Health informatics in developing countries : an analysis and two African case studies
This thesis relates informatics to the problems of health and medicine experienced in less developed countries. It evaluates the potential of health informatics and investigates the issues that constrain successful implementations. This serves as a basis for establishing a generic description of viable computer applications in the developing world. The thesis contains two case studies from sub-Saharan Africa. The first, undertaken in The Gambia, is based on a computer-assisted data collection system used in a longitudinal child health survey. The second, undertaken in Kenya, relates to a medical decision-aid system used in an out-patient clinic of a district hospital. In each case, an outline is given of the background to the application domain, and an analysis is made of some comparable prior systems that have been developed and evaluated. The two case studies provide interesting investigatory comparisons since both systems are used by health personnel with little computer experience, and exploit some state-of-the-art technologies despite the identified constraints that exist in developing countries. The context, system design, methods, and results of each case are described. A generalised evaluation approach is proposed and is used to summarise the case study findings. The evaluation framework employed includes components related to functional and human perspectives as well as the anticipated benefits to the health care system. The thesis concludes by suggesting some guidelines for the design and evaluation of future health information systems.