- Oslo, Oslo, Norway
Petter Nielsen
University of Oslo, Institutt for Informatikk, Faculty Member
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The integration of isolated software components into large‐scale and complex information systems is a topic that attracts the interest of many information systems practitioners and researchers. However, less attention is given to the... more
The integration of isolated software components into large‐scale and complex information systems is a topic that attracts the interest of many information systems practitioners and researchers. However, less attention is given to the intricate processes by which these infrastructures are built using multiple independent software components. Different actors introduce these components, which can lead to a “battleground of functional roles” where components are replacing and blocking each other. To better understand this phenomenon, we conducted multiple case studies involving the development of a large‐scale information system for communicable disease detection, prevention, and control in Vietnam. We collected empirical data through various methods, including interviews, focus groups, and participation observation. We identified different strategies employed by actors to block, remove, or replace other software components, protect their position, and find a way to join the existing and established systems. This paper contributes to this topic by theorizing a strategy called “hybrid vigor,” which allows for the combination of the strengths of individual software components and enables sustainable evolution.
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Enterprise software packages are increasingly designed as ex-tendable software platforms. These platforms are characterised by modular architecture that allows third parties to innovate and create value through the development of... more
Enterprise software packages are increasingly designed as ex-tendable software platforms. These platforms are characterised by modular architecture that allows third parties to innovate and create value through the development of complementary applications. The development process of complementary applications from scratch is resource-intensive. One way of optimising the development process is by using the component-based software engineering (CBSE) approach that focuses on software reuse and suggests building applications with reusable components. There is a considerable amount of literature on CBSE; however, there has been little discussion on how component-based software engineering can strengthen third-party application development in the context of an enterprise software platform ecosystem. Specifically, it is unclear how the challenge of component trustworthiness can be addressed in this context. To explore this, we conducted a design science research(DSR) study to answer the ...
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1Next generation mobile communication infrastructure: UMTS and WLAN – who will succeed?
The paper argues that the study of ICT usage among small and medium sized enterprises benefits from a combination of methods, including diffusion studies, institutional analyses, and studies of post-adoption behaviour. Keywords: Diffusion... more
The paper argues that the study of ICT usage among small and medium sized enterprises benefits from a combination of methods, including diffusion studies, institutional analyses, and studies of post-adoption behaviour. Keywords: Diffusion models, infrastructure, domestication, small and medium sized enterprises, SME, ICT.
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Digital health represents a research field dedicated to realising digital technologies’ potential and developing knowledge about their feasibility and impacts. Yet, drawing on a critical review of the articles in the most prominent... more
Digital health represents a research field dedicated to realising digital technologies’ potential and developing knowledge about their feasibility and impacts. Yet, drawing on a critical review of the articles in the most prominent multidisciplinary digital health journals, this paper argues that the digital health field has not profoundly engaged with its core subject, namely technology. The features of digital technologies remain in the background, and research is disconnected from the complexities of healthcare settings, including multiple technologies, established practices and people. Instead, the overarching focus in the digital health literature is the processing capabilities of digital technologies and their posited impacts. This paper proposes a research direction in digital health where technology and the context of use take a more prominent role. It argues that realising the potential of digital health requires intensive investigation drawing on different disciplines, gro...
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In this article we consider the notion of digital global public good and articulate our understanding of it. Against this conceptual foil, we examine the development of DHIS2, a global health platform inspired by public goods, focusing on... more
In this article we consider the notion of digital global public good and articulate our understanding of it. Against this conceptual foil, we examine the development of DHIS2, a global health platform inspired by public goods, focusing on the paradoxes that arise in the scaling process. We find that the scaling dynamics played out differently at the macro and micro levels, giving rise to the following paradoxes: addition of new functionalities to cater to the universe of users across the world (macro level) works counter to the needs of users in particular locations (micro level); responsiveness to the requests of the donors with a global view (macro level) distorts the production process, as the voices of users, situated in remote locations in developing countries, are not adequately heard; the system needs to be simultaneously relevant across the global (macro level) and the local (micro level), when the former calls for decontextualization and the later (re)contextualization. We then discuss challenges these paradoxes create with regard to attaining non-rivalry and non-exclusion, the defining characteristics of a public good.
