An institutional analysis on the dynamics of the interaction between standardizing and scaling processes: a case study from Ethiopia

Abstract

This paper presents an institutional theory-inspired analysis of the dynamics of interaction between processes of standardizing and scaling, in the context of Health Information Systems implementation in the Ethiopian public health care system. Standardizing and scaling have, in existing research, been treated primarily as independent technical processes that are isolated from the institutional context in which they take place. This paper tries to redress this balance in this research in two ways. Firstly, it argues for these processes to be taken as inter-related which can both support and undermine each other. Secondly, this mutual interaction is argued to be mediated by the institutional context. Specifically, we draw upon concepts from institutional theory inspired by Douglas North, focusing on the degree of overlap between formal institutions (attempts to establish formal policy on activities such as the definition of indicators and uniform reporting formats) and informal constraints in practice reflected in inadequate capacity – both technological and human, and existing work practices.

Keywords:

• Health Information Systems
• institutional theory
• scaling
• standardizing

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Erratum: An institutional analysis on the dynamics of the interaction between standardizing and scaling processes: a case study from Ethiopia

Additional information

Notes on contributors

Selamawit Molla Mekonnen

About the authors

Selamawit Molla Mekonnen is currently a Ph.D. student at the Informatics Department, University of Oslo. Since 2003, she has been involved in Health Information System (HIS) development and implementation in many developing countries. Her research interest revolves around the issue of HIS integration in developing countries; specifically, concerning exploring the link between organization culture and HIS integration.

Sundeep Sahay

Sundeep Sahay is a professor in Informatics at the University of Oslo, Norway. After completing his doctoral studies at Florida International University, he has held research and teaching positions at the Universities of Cambridge and Salford in the U.K., and at the University of Alberta in Canada. He published quite extensively regarding HIS, outsourcing and GIS.