Design Principles for Building Institutions to Support Expanded PHI

The impact of ICTs is greatly influenced by the institutional context of their introduction and use. Where there are deep flaws in the health sector architecture and programme design, these undermine the effectiveness of the HIS deployed and these design flaws tend to be amplified when they are automated. However if one is conscious of these flaws, and ICTs are designed to address these, ICTs can be a game changer in correcting the structural flaws of health systems and programmes. Some design principles to enable this are elaborated upon next.

Treat information and communications technologies' introduction and use as a process of negotiation

No institutional entity should be powerful enough to impose a solution all on their own, and expect all others to drop their systems and accept their single window of truth. There will never be any single version of the truth and such a quest may not even be desirable. What is needed is a consensus for action, guided by an increasing appreciation of all the evidence and information available. Understanding the terms under which information is produced, disseminated, and used helps to build a better appreciation of the information itself, and make more informed choices of what sources to rely on and for what purposes. Institutional leaderships should shape the change in a more productive direction, and create the environment in which negotiations can take place and consensus decisions can be made.

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