Take a look at the new version of this page: [ beta version ]. Tell us what you think.

ABSTRACT

This paper will address issues of user participation in a large centralistic organization. It is based on one year experience of developing a computerized health information system within the Cuban health services. Relevant literature suggests that participative methods may be less feasible in centralistic environments. This paper confirms this by describing how participation in Cuba is restricted by political and organizational constraints. There is however documented that participatory approaches may be very rewording where such constraints are overcome. Experiences from a broad range of health units and organizational levels in the Cuban project show a trend of weakening centralistic control with regard to hierarchical level and geographic distance, and thus more autonomous organizational units and participating individuals at lower level farther from Havana. The research reported is carried out within a framework of a larger network of similar health information projects being carried out in Africa and Asia, and the case of Cuba is being compared with experience from these countries.

REFERENCES

• 1: Braa J (1996) Community-based participatory design in the Third World. In Blomberg J, Kensing F, Dykstra-Erickson E: PDC'96 Prodeedings of the Participatory Design Conference. Computer Professionals for Social responsibility, USA, pp. 15--24
• 2: Braa J, Blobel B (2003): Strategies for health information systems development in developing countries. The health commission's report. WITFOR 2003 White Book. Proceedings of IFIP World Information Technology Forum
• 3: Braa J. and Hedberg C. (2002) "The Struggle for developing District Health Information Systems in South Africa" in The Information Society, 18 (2), pp. 113--127
• 4: Braa J, Monteiro E. and Sahay S. (2003) "Networks of action: sustainable health information systems across developing countries" Submission for special issue on Action Research, MIS Quarterly
• 5: Reinhard Budde , K. Kuhlenkamp , K. Kautz , H. Zulighoven, Prototyping: An Approach to Evolutionary System Development, Springer-Verlag New York, Inc., Secaucus, NJ, 1992
• 6: Bødker S. and Grønbæk K. (1991) "Design in Action: From Prototyping by Demonstration to Cooperative Prototyping" in J. Greenbaum and M. Kyng (eds.) "Design at work: Cooperative design of computer systems" Lawrencce Erlbaum Associates, pp. 1--24
• 7: Engelstad and Gustavsen, B. "Swedish network development for implementing national work reform strategy", Human Relations, 46(2), February 1993, pp 219-248.
• 8: Joan Greenbaum , Morten Kyng, Introduction: situated design, Design at work: cooperative design of computer systems, Lawrence Erlbaum Associates, Inc., Mahwah, NJ, 1992
• 9: Jonathan Grudin, Interactive Systems: Bridging the Gaps Between Developers and Users, Computer, v.24 n.4, p.59-69, April 1991 [doi>10.1109/2.76263]
• 10: Grudin J, Pruitt J (2002): Personas, Participatory Design and Product Development: An Infrastructure for Engagement. In Binder T, Gregory J, Wagner I (eds.): PDC 2002. Participatory Design Conference. Enquiring into the politics, contexts and practices of collaborative design work. Proceedings. Malmø, Sweden.
• 11: Heeks R. (1999) "The Tyranny of Participation in Information Systems: Learning from Development Projects" Working paper no. 4 in Development Informatics series, University of Manchester. ISBN: 1 9025 1820 9
• 12: Heeks R, Mundy D. and Salazar A. (1999) "Why Health Care Information Systems Succeed or Fail" Working paper no. 9 in Information Systems for Public Sector Managementseries, University of Manchester, ISBN: 1--90251825X
• 13: Rob Kling, Social Analyses of Computing: Theoretical Perspectives in Recent Empirical Research, ACM Computing Surveys (CSUR), v.12 n.1, p.61-110, March 1980 [doi>10.1145/356802.356806]
• 14: Korpela M. (1994) "Nigerian Practice in Computer Systems Development: A Multidisciplinary Theoretical Framework, Applied to Health Informatics". Espoo: Helsinki University of Technology
• 15: Lippeveld, T. and Sauerborn, R. (2000) "A framework for designing health information systems" in Lippeveld, T. et al.: "Design and implementation of health information systems", chapter 1 & 2, WHO, Geneva
• 16: Littlejohn P, Wyatt J. C. and Garvican L. (2003) "Evaluating computerised health information systems: hard lessons still to be learnt". BMJ, Volume 326
• 17: M. Lynne Markus, Power, politics, and MIS implementation, Communications of the ACM, v.26 n.6, p.430-444, June 1983 [doi>10.1145/358141.358148]
• 18: RHINO (2002) "The Potomac Statement on Investment in Routine Health Information Systems in Developing Countries", Routine Health Information Network (RHINO) 2002. http://www.cpc.unc.edu/projects/measure/rhino/rhino.html
• 19: Sæbø,J & Titlestad, O (2003) "Evaluation of a Bottom-Up Action Research Project in a Centralised Setting: HISP in Cuba" Proceedings of the 37th Hawaii International Conference on System Sciences
• 20: WHO (2003) http://www.who.int/country/en/ http://www.who.int/country/en/ Country reports
• 21: Witfor (2003) "Vilnius Declaration." IFIP World Information Technology Forum, Vilnius