Trial lecture
The Importance of Context in Healthcare IT Research
Time and place: June 9, 2026 11:15 AM. Kristen Nygaards sal (5370), Ole-Johan Dahls hus.
Main research findings
This thesis presents a different perspective on the implementation of a mobile-based Integrated Community Health Information System (iCHIS) across 28 districts in Malawi. The analysis of iCHIS in this study emphasises its role in strengthening protocol adherence among non-medical personnel known as Community Health Workers (CHWs). Community Health Workers (CHWs) are responsible for providing healthcare services within the community, including referring children under the age of five who require special treatment to healthcare facilities. However, the ability to identify individuals in need of urgent referrals often relies on each CHW's commitment, which may be lacking at times. Strengthening protocol adherence aims to improve the quality of care and, more importantly, reduce mortality and morbidity rates for children under five. The study aimed to analyse how iCHIS supports CHWs in referring patients presenting with danger signs to higher-level facilities. I explored social practices that extend beyond smartphone use in healthcare services, including their influence on CHWs’ perceptions, unintended consequences, and the broader impact of smartphone use across various social structures. Furthermore, I investigated how groups, such as Village Health Committees at the community level, may influence patients’ referrals. The study has shown that strengthening adherence to referral protocols at the community level requires collaboration among healthcare service providers at both the community and health facility levels. All stakeholders must therefore be engaged in the implementation of iCHIS. Excluding any may disrupt the chain, thereby impeding the referral process at the community level. Additionally, I found that empowering CHWs' social groups can enhance members' development of smartphone skills, especially for those residing in remote areas where support is difficult to access. I also found that the use of smartphones for healthcare services can improve protocol adherence by employing validation checks that ensure all steps in the assessment process are followed, decision support algorithms that help correctly identify danger and non-danger signs, enabling CHWs to make informed decisions and reminders prompting patient follow-ups. Moreover, smartphones enhanced CHWs' time management, improved their status, boosted their confidence, and built their digital skills.
Adjudication committee
- Senior lecturer Faraja Teddy Igira, Institute of Finance Management, Tanzania
- Associate Professor Xiao Xiao, Copenhagen Business School, Denmark
- Associate Professor Terje Aksel Sanner, Department of Informatics, University of Oslo, Norway
Supervisors
Professor Jens Johan Kaasbøll, University of Oslo, Norway
Associate Professor Chipo Kanjo, University of Malawi, Malawi
Chair of defence
- Professor Dag Langmyhr, Department of Informatics, University of Oslo
Contact information at Department: Mozhdeh Sheibani Harat