in the politico-historical context. Our empirical material is a cross-national comparative analysis of the current reporting systems for administrative health data in Mozambique, Tanzania and in the state of Andhra Pradesh in India. Several problems are associated with the existing systems and the need to change or replace them is recognized. For example, due to the donor- and aid-dependent economies of most developing countries, there are often other specialized health care programs e.g. targeted towards specific diseases like malaria, tuberculosis and HIV/AIDS. These programs usually have their own reporting systems, and the result emerging over time is a disintegrated and heterogeneous collection of systems. The challenges associated with attempting to change such large-scale, heterogeneous and fragmented systems involve complex dilemmas. As the current information systems are embedded and institutionalized nationwide, a realistic strategy need to take a phased approach whereby present systems are gradually integrated into the environment. In the case of donor-supported and -managed program, the national health authorities may not even have the required power to intervene. Thus the existing reality cannot be ignored or done away with, whether it be the information systems, the institutions or the work practices; they constitute the point of departure. Analytically, we draw on recent socio-technical conceptualizations of large, integrated systems - so-called information infrastructures - especially through recent elaborations in the theoretical foundation in actor-network theory (ANT). The development strategy we suggest emphasizes an evolutionary, ‘cultivating’ approach while at the same time accepting that there will be a certain level of non-integration (often perceived of as ‘mess’) as chronic.
  • Thumbnail Image
    Item
    UDSM Researchers Comes with an Inspiring ICT-based Solution to Improve Road Safety
    (Guardian News Paper, 2016-08) Mndeme, Mathew M.; Mvungi, Nerey H.; Kundaeli, Herald K.; Kimaro, Honest C.; Hamisi, Ndeyetabura
    Researchers at CoICT lead by Prof Nerey Mvungi, Dr. Honest Kimaro, Prof. Herald Kundaeli, Dr. Hamisi Ndetabura, and Mathew Mndeme, are undertaking a scientific research on how authorities responsible with road safety management can leverage on the potential of ICT-based systems in addressing safety challenges. This research project is supported by TCRA in its efforts to advance ICT researches and innovations in the country. Since the inception of this study over two years ago, CoICT researchers have consulted a number of stakeholders including all relevant government authorities/institutions involved with transportation and road safety management, the focus being to understand existing information systems and those in pipeline for implementation. Researchers have established relationships among these systems and their challenges that can be addressed through ICT innovative solutions. One of the immediate outputs to the study is the development of an Integrated Road Safety Management System, Christianised as iROAD
  • Thumbnail Image
    Item
    UDSM waja na Suhuhisho la Kielekroniki Kuboresha Usalama wa Barabarani
    (Habari Leo, 2016-08) Mndeme, Mathew M.; Mvungi, Nerey H.; Kundaeli, Herald K.; Kimaro, Honest C.; Hamisi, Ndeyetabura
    Kwa kuzingatia changamoto zilizooanishwa hapo juu na nyingine, watafiti wa fani ya TEHAMA wa CoICT wakiongozwa na Prof. Nerey Mvungi, Dkt. Honest Kimaro, Prof. Herald Kundaeli, Dkt. Ndyetabura Hamisi na Bw. Mathew Mndeme chini ya ufadhili wa Malamlaka ya Mawasiliano Tanzania (TCRA) na kwa kushirikiana na wadau mbalimbali wanaojishughulisha na usalama barabarani, wanafanya utafiti wa jinsi ya kutumia mifumo ya TEHEMA ili kuchangia katika kutatua matatizo ya utekelezaji wa sheria na kanuni za usalama barabarani. Kwa zaidi ya miaka miwili iliyopita, CoICT imekutana na wadau mbalimbali kama Wizara ya Mambo ya Ndani na ya Ujenzi na Mawasiliano, Jeshi la Polisi, Sumatra, Tanroad, Costech, TRA, na wengine wengi ili kuelewa mifumo ya taarifa iliyopo na inayotegemewa kutumika. Hali kadhalika, kuona kama kuna uhusiano wa mifumo iliyoko kati ya taasisi moja na zingine, pamoja na changamoto za mifumo hiyo ili kutafuta suluhisho la kitafiti kupitia matumizi ya TEHAMA. Moja ya matokeo ya la utafiti huu ni mfumo wa kielekroniki ujulikanao kama Integrated Road Safety Management System au iROAD kwa kifupi.