Jens Johan Kaasbøll

• Kanjo, Edith Chipo Hilda; Hara, Joshua & Kaasbøll, Jens Johan (2020). Digital Empowerment for Health Workers and Implications on EMRs Utilisation. Journal of Health Informatics in Africa.  ISSN 2197-6902.  6(2), s 74- 83 . doi: 10.12856/JHIA-2019-v6-i2-262 Vis sammendrag

  Background and Purpose: Utilization of Electronic Medical Records (EMRs) bring many benefits to patient record handling. Previous research has shown that medical doctors in hospitals in Africa had poor IT skills, partly disabling their use of EMRs. Working in health centres, we wanted to know how to improve the digital skills of their personnel. Methods: Qualitative methods including interviews, informal discussions and observation were used for data collection. The study was conducted in three health facilities in Malawi, selected purposively as these were the ones implementing the EMR under study. The study targeted all staff that were capturing data at point of care using the app between January and June 2019. Results: Personnel in the health centres were computer illiterate, even if they used phones, and some smart phones. After computer training, they were still not comfortable using EMRs because their typing speed was delaying the process. Improving the typing speed allowed the users to comfortably use the EMRs. Three levels of EMR empowerment were identified; being able to 1) use EMR where typing speed is less relevant, 2) use EMR at point of care, 3) guide colleagues on their EMR use and find new ways of exploiting the technology. For reaching level 2, 50-100 hours of typing practice would be necessary. Conclusions: Health workers who lack computer skills tend to shy aware from using EMRs. Even if falling prices of equipment will enable more EMRs in rural areas, the digital empowerment process will still require significant resources.

• Ayebazibwe, Immaculate; Kimaro, Honest Christopher & Kaasbøll, Jens Johan (2019). System use and user satisfaction in the adoption of electronic medical records systems: A case of DHIS2 tracker implementation in Tanzania. IFIP Advances in Information and Communication Technology.  ISSN 1868-4238.  551, s 63- 75 . doi: 10.1007/978-3-030-18400-1_6
• Chhetri, Amrit; Iversen, Mari; Kaasbøll, Jens Johan & Kanjo, Chipo (2019). Evaluating mHealth Apps Using Affordances: Case of CommCare Versus DHIS2 Tracker. IFIP Advances in Information and Communication Technology.  ISSN 1868-4238.  551, s 619- 632 . doi: 10.1007/978-3-030-18400-1_51
• Kaasbøll, Jens Johan; Kanjo, Chipo & Kimaro, Honest C. (2019). Building Sustainable Collaborations and Academic Networks in Low Income Countries: Case of Master Programmes. IFIP Advances in Information and Communication Technology.  ISSN 1868-4238.  552, s 398- 408 . doi: 10.1007/978-3-030-19115-3_33
• Msiska, Brown Chawanangwa; Nielsen, Petter & Kaasbøll, Jens Johan (2019). Leveraging Digital Health Platforms in Developing Countries: The Role of Boundary Resources, In Petter Nielsen & Honest C. Kimaro (ed.),  Information and Communication Technologies for Development: Strengthening Southern-Driven Cooperation as a Catalyst for ICT4D. 15th IFIP WG 9.4 International Conference on Social Implications of Computers in Developing Countries, ICT4D 2019, Dar es Salaam, Tanzania, May 1–3, 2019, Proceedings, Part I.  Springer Nature.  ISBN 9783030183998.  Kapittel.  s 116 - 126
• Asah, Flora Nah; Chikumba, Patrick Albert; Kaasbøll, Jens Johan; Manya, Ayub Shisia; Moyo, Christon M.; Msiska, Brown Chawanangwa & Senyoni, Wilfred (2018). From Sustainable to Continuously Adaptive Information Systems, In Paul Cunningham & Miriam Cunningham (ed.),  IST-Africa 2018 Conference Proceedings.  IIMC International Information Management Corporation.  ISBN 978-1-905824-60-1.  Article.  s 1 - 10 Vis sammendrag

  Many previous studies have pointed to unsustainable information systems in developing countries, meaning that software is not used after some time. When a system fails in one of seven identified dimensions, people will not use it, hence these are unsustainability criteria. This paper reports from three health information systems having been adapted to a changing environment over more than a decade. Data is collected from documents and from three of the authors’ experience and systematized and analyzed by the other authors. Sustainability was redefined to mean the ability of an information system to adapt to new requirements, where software replacement may be one of the adaptations made. Factors which contributed to sustainability were found in the seven dimensions for unsustainable systems. Taking advantage of findings from other literature, including more stakeholders in the system was identified as an additional strategy for sustaining the systems.

