Challenges in Health Information Systems Integration: Zanzibar Experience
The health care milieu of most developing countries is characterized by multiplicity of vertical programs supported by myriad of donors. Often, the vertical programs maintain their own uncoordinated information systems which are in conflict with the primary health care goals of integrated district based health information systems. While some countries have managed to integrate the vertical reporting systems into the national HIS, ensuring reliance and continuous use of the integrated HIS by the programs’ managers is still a big challenge. The fragmentation of the HIS after integration, ensuing from the non reliance and compliance to the integrated system, has not received much attention empirically or analytically. Most of the contemporary research in HIS integration focused on the challenges in the process of achieving integration. The paper advocates the need to understand the nit gritty of what goes on after implementation which as the case suggests, presents enormous challenges to the HIS integration initiative. By drawing on an empirical case, the study revealed the tensions that exists between the ministry of health which strived to standardize and integrate the HIS and the vertical programs which pushed the agenda to maintain their systems alongside the national HIS. However, as implied from the study, attaining integration entails the ability to strike a balance between the two forces, which can be achieved by strengthening communication and collaboration linkages between the stakeholders and making use of gateways.