Corrina Moucheraud|Amee Schwitters|Chantelle Boudreaux|Denise Giles|Peter H. Kilmarx|Ntolo Ntolo|Zwashe Bangani|Michael E. St. Louis|Thomas Bossert
Sustainability of health information systems: a three-country qualitative study in southern Africa
University of California, Los Angeles|Lesotho Planned Parenthood Association|Harvard Global Health Institute|Center for Global Health|Centers for Disease Control and Prevention|Harvard Global Health Institute
health information systems central strong health systems assist patient program management quality improvement disease surveillance strategic use information many donors worked improve health information systems particularly supporting introduction electronic health information systems ehis considered responsive efficient older paperbased systems many donordriven programs increasing focus country ownership sustainability investments key concern analysis explores potential sustainability ehis investments malawi zambia zimbabwe originally supported united states presidents emergency plan aids relief pepfar using framework based sustainability theories health systems literature analysis employs qualitative case study methodology highlight factors may increase likelihood donorsupported initiatives continue original support modified ends findings highlight commonalities around possible determinants sustainability study found great optimism potential ehis perceived risks may result hesitancy transition completely parallel use paperbased systems full stakeholder engagement likely crucial sustainability well integration activities within health system funded development partners literature suggests sustainable system clearlydefined goals around stakeholders rally achieved systems studied study also found technical resource constraints affecting system usage maintenance upgrades repairs may limit ehis sustainability even pillars addressed sustainability ehis faces many challenges could addressed systems technical design stakeholder coordination building organizational capacity maintain enhance systems requires time attention likely enhance longterm outcomes