Stakeholder participation in the development of an electronic medical record system in Malawi

Abstract

In this paper we are concerned with stakeholders' participation in the development of an Electronic Medical Record (EMR) system for health facilities in Malawi, Africa. We draw on insights gained during the process of an Action Research project, which involved different stakeholders. We examine the different roles and forms of participation of these stakeholders. Through this, we illustrate how participation changes over time and co-evolves with the progress of the project. Our analysis also reveals that, in rural low-resource settings, expected end-users of EMR systems do not always have the health domain knowledge or expertise to effectively participate in such design projects. Therefore, participation of managers and other health domain experts is essential in order to supplement users' limited specialized knowledge of the domain.