• Ismanov, Zufarzhan; Iversen, Mari; Kaasbøll, Jens Johan; Manda, Tiwonge Davis & Ni, Ilia (2018). Patient information systems for hospitals versus primary health care – implications for data structures and user interaction, In Paul Cunningham & Miriam Cunningham (ed.),  IST-Africa 2018 Conference Proceedings.  IIMC International Information Management Corporation.  ISBN 978-1-905824-60-1.  KAPITTEL. Vis sammendrag

  Research has shown that implementing information systems in hospital wards is notoriously difficult, regardless of the amount of resources used. This paper reports findings from ongoing efforts to adapt a software solution designed for primary care, to support practices and protocols around inpatient neonatal care in a hospital ward. Practices and protocols to be supported include: patient admission and discharge, calculation of medicine doses, and hourly monitoring of patients’ vitals and medication. Experimental results show that, using the system for patient admission and discharge was rather straight forward, except a work-around had to be done in the data model. Calculation of medicine doses was also implemented. On the other hand, using the software solution for the hourly monitoring and medication of patients was deemed considerably difficult, as this required a tablet at each bedside, with custom developed user interaction. Similar issues have been found in other studies of electronic medical records.

• Wu, Tsung-Shu Joseph; Kagoli, Matthew; Kaasbøll, Jens Johan & Bjune, Gunnar Aksel (2018). Integrated Disease Surveillance and Response (IDSR) in Malawi: Implementation gaps and challenges for timely alert. PLOS ONE.  ISSN 1932-6203.  13(11), s 1- 19 . doi: 10.1371/journal.pone.0200858 Vis sammendrag

  Objective: The emerging and recent 2014 Ebola Virus Disease (EVD) outbreaks rang the bell to call upon efforts from globe to assist resource-constrained countries to strengthen public health surveillance system for early response. Malawi adopted the Integrated Disease Surveillance and Response (IDSR) strategy to develop its national surveillance system since 2002 and revised its guideline to fulfill the International Health Regulation (IHR) requirements in 2014. This study aimed to understand the state of IDSR implementation and differences between guideline and practice for future disease surveillance system strengthening. Methods: This was a mixed-method observational study. Quantitative data were to analyze completeness and timeliness of surveillance system performance from national District Health Information System 2 (DHIS2). Qualitative data were collected through interviews with 29 frontline health service providers from the selected district and key informants of the IDSR system implementation and administration at district and national levels. Findings: The current IDSR system showed relatively good completeness (76.4%) but poor timeliness (41.5%) of total expected monthly reports nationwide and zero weekly reports. The challenges of IDSR implementation revealed through qualitative data included lack of supervision, inadequate resources for training and difficulty to implement weekly report due to overwhelming paperwork at frontline health services. Conclusions: The differences between IDSR technical guideline and actual practice were huge. The developing information technology infrastructure in Malawi and emerging mobile health (mHealth) technology can be opportunities for the country to overcome these challenges and improve surveillance system to have better timeliness for the outbreaks and unusual events detection.

• Isaksen, Helene; Iversen, Mari; Kaasbøll, Jens Johan & Kanjo, Chipo (2017). Design of Tooltips for Data Fields: A Field Experiment of Logging Use of Tooltips and Data Correctness, In Aaron Marcus & Wentao Wang (ed.),  Design, User Experience, and Usability: Understanding Users and Contexts.  Springer.  ISBN 978-3-319-58640-3.  Artikkel.  s 63 - 78 Vis sammendrag

  Many health professionals in developing countries carry out tasks which require a higher level of education than they have. To help such undereducated health workers filling correct data in patient information systems, data fields were furnished with tooltips for guiding users. In a previous study with questionnaires and interviews, health workers preferred tooltip contents being normal values of the data with medical explanation as the second best. The experiment reported in this paper set out to test these content alternatives and also aimed at finding health workers’ use of tooltips and possible effects on data correctness. In order to resemble the work setting, each of the 15 undereducated health workers participating was given a tablet PC with the patient information system and booklet of 22 cases to be entered over a period of two weeks. They were given a one hour introduction to the system. Their use of the tablet was recorded, and after completing, the participants were interviewed. The health workers opened tooltips frequently for the first cases, and thereafter the use dropped. Reasons given were that they learnt the data field during the first cases, and thereafter they did not need the tooltips so often. The number of correct data entries increased over time. The group with medical explanation tooltips performed better than the group with normal value tooltips, thus the preferred tooltip in the questionnaire gave a lower performance than the second alternative. While the experiment demonstrated that tooltips improved performance, it did not quantify the effect.

