Integrative Approach of Implementing Geographic Information System for Health Management: Lessons Learnt from Malawi

摘要

Literature has proposed different frameworks of implementing Geographic Information System (GIS) in developing countries, and one of them is the integrative framework in which GIS implementation activities are typically linked with activities of implementing other programs or projects. Thus, the paper discusses how the integrative framework has been applied in the GIS implementation for health management in Malawi and lessons learnt from such an application. The understanding is that GIS implementation is unique to a particular organisation, with some unique technical and organizational impacts and implications that need to carefully be addressed. This case study was conducted at the national level in Malawi’s Ministry of Health between June 2015 and April 2017. In Malawi, several initiatives towards GIS implementation have been taking place since 2002, which involve the policy formulation, user training, generation of static maps, collection of spatial data (i.e. geodata) for health facilities, and deployment of DHIS2 GIS. Qualitative interpretive research methods were applied and data was collected through semi-structured interviews, document analysis and participant observation. The paper argues that it is important to consider specific problem domains and options of integration when deciding on the integrative approach of GIS implementation. The paper identifies geodata, technology and expertise as the specific problem domains, and fully linked, partially linked, and not linked as options for integration. The paper claims that compatibility of activities to be linked is one factor that can determine whether or not to apply the integrative approach. Generally, the major opportunity of the integrative approach of GIS implementation is the utilisation of time and resources such as people and finances. However, the main challenge is the lack of control on allocation and use of those resources, particularly people and their knowledge because most activities have been managed by collaborating organisations. This may bring challenges on local capacity building.