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In this article we consider the notion of digital global public good and articulate our understanding of it. Against this conceptual foil, we examine the development of DHIS2, a global health platform inspired by public goods, focusing on... more
In this article we consider the notion of digital global public good and articulate our understanding of it. Against this conceptual foil, we examine the development of DHIS2, a global health platform inspired by public goods, focusing on the paradoxes that arise in the scaling process. We find that the scaling dynamics played out differently at the macro and micro levels, giving rise to the following paradoxes: addition of new functionalities to cater to the universe of users across the world (macro level) works counter to the needs of users in particular locations (micro level); responsiveness to the requests of the donors with a global view (macro level) distorts the production process, as the voices of users, situated in remote locations in developing countries, are not adequately heard; the system needs to be simultaneously relevant across the global (macro level) and the local (micro level), when the former calls for decontextualization and the later (re)contextualization. We then discuss challenges these paradoxes create with regard to attaining non-rivalry and non-exclusion, the defining characteristics of a public good.
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Digital health represents a research field dedicated to realising digital technologies' potential and developing knowledge about their feasibility and impacts. Yet, drawing on a critical review of the articles in the most prominent... more
Digital health represents a research field dedicated to realising digital technologies' potential and developing knowledge about their feasibility and impacts. Yet, drawing on a critical review of the articles in the most prominent multidisciplinary digital health journals, this paper argues that the digital health field has not profoundly engaged with its core subject, namely technology. The features of digital technologies remain in the background, and research is disconnected from the complexities of healthcare settings, including multiple technologies, established practices and people. Instead, the overarching focus in the digital health literature is the processing capabilities of digital technologies and their posited impacts. This paper proposes a research direction in digital health where technology and the context of use take a more prominent role. It argues that realising the potential of digital health requires intensive investigation drawing on different disciplines, grounded on understanding healthcare processes, related informational needs and the concrete features of digital technologies.
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In March 2020 the number of confirmed COVID-19 cases in Norway increased rapidly, and the efforts to trace contacts of positive cases were under severe pressure. Contact tracing in Norway is the responsibility of the municipalities, and... more
In March 2020 the number of confirmed COVID-19 cases in Norway increased rapidly, and the efforts to trace contacts of positive cases were under severe pressure. Contact tracing in Norway is the responsibility of the municipalities, and no standardized or coordinated contact tracing practices were at the time in place on the national level. The afflicted municipalities did their best to cope with the chaotic situation and did contact tracing using excel spreadsheets or pen and paper. These approaches have their flaws, and in particular, failed to scale in several municipalities. In this paper, we report from a case study of collaborative efforts made to address this challenging situation by the University of Oslo (UiO), the Norwegian Association of Local and Regional Authorities (KS), the Norwegian Public Health Institute (NPHI), and several municipalities. The DHIS2 software platform and experiences implementing DHIS2 for contact tracing in other countries were the basis for these ...
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The purpose of this paper is to initiate a debate about whether and how we can embed socio-economic development in information technology (IT). The ICT4D research community has spent significant efforts on critically exploring,... more
The purpose of this paper is to initiate a debate about whether and how we can embed socio-economic development in information technology (IT). The ICT4D research community has spent significant efforts on critically exploring, problematising and theorising how IT can challenge and often work against development. This paper takes a different approach by exploring if and how to embed development values in IT. The paper contributes by suggesting a concept of development by design, emphasising how to embed development throughout the design and lifecycle of IT. This concept’s basis is socio-economic development as reflected in notions of digital divides, including the values of access to IT, the relevance of IT, social inclusion through IT, and participation in digital innovation. Based on these values and inspired by ideas on how to embed values in IT, this paper also offers an early version of a framework of practice-oriented design principles. This framework can promote socio-economi...
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Software platforms present novel opportunities for innovation across heterogeneous settings, users and areas of use. We report from the case of the Health Information System Programme (HISP) that started out in post-apartheid South Africa... more
Software platforms present novel opportunities for innovation across heterogeneous settings, users and areas of use. We report from the case of the Health Information System Programme (HISP) that started out in post-apartheid South Africa more than two decades ago. The programme centres on the development of an open source software – called DHIS2 – primarily for decentralized public health management. Today, DHIS2 is a software platform with a significant global footprint. We contribute to literature on innovation for development, by identifying and examining processes of inclusive innovation pertaining to the longitudinal development of DHIS2. We find that a combination of long-term capacity building and knowledge sharing, consensus-based decision-making, and a modular platform architecture facilitates inclusive innovation. However, short term and project-oriented funding limits the sharing and scale-up of local innovations while the size of the venture and the heterogeneity of actors moderates inclusion in the development of core components of the platform.