• Isaksen, Helene; Iversen, Mari; Kaasbøll, Jens Johan & Kanjo, Chipo (2017). Design of Tooltips for Health Data, In Paul Cunningham & Miriam Cunningham (ed.),  IST-Africa 2017 Conference Proceedings.  IIMC International Information Management Corporation.  ISBN 978-1-905824-56-4.  Artikkel.  s 1 - 8 Vis sammendrag

  Tooltips are regarded as beneficial methods for users to understand either a user interface element or tasks related to the system. However, little research has compared text, tables and illustrations or addressed the content of tooltips, thus this research aims to address this aspect. Through a question-suggestion approach, accompanied by interviews and questionnaires, we have looked at what actual users would prefer as expression format and content type for tooltips. We found that text is the preferred type of expression, while normal values are the preferred content type.

• Isaksen, Helene; Iversen, Mari; Kaasbøll, Jens Johan & Kanjo, Chipo (2017). Methods for Evaluation of Tooltips, In Masaaki Kurosu (ed.),  Human-Computer Interaction. User Interface Design, Development and Multimodality.  Springer.  ISBN 978-3-319-58071-5.  Artikkel.  s 297 - 312 Vis sammendrag

  Tooltips are context-sensitive help aimed at improving learnability of a system. Evaluation of tooltips would therefore be a part of evaluation of documentation, which is a subcategory of evaluation of software learnability. Previous research only includes two evaluations of tooltips, both gauging learning outcome after initial training, while the purpose of tooltips is helping users whenever in doubt when using systems after training. The previous evaluations are therefore of a low content validity. This paper concerns data field tooltips aimed at improving correctness of data entry. It present studies a scale of content validities. On the low level is a questionnaire on users’ opinion, which is a cheap evaluation. The medium type of evaluation was an adapted question-suggestion test measuring learning outcome. The high content validity evaluation method was a field experiment over two weeks, which demonstrated improved performance caused by tooltips. If the cheap questionnaire came out with the same preferences as the costly experiment, doing the questionnaire could have replaced experiments. However, the experiment did not confirm the results from the questionnaire.

• Namatovu, Esther; Sæbø, Johan Ivar & Kaasbøll, Jens Johan (2017). Mobilities of the Community Health Work Practice: Mobile Health System Mediated Work. Journal of Community Informatics.  ISSN 1712-4441.  13(3), s 54- 74 Vis sammendrag

  New technologies have been implicated in various forms of mobilities creating new realities and questioning normative categories and the order in contexts where they are applied. Our study argues that through understanding technology mobilities, we uniquely bring to light new forms of social phenomena that materialize with interactions between mHealth systems and the work of Community Health workers in Malawi. Through the analysis, we also elaborate the role of both human and non-human actants in work transformations. This is important in managing technological innovations and theorizing electronically supported work practices.

• Moyo, Christon M.; Kaasbøll, Jens Johan; Nielsen, Petter & Sæbø, Johan Ivar (2016). The information transparency effects of introducing league tables in the health system in Malawi. Electronic Journal of Information Systems in Developing Countries.  ISSN 1681-4835.  75:2, s 1- 16 . doi: 10.1002/j.1681-4835.2016.tb00544.x
• Bjørge, Ellen Marie; Jønsson, Anniken; Kaasbøll, Jens & Pinard, Matthieu (2015). Training Mentors of Health Information Systems through eLearning, In Petter Nielsen (ed.),  Proceedings of the 13th International Conference on Social Implications of Computers in Developing Countries.  Universitetet i Oslo.  ISBN 978-82-7368-465-3.  Article.  s 312 - 319 Vis sammendrag

  The district health information system (DHIS) is currently used in more than 40 developing countries. The project aims in finding effective training methods to improve user’s learning outcomes and in grooming mentors that can attract new users. Based on literature recommendations and a user survey, an eLearning course through an in-app in the software is under development to be used in low connectivity areas. The eLearning course will emphasize interactivity, motivation, practice exercises and feedback. In addition to the normal user level, this course also has a mentor level to be taken by some users in each site where the system is used, such that the mentors can guide new users locally.

