{"title":"Contextually balanced engagement: Navigating paradoxes of localisation and cultural embedding in rural health information systems implementation","authors":"Israr Qureshi, Dhirendra Mani Shukla, Babita Bhatt, Pradeep Hota, Ruonan Sun","doi":"10.1111/isj.12522","DOIUrl":null,"url":null,"abstract":"<p>Although health information systems (HIS) play an important role in elevating health standards, a comprehensive understanding of how to effectively implement HIS in rural areas is lacking. This issue becomes more significant when considering that globally a majority of the approximately 1.5 million deaths of children under the age of five in 2019 that were attributable to vaccine-preventable diseases occurred in rural areas. Accordingly, we ask two questions. How does rurality influence the implementation of information and communication technology for development (ICT4D) projects? How do organisations navigate challenges associated with rurality during the implementation of these projects? Our findings, derived from an in-depth case study of a social enterprise in rural India, reveal two paradoxes that pose challenges to the effective implementation of HIS in rural settings: the localisation paradox and the cultural embedding paradox. We found that contextually balanced engagement was comprised of four organisational responses—prioritising; localising; cultural adjustment; and engaging stakeholders—that help navigate the challenges posed by the localisation and cultural embedding paradoxes. Synthesising these findings, we develop a process model that shows how the implementation of HIS in rural areas is shaped by the descriptive and sociocultural characteristics of rurality. Further, organisations require a dynamic approach, engaging in multiple responses over time to navigate the paradoxes inherent in HIS implementation. We suggest that organisational responses to paradoxical tensions stemming from the descriptive and sociocultural characteristics of rurality lead to the development of HIS <b>e</b>nabled for rurality. Our findings contribute the understanding of ICT4D projects implementation.</p>","PeriodicalId":48049,"journal":{"name":"Information Systems Journal","volume":"34 6","pages":"2024-2059"},"PeriodicalIF":6.5000,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/isj.12522","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Information Systems Journal","FirstCategoryId":"91","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/isj.12522","RegionNum":2,"RegionCategory":"管理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFORMATION SCIENCE & LIBRARY SCIENCE","Score":null,"Total":0}
引用次数: 0
Abstract
Although health information systems (HIS) play an important role in elevating health standards, a comprehensive understanding of how to effectively implement HIS in rural areas is lacking. This issue becomes more significant when considering that globally a majority of the approximately 1.5 million deaths of children under the age of five in 2019 that were attributable to vaccine-preventable diseases occurred in rural areas. Accordingly, we ask two questions. How does rurality influence the implementation of information and communication technology for development (ICT4D) projects? How do organisations navigate challenges associated with rurality during the implementation of these projects? Our findings, derived from an in-depth case study of a social enterprise in rural India, reveal two paradoxes that pose challenges to the effective implementation of HIS in rural settings: the localisation paradox and the cultural embedding paradox. We found that contextually balanced engagement was comprised of four organisational responses—prioritising; localising; cultural adjustment; and engaging stakeholders—that help navigate the challenges posed by the localisation and cultural embedding paradoxes. Synthesising these findings, we develop a process model that shows how the implementation of HIS in rural areas is shaped by the descriptive and sociocultural characteristics of rurality. Further, organisations require a dynamic approach, engaging in multiple responses over time to navigate the paradoxes inherent in HIS implementation. We suggest that organisational responses to paradoxical tensions stemming from the descriptive and sociocultural characteristics of rurality lead to the development of HIS enabled for rurality. Our findings contribute the understanding of ICT4D projects implementation.
尽管卫生信息系统(HIS)在提高卫生标准方面发挥着重要作用,但人们对如何在农村地区有效实施卫生信息系统缺乏全面了解。考虑到 2019 年全球约有 150 万五岁以下儿童死于可通过疫苗预防的疾病,其中大部分发生在农村地区,这个问题就变得更加重要。因此,我们提出了两个问题。农村地区如何影响信息和通信技术促进发展(ICT4D)项目的实施?在实施这些项目的过程中,各组织如何应对与农村地区相关的挑战?我们对印度农村地区的一家社会企业进行了深入的案例研究,研究结果揭示了在农村地区有效实施信息与传播技术促进发展项目所面临的两个悖论:本地化悖论和文化嵌入悖论。我们发现,情境平衡的参与包括四种组织反应--优先化、本地化、文化调整和利益相关者参与--这有助于应对本地化和文化嵌入悖论带来的挑战。综合这些研究结果,我们建立了一个过程模型,该模型显示了在农村地区实施 HIS 如何受到农村描述性特征和社会文化特征的影响。此外,组织需要一种动态的方法,随着时间的推移采取多种应对措施,以驾驭 HIS 实施过程中固有的悖论。我们认为,组织对农村的描述性特征和社会文化特征所产生的矛盾张力的反应,导致了为农村地区而启用的 HIS 的发展。我们的研究结果有助于理解 ICT4D 项目的实施。
期刊介绍:
The Information Systems Journal (ISJ) is an international journal promoting the study of, and interest in, information systems. Articles are welcome on research, practice, experience, current issues and debates. The ISJ encourages submissions that reflect the wide and interdisciplinary nature of the subject and articles that integrate technological disciplines with social, contextual and management issues, based on research using appropriate research methods.The ISJ has particularly built its reputation by publishing qualitative research and it continues to welcome such papers. Quantitative research papers are also welcome but they need to emphasise the context of the research and the theoretical and practical implications of their findings.The ISJ does not publish purely technical papers.