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The impacts of the COVID-19 pandemic, disproportionally affecting vulnerable people and deepening pre-existing inequalities (Dreze, 2020; Qureshi, 2021), have interested the very same "development" processes that the IFIP... more
The impacts of the COVID-19 pandemic, disproportionally affecting vulnerable people and deepening pre-existing inequalities (Dreze, 2020; Qureshi, 2021), have interested the very same "development" processes that the IFIP Working Group 9.4 on the Implications of Information and Digital Technologies for Development has dealt with over time. A global development paradigm (Oldekop et al., 2020) has emerged in response to the global nature of the crisis, infusing new meaning in the spirit of "making a better world" with ICTs (Walsham, 2012) that always have characterised ICT4D research. Such a new meaning contextualises our research in the landscape of the first pandemic of the datafied society (Milan & Trere, 2020), coming to terms with the silencing of narratives from the margins within the pandemic (Milan et al., 2021) - in Qureshi's (2021) words, a "pandemics within the pandemic" producing new socio-economic inequities in a state of global emergency.
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With adherence to treatment, HIV positives can live a normal life. Accordingly, investments are made and health systems are expanded to reach those at risk in developing countries, where HIV is reported to be most endemic. At the same... more
With adherence to treatment, HIV positives can live a normal life. Accordingly, investments are made and health systems are expanded to reach those at risk in developing countries, where HIV is reported to be most endemic. At the same time, many developing countries still rely heavily on paper-based tools which are found to be inefficient when large numbers of patients are involved and of limited use to support follow ups and assure adherence to treatment. In this paper, as we move from an existing paper base and to a digital and online information management system, we focus on improving our understanding of how to use an existing system made for collecting, aggregating and presenting population based routine data to support individual follow-up of HIV positives and their adherence to treatment. We approach this through an action research project in Sierra Leone where we have piloted a HIV patient information management system. We contribute insights on health information system sc...
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The pervasiveness of digital platforms has resulted in the emergence of digital health platforms addressing various health care needs globally. Digital platforms, typically, bring about an international division of labor between platform... more
The pervasiveness of digital platforms has resulted in the emergence of digital health platforms addressing various health care needs globally. Digital platforms, typically, bring about an international division of labor between platform owners in developed countries where they are usually developed and platform consumers in developing countries leveraging them. In this relationship, boundary resources, such as documentation and application programming interfaces, are critical elements in the efforts to leverage digital health platforms in developing countries. This paper uses the case of the digital health platform DHIS2 in Malawi to elucidate and discuss the enabling and restricting roles played by boundary resources towards efforts leveraging digital health platforms in developing countries.
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Despite increased attention paid to health information systems and their key role for improving health systems in in Low and/or Middle income countries (LMICs), it is believed that data from majority of the health information systems... more
Despite increased attention paid to health information systems and their key role for improving health systems in in Low and/or Middle income countries (LMICs), it is believed that data from majority of the health information systems contribute little to the decision-making processes due to poor data quality. We carried out an exploratory assessment of the health information system in Kenya with the main objective of determining the quality of data in terms of accuracy, timeliness and completeness. The study also considered the reasons for the observed data quality status. Data quality audits were carried out in selected health facilities. Data from the source documents at health facilities were compared to the data in the national health information systems for the same period. Key informant interviews were conducted and focus group discussions conducted during quarterly review meetings at regional levels. The study revealed that the completeness rate for the monthly reports was 86...
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In this paper, we discuss the potential of Cloud Computing in terms of how it can strengthen health information systems in developing countries. The focus is on how cloud computing can enable the integration and harmonization of... more
In this paper, we discuss the potential of Cloud Computing in terms of how it can strengthen health information systems in developing countries. The focus is on how cloud computing can enable the integration and harmonization of fragmented systems and provide real-time information to health managers for evidence based decision making. Like any new technology, cloud computing is no silver bullet. Based on a case study of the innovative use of cloud computing for the national health information system in Kenya, this paper explores related opportunities and challenges experienced. The concept of IT affordance is used to analyze cloud computing in this context, its potential and its implications. The key contribution of this paper is an improved understanding of how cloud computing can enhance health management by acting as a catalyst for integration.