• Bjørge, Ellen Marie; Jønsson, Anniken; Kaasbøll, Jens & Pinard, Matthieu (2015). From user training courses and central support To creating local user competence for mentoring colleagues: a preliminary study in Malawi, In Paul Cunningham & Miriam Cunningham (ed.),  IST-Africa 2015 Conference Proceedings.  IIMC International Information Management Corporation.  ISBN 978-1-905824-50-2.  Article. Vis sammendrag

  Learning to use distributed business systems requires expensive and sustained training efforts. An approach to nurture local users to become mentors for colleagues has been developed as an alternative to training courses. A user level plus a mentor level distance learning course were evaluated amongst users of a health information system in Malawi. The user level course was adequate for users with some computer fluency, while IT novices required a mentor present. The mentor level course required the mentors to have higher system competence than most of the relevant users had. An advanced level course between the user and the mentor levels is therefore suggested, in addition to including more practicals and cooperative, reflective components in the mentor course. With such amendments, distance learning courses can replace most face-to-face training courses and training of trainers approaches for implementation of information systems.

• Moyo, Christon M.; Frøyen, Marte Hesvik; Sæbø, Johan Ivar & Kaasbøll, Jens (2015). Using Performance League Tables to Promote Acccounability and Feedback in Health management in Malawi, In Petter Nielsen (ed.),  Proceedings of the 13th International Conference on Social Implications of Computers in Developing Countries.  Universitetet i Oslo.  ISBN 978-82-7368-465-3.  Article.  s 265 - 276 Vis sammendrag

  One of the challenges of health management in developing countries is the existence of weak accountability and feedback practices. This paper assesses the conditions for introducing performance league tables for promoting accountability and feedback in health management. A qualitative approach with an interpretive perspective has been adopted in this study. Data was collected using interviews, prototyping, observations and document analysis. The assessment revealed the importance of having a participatory process in the design and implementation of league tables used within the existing management practices. This ensures flexibility in the use of performance league tables. In addition, appropriate technology should facilitate availability and accessibility of data to stakeholders so that they manipulate it to suit their needs. Collaboration among stakeholders is a critical condition for ensuring access to additional resources for the implementation of performance league tables. A decentralized approach to league table definition allows districts to choose and weight indicators according to their own goals. Relevance, local choices through a participatory bottom up design process leads to broader acceptance and use of the performance league tables.

• Moyo, Christon M.; Nkhonjera, Tasokwa & Kaasbøll, Jens (2015). Assessing the Use of Mobile Technology to improve Timeliness of HMIS Reports in Malawi, In Paul Cunningham & Miriam Cunningham (ed.),  IST-Africa 2015 Conference Proceedings.  IIMC International Information Management Corporation.  ISBN 978-1-905824-50-2.  Artikkel.  s 1 - 9 Vis sammendrag

  Low timeliness of routine HMIS reports has been a major concern in many developing countries. The deployment and use of mobile technology in these countries offers an opportunity to use it to improve timeliness of report sent to the next level. The aim of this study is to assess the use of mobile technology for improving timeliness of reports in one district in Malawi. Data was collected using semi-structured interviews, observations, field notes and document review. DHIS2 mobile implementation has shown some positive results concerning knowledge and skills development; improved timeliness of reports; reduction in the cost of sending reports and delegation of responsibility in data entry from the district to the health facility. The deployment of mobile technology for reporting requires appropriate technical, behavioural and organizational factors to effectively contribute to improved timeliness of reports.

• Chawani, Marlen Stacey; Kaasbøll, Jens & Finken, Sisse (2014). Stakeholder Participation in the development of an Electronic Medical Record system in Malawi. PDC.  ISSN 2150-5896.  1, s 71- 80 . doi: 10.1145/2661435.2661444 Vis sammendrag

  In this paper we are concerned with stakeholders’ participation in the development of an Electronic Medical Record (EMR) system for health facilities in Malawi, Africa. We draw on insights gained during the process of an Action Research project, which involved different stakeholders. We examine the different roles and forms of participation of these stakeholders. Through this, we illustrate how participation changes over time and coevolves with the progress of the project. Our analysis also reveals that, in rural low-resource settings, expected endusers of EMR systems do not always have the health domain knowledge or expertise to effectively participate in such design projects. Therefore, participation of managers and other health domain experts is essential in order to supplement users’ limited specialized knowledge of the domain.

