A challenge with mHealth in developing countries is that implementations are frequently treated as standalone solutions. Implementations fail because they are not sufficiently aligned with existing... Show More

A challenge with mHealth in developing countries is that implementations are frequently treated as standalone solutions. Implementations fail because they are not sufficiently aligned with existing health information infrastructures (II). An interesting tool for evaluating implementation efforts in the context of the overall health II strategy, and thus potentially useful for identifying and mitigating risks, is the Bootstrap strategy. Bootstrapping is concerned with addressing take-off challenges facing novel solution implementations through incremental progression, resource maximization, mutual learning, and complexity mitigation. Although the strategy has been previously employed in retrospect to explain how implementation take-off challenges can be alleviated, less is known about its effectiveness as a tool for real time implementation risk assessment. Drawing on an action research mHealth project in Malawi, the study confirms bootstrapping as an effective tool for risk assessment, although the case also reveals that it may not always be easy to mitigate risks identified.

In developing countries, implementation of FOSS health information systems demands participation of diverse organizational actors and, can be considered similar to software outsourcing exercise. The... Show More

In developing countries, implementation of FOSS health information systems demands participation of diverse organizational actors and, can be considered similar to software outsourcing exercise. The multi sectoral actors operate in a network form of governance model where psychological and social contracts are important in maintain the fabric of the network organization. Inter-personal and inter-organizational trust is a key constituent in psychological and social contracts in IS outsourcing. This article attempt to reflect the empirical evidence of trust based governance of the network organization around 2 FOSS HIS implantation within the state health sector with an inter-organizational trust lenses. The longitudinal case studies try to understand how health managers' trust towards FOSS implementors changed and shaped HIS implementation trajectories with long term repeated interactions during two HIS implementations in Sri Lankan context.

The hallmark article by Thaddeus and Maine (1994) presented a framework to reducing maternal mortality by addressing the delays: (1) deciding to seek care; (2) reaching care; and (3) receiving... Show More

The hallmark article by Thaddeus and Maine (1994) presented a framework to reducing maternal mortality by addressing the delays: (1) deciding to seek care; (2) reaching care; and (3) receiving adequate care. This project developed a phone-based system used by traditional birth attendants to address the three delays in two districts in rural Zanzibar. Mobile phones provided: clinical algorithms to screen pregnant mothers for danger signs; phone numbers and mobile banking to arrange and pay for transportation; and contacts for health facility staff to alert them of referrals. 938 mothers participated in the “mHealth for Safer Deliveries” project. The intervention achieved a 71.0% facility delivery rate in the project zone, compared to the regional average of 32.0% (NBS and ICF Macro, 2011). This project demonstrated the effectiveness of mobile technology in addressing childbirth's three delays and its potential to impact maternal mortality in low-income countries.

This paper presents a software system based on smart cards technology for recording, monitoring and studying patients of any surgery specialty (General Surgery, Orthopedics, Neurosurgery, etc). The... Show More

This paper presents a software system based on smart cards technology for recording, monitoring and studying patients of any surgery specialty (General Surgery, Orthopedics, Neurosurgery, etc). The system is also suitable for the computerization of any surgery specialty clinic and the respective surgical material repositories. Dynamic customization functions adapt the system to the different characteristics of the surgery specialties. Special customization is involved concerning implantable materials. The .NET platform and Java Cards used for the development of the system and the architectural model of the system are designed towards satisfying the basic integration and interoperability issues. The developed system is “doctor-friendly” because it is based on classifications and knowledge grouping used in every day clinical practice provided from medical experts on the field but is not intended to be a complete Electronic Medical Record (EMR). The major scope of this effort is the development of a system that offers a fast and easy installable, low cost solution in health environments still immature in adopting solutions based exclusively on Informatics and is designed to be installed in small Private Medical Consulting Rooms to Community Clinics, Health Centers, Hospital Surgery Departments till Central Health Organizations.