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Addressing the need to theorize digital technologies and innovation processes, this paper focuses on how digital innovation can be contextualized in developing countries and made relevant to solve current development challenges. We draw... more
Addressing the need to theorize digital technologies and innovation processes, this paper focuses on how digital innovation can be contextualized in developing countries and made relevant to solve current development challenges. We draw on a current and long-term engagement in the innovation processes unfolding in a living lab established in the public health sector of rural India. Our object of analysis is innovations in the realm of digital technologies in relation to social development, in our case public health. The theoretical framework combines concepts of digital and frugal innovations to develop the notion of frugal digital innovation which emphasizes the need for building intersections between technical, social and institutional innovations. Particular attention is paid on how the material properties of digital technologies, including their ability to recombine, reuse, configure and integrate enable such frugal digital innovation processes. Another contribution of this paper is to understand “how” such innovation processes can be enabled, which we operationalize through the concept and principles of a living lab. Empirically, examples are provided of innovations that have been enabled through this lab. The paper thus makes two key contributions to IS research: one, develop the notion of frugal digital innovation, which has the potential of use in other innovation contexts; and, two, understanding how the living lab contributes to enabling such innovation processes.
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The purpose of this paper is to explore tensions in global public goods (GPG), based on the case of digital platforms for innovation. GPG designs promise normative ideals of non-rivalry and non-exclusivity, which in practice are... more
The purpose of this paper is to explore tensions in global public goods (GPG), based on the case of digital platforms for innovation. GPG designs promise normative ideals of non-rivalry and non-exclusivity, which in practice are challenged in reality and fraught with tensions. This paper draws on theory of contradictions to illustrate some of these tensions, which confronts simplistic and linear views that implementing GPG health management platforms will translate unproblematically to efficiency gains. The paper explores field data collected by the authors in the Health Information Systems (HISP) research programme around a digital platform (DHIS2) installed in over 80 countries globally, primarily in the health sector. Episodes are taken from action research undertaken by the authors drawn from experiences of multiple implementations in various countries. This paper furthers the theoretical understanding of contradictions arising from the espoused ideals of GPGs and the realities of their implementation and use. The implications focus on the need to move away from simple deterministic visions of GPG towards acknowledging the contested nature of their outcomes.
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League tables are used to compare the performance of different entities in the health systems in developing countries. The aim of this paper is to study the implementation process and its effects related to a computerized league table... more
League tables are used to compare the performance of different entities in the health systems in developing countries. The aim of this paper is to study the implementation process and its effects related to a computerized league table application in Malawi. Focusing on the health district and using a field experiment research approach, the focus is on the implementation process and how it improves information transparency for health managers. Based on routine health data recording in the health management information system DHIS2, the introduced league table was used by the district health management teams in the pilot districts to rank and compare performance among their health facilities. While the introduction of the league tables was challenging, it also showed its potential through effects including improved visibility of information and accessibility for managers, better understanding of indicators, the identification of data quality issues, skills acquisition in computing and information use and improved communication and collaboration among stakeholders.
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Scaling health information system from small scale pilots to national systems in developing countries poses a key challenge to system designers and health managers. As a consequence, many projects dissolve and die before they reach the... more
Scaling health information system from small scale pilots to national systems in developing countries poses a key challenge to system designers and health managers. As a consequence, many projects dissolve and die before they reach the scale where they are useful for information management. The concept of bootstrapping from the Information Infrastructure literature has proven useful to discuss and understand how to initiate and grow large-scale, complex and networked information systems from scratch. We use this concept to analyze and discuss an empirical case of building a large scale medical licensing system in a Southeast Asian country. Beyond describing the process leading up to the success of the licensing system, we contribute by identifying a range of factors influencing the bootstrapping process and we suggest extensions to make the bootstrapping strategy relevant in this context.
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... Braa, Jørn, E Macome, J Costa, J Mavimbe, J Nhampossa, B José, A Manave, and A Sitói. 2001. ... Ciborra, Claudio U., Kristin Braa, Antonio Cordella, Bo Dahlbom, Angelo Failla, Ole Hanseth, Vidar Hepsø, Jan Ljungberg, Eric Monteiro,... more
... Braa, Jørn, E Macome, J Costa, J Mavimbe, J Nhampossa, B José, A Manave, and A Sitói. 2001. ... Ciborra, Claudio U., Kristin Braa, Antonio Cordella, Bo Dahlbom, Angelo Failla, Ole Hanseth, Vidar Hepsø, Jan Ljungberg, Eric Monteiro, and Kai A. Simon. 2000. ...
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Copyright © with the author(s). The content of this material is to be considered preliminary and are not to be quoted without the author(s)'s permission.
