On Being Specific about Power: Institutional Dualism in Information Systems Integration

Abstract

Why is information systems integration in the public healthcare sector complicated? This paper unpacks the causes of such intricacy using the concept of institutional dualism. The empirical materials are derived from the Zanzibar healthcare sector, where data were collected using qualitative methods such as interviews, focus group discussions, document analysis, and participant observation. Cases from selected health programmes are examined in essence in order to shed light to which we can understand the HIS integration process as a straddling task of institutional matching or mixing where multiple institutions meet. Findings suggest that the resulting trajectories are the results of power interplay between actors involved, where power highly shapes reality and consequently affecting the prospects of the HIS integration.