Introducing Digital Health in Post Conflict Mozambique: A Historical Perspective

Abstract

Implementation of digital health in low- and middle-income countries is susceptible to influences of several institutional dynamics, through interactions of technological artefacts, political and other environmental conditions. These dynamics may lead to contradictions, not always obvious nor easily acknowledgeable. History can be valuable to understand and pursue explanations around why and how a technology gets adopted and institutionalized or not in particular settings. This study is part of a project focusing on a longitudinal case, where history is reconstructed over twenty years, in three phases: introducing digital health in post conflict Mozambique (2000–2007), disruption of initial efforts to introduce District Health Information Systems (DHIS) platform (2008–2014) and, adoption and scaling up of DHIS2 nationally (2015–2021). For the purposes of this paper, we conduct analysis to the initial period, with institutionalist lenses, aiming to identify the set of contradictions raised within the context of study and discuss implications for the future.