Spatial Data Infrastructures (SDIs) are envisioned to increase efficiency, transparency and equity, but realising this potential has proven problematic. We argue that insights from studies of large-scale, integrated but distributed... more
Spatial Data Infrastructures (SDIs) are envisioned to increase efficiency, transparency and equity, but realising this potential has proven problematic. We argue that insights from studies of large-scale, integrated but distributed information systems, dubbed "information infrastructures, " are applicable. This perspective may help address an important dimension of SDIs: their character of being public goods rather than private assets. We identify and illustrate four key aspects of information infrastructures that underpin such a public good’s focus. First, we advocate the necessity of deploying a socio-technical rather than a limited technical perspective. We further argue that the notion of installed base is central, that it is important to be aware of the "politics of representations " and to accept the unavoidable "messiness " of reality. We illustrate these concepts through examples from health care in developing countries, an area particularly con...
Research Interests: Health Care, Public Good, Developing Country, Public Goods, SDI, and 9 moreInformation Infrastructure, Spatial Data Infrastructures, Information and Communication Technology (ICT) for Development, Spatial Data Infrastructure, Installed Base, Information Infrastructures, Geographic Information System, GIS, and Geographical Information Systems
The Health Information Systems Programme (HISP) is a sustainable and scalable research project enabling and supporting health information systems implementation in more than 100 developing countries. In this paper, we present the... more
The Health Information Systems Programme (HISP) is a sustainable and scalable research project enabling and supporting health information systems implementation in more than 100 developing countries. In this paper, we present the historical roots, the status, and discuss the future of HISP and its software (DHIS2). We also reflect on factors contributing to the project’s global success and find the open and participatory approaches to HISP and DHIS2 software development, and implementation in countries as key. For the future, we discuss strategies to stabilise as well as grow the HISP and DHIS2 community into a sustainable ecosystem.
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Proceedings of the 13th International Conference on Social Implications of
Computers in Developing Countries.
Computers in Developing Countries.
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As a result of a study increase in reach, range, and processing capabilities, information systems no longer appear as independent, but rather as integrated parts of large scale networks. These networks offer a shared resource for... more
As a result of a study increase in reach, range, and processing capabilities, information systems no longer appear as independent, but rather as integrated parts of large scale networks. These networks offer a shared resource for information delivery and exchange to communities, which appropriate them for their respective purposes. Such information infrastructures are complex in several ways. As they are composed of a variety of different components, their openness and heterogeneity make them inherently uncontrollable; through their expansion, these various interconnected networks enter new interdependencies; while they are based on existing technical and social networks, they also need to develop and grow over a long period of time; and, they are developed as a distributed activity. Examples of such information infrastructures include the Internet, National Information Infrastructure (NII) initatives and industry-wide EDI networks, as well as corporate-wide implementations of enterprise systems.
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The purpose of this paper is to explore digital global public goods (DGPG) as a foundation for theorizing platforms for development. Global public goods (GPG) are widely accepted as fundamental for socioeconomic development due to... more
The purpose of this paper is to explore digital global public goods (DGPG) as a foundation for theorizing platforms for development. Global public goods (GPG) are widely accepted as fundamental for socioeconomic development due to non-rivalry, non-exclusivity and global relevance. However, the challenges of extending the ideals of GPG to the digital platforms domain are poorly understood and further theoretical developments are needed to advance our current knowledge of this relationship. To theorize the challenges we draw on the GPG, digital platforms literature and concepts related to paradoxes. We illustrate the value of these ideas in making sense of the case study of the district health information system (DHIS2) digital platform for health information primarily used in developing countries. Furthermore the case analysis provides some practical implications on DGPG platforms.
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In this paper, we pose the critical question of how to strengthen digital cooperation to improve health systems, which we analyse based on our 20 years of experience with the Health Information Systems Programme (HISP) R&D initiative. The... more
In this paper, we pose the critical question of how to strengthen digital cooperation to improve health systems, which we analyse based on our 20 years of experience with the Health Information Systems Programme (HISP) R&D initiative. The HISP enabled digital cooperation, which we illustrate with the Covid-19 case, is built around a shared ideology (of using existing digital public goods and capacities), in a rapid manner (by leveraging the platform features of DHIS2) engaging with partners across multiple disciplines (informatics, infectious diseases, public and global health).
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The Health Information Systems Programme (HISP) is a sustainable and scalable research project enabling and supporting health information systems implementation in more than 100 developing countries. In this paper, we present the... more
The Health Information Systems Programme (HISP) is a sustainable and scalable research project enabling and supporting health information systems implementation in more than 100 developing countries. In this paper, we present the historical roots, the status, and discuss the future of HISP and its software (DHIS2). We also reflect on factors contributing to the project's global success and find the principles of HISP organizing, DHIS2 software development and implementation in countries with a basis in open and participatory approaches as key. For the future, we discuss strategies to stabilize as well as grow the HISP and DHIS2 community into a sustainable ecosystem.