Browsing by Author "Shidende, Nima Herman"

Now showing 1 - 4 of 4
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    Challenges in implementing patient‐centred information systems in Tanzania: An activity theory perspective
    (Wiley, 2014) Shidende, Nima Herman
    Defaulter tracing systems are patient centred information systems which are used to enhance monitoring of patients who have dropped out of health programs. The aim of this study is to explore the operation of defaulter tracing systems in practice. The study has been undertaken in Tanzanian health facilities by using qualitative data collection methods. Activity theory is employed as a conceptual framework to analyze the findings. Findings show that the implementation of defaulter tracing system is challenged by issues of the existing information systems, such as absence of clear guidelines and tools, and information recording incompleteness, as well as contextual issues. The paper contributes to Healthcare Information System literature (HIS) which has elaborated how patient centred information systems are utilized in practice at the level of primary health care. This study concludes by providing implications for policy, practice, design and implementation.
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    Gendering design of M-Health applications to support marginalized women: A case of maternal and child health services in Tanzania
    (Kennesaw State University, 2019) Makaranga, Joseph Thobias; Shidende, Nima Herman
    This study aimed at addressing a gap in the existing literature by providing empirical insights into gendered ICT design in rural African settings. The research used qualitative research methods to identify design weaknesses that were causing the exclusion of the poorest and most rural women. The research design enrolled rural women to inform the redesign of the Tanzanian mHealth application, the DHIS Tracker. The app is designed to enable economically disadvantaged rural women to receive targeted healthcare appointments and advice via SMS text messages. Gendered design is used as a conceptual framework to guide the analysis. Also, we use insights from Buskens (2015)’s categories of strategies for empowering women; conformist, reformist and transformist to inform how gendered design can be done in the rural African context. The article ends by providing insights to policy and managerial levels that can be used to promote women empowerment.
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    Re-visiting design-after-design: Reflecting implementation mediators connectedness in distributed participatory design activities
    (ACM Press, 2014) Shidende, Nima Herman; Mörtberg, Christina
    This paper aims at an extended understanding of the design facilitators' role, here implementation mediators, in participatory design practices. In reflecting connectedness between use and design in a distributed open source software design practice, a particular focus is devoted to the implementation mediator’s interaction between local users, global software developers, and local designers who are geographically distributed, possess different technological skills, and different work experiences. The implementation mediators’ insights are useful in the design of large information systems that involve distributed actors. A maternal and child health setting in Tanzania was the case in this study. An ethnographic study involving interactions with global developers and participative activities in local health practices were conducted. In addition, mediators connected local and global designers to configure a computer system for a particular context; configured participation, involving health workers in designing practices. We present the role of the implementation mediators and its related participatory activities by using the notion of design-after-design. We also highlight the challenges which could face implementation mediators in distributed participatory design activities.
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    The role of context in the co-evolution of work and tools: A case from the primary health sector in Tanzania
    (Emerald, 2016) Shidende, Nima Herman; Aanestad, Margunn; Igira, Faraja
    Purpose This paper presents a work-centred study of how information systems practices and tools become shaped by their context. The purpose of this paper is to increase the understanding of how practices and tools co-evolve, with a specific focus on the role of context, and based on this to offer relevant design implications. The empirical motivation comes from attempts to utilize information and communication technologies (ICT) in resource-constrained settings. Design/methodology/approach Empirical work was conducted in primary healthcare facilities in Tanzania that offer Prevention of Mother-To-Child Transmission services. Four health facilities with different organizational and socio-economic characteristics were studied using ethnographic methods (participant observation, interviews and document analysis). The authors have employed activity theory as the theoretical framework, since it explicitly places human activity within a cultural, social and temporal (developmental) context. Specifically, the concept of mediation breakdown was used for data analysis at activity, action and operation levels. Findings By focusing analytically on situations of mediation breakdown in the situation of use, at both an activity, action and operation level, the authors have achieved an understanding of how information tools are being adapted to both their contextual conditions and the information needs of the community of users. Research limitations/implications The study illustrates the decisive role that context may play in shaping the actual usage of information technology. While the detailed findings were specific to the concrete domain, time and place, in general, an increased awareness of the role of context may lead to more robust approaches to the introduction of ICT solutions. Originality/value While activity theory literature offers insight on how to analyse context, the discussion is limited to the understanding of how context can be modelled into artefacts. The paper suggests that the contradiction concept is useful for studying the role of context and its impact in co-evolution of work and information tools. The study also contributes to the discourse in health information systems in developing countries by emphasizing the crucial role of the front line health workers’ own problem solving, invention and adaptation of information tools.