Introducing digital health information systems in post-conflict Mozambique: a historical perspective

The institutional dynamics around digital Health Information Systems implementations are subject to influences from the technological artefacts themselves or contextual conditions from the setting. These not always obvious and easily visible, appearing intrinsically hidden, may only be made perceptible through analysing patterns across a historical timeframe. Recognizing history's potential, both as a tool and a means for enabling this analysis, we seek to build a situated understanding of the technology adoption and institutionalization processes, valuable to support future implementation efforts. This analysis is conducted as a historical study based on implementing a digital platform for public health management in Mozambique, a low- and middle-income country recovering from the aftermath of colonial rule and violent civil war. While the overall study spans twenty years since 2000, this paper focuses on the first seven years to identify institutional contradictions and how these shaped the adoption and evolution of digitally based systems processes.