• Chawani, Marlen Stacey; Kaasbøll, Jens; Finken, Sisse; Herstad, Jo & Malata, Address (2014). Balancing work practices and protocols in the design of EMR systems: The case of developing an EMR system for antenatal care services in Malawi. Electronic Journal of Information Systems in Developing Countries.  ISSN 1681-4835.  63(1), s 1- 26 . doi: 10.1002/j.1681-4835.2014.tb00446.x Vis sammendrag

  Implementing ICTs in healthcare settings has proved to be very challenging such that progress towards widespread adoption and use of Electronic Medical Record (EMR) systems has been slow. The challenges of implementing these technologies have been described as complex, diverse, and locally situated. One of the challenging aspects of designing EMR systems is the need for inscribing standardised protocols whilst taking into account local work practices. Previous research has called for the need to balance work practices and protocols in the design of EMR systems. We present an attempt to balance the work practices and protocols in the development of an EMR system for antenatal care in a developing country, Malawi. This was done through implementing weak inscriptions of the protocols in some cases and strong inscriptions in other cases. The study highlights the important role that clients play in healthcare work and thus, influence the design of EMR systems.

• Dittrich, Yvonne; de la Harpe, Retha; Korpela, Mikko; Gertrudes, Macueve; Bekele, Rahel & Kaasbøll, Jens (2014). Participation for Development, In Andrew Clement; Heike Winschiers; Vincenzo D'Andrea & Keld Bødker (ed.),  Proceedings of the 13th Participatory Design Conference: Short Papers, Industry Cases, Workshop Descriptions, Doctoral Consortium papers, and Keynote abstracts - Volume 2.  ACM Digital Library.  ISBN 978-1-4503-3214-9.  Workshop description.  s 213 - 214 Vis sammendrag

  Information and Communication Technology (ICT) is more and more promoted as a driver and facilitator of economic growth and development in low and middle income countries. ICT for Development (ICT4D) though has mixed successes. Sustainability of solutions and usability respectively usefulness for the intended beneficiaries have been reported as causes. Participatory approaches to development have been proposed to address these causes. Participatory Design (PD) seems like a perfect fit. However, at the Participatory Design Conferences, research that addresses PD in low and middle income countries is rare. The workshop aims at bringing together the PD researchers working with under-privileged communities and attracting researchers from the ICT4D communities to the PD conference. The goal is to share experiences and start a discussion on how participation, ICT and development might relate.

• Kaasbøll, Jens (2014). Suitability of diagrams for IT user learning, In Carlos J. Costa & Aparicio Manuela (ed.),  ISDOC '14 Proceedings of the International Conference on Information Systems and Design of Communication.  ACM Publications.  ISBN 978-1-4503-2713-8.  Paper.  s 56 - 62 Vis sammendrag

  Training and user documentation aim at people being able to use IT when returning from training. Such transfer is in general difficult to achieve. Based on a model of IT use learning, two types of diagrams in documentation were compared in a field study; instructions showing the sequence of how to carry out an operation by means of screen shots and structural models showing data structures without user interface elements. Instructions were in general favoured. Even if the instructions only to a small extent were presented with projector during training, the trainees stated that they learnt a lot from these presentations. The learning outcome might have been the existence of an operation and where in the software to locate it. While primarily intended as help for understanding data structures, the trainees also used structural models as guides for carrying out operations. Instructions in particular, but also structural models were utilised by the trainees after the training sessions, hence helping transfer. Trainers should include both types of models in courses.

• Kaasbøll, Jens Johan (2013). A Three-level Content Model of Learning IT Use, In Terje Fallmyr; Bendik Bygstad; Jørgen Fog; Laurence Habib; Bjørn Erik Munkvold; Andreas Lothe Opdahl & Guttorm Sindre (ed.),  NOKOBIT 2013 : Universitetet i Stavanger 18. - 20. november 2013 : Norsk konferanse for organisasjoners bruk av informasjonsteknologi.  Akademika forlag.  ISBN 978-82-321-0373-7.  Research paper.  s 173 - 188 Vis sammendrag

  Super-users often get the responsibility of training and helping other users with learning revamped business systems. This requires the super-users to have competence for solving IT related problems. Studies have shown that good problem solvers work systematically, but little else is known about what super-user competence is or how it can be attained. Taxonomies for IT user learning have been suggested, but they do not seem to be built on theory and they miss competence areas. Also, the taxonomies do not indicate how to climb the competence ladder. Based on research from IS, library and information science, HCI, and school research, three subject matter areas of IT use competence are suggested; information, IT and the fit of IT in business. For each of these three contents areas, three competence levels are identified; skill, understanding and problem solving. The understanding level is often overlooked in documentation, training as well as research. An implication of the three level contents model is that conceptual models aimed at guiding understanding should be divided into functional models for understanding input-process-output and structural models for understanding data structures, technology principles, and business fit. The three level contents model also points to the need for research on training for problem solving.

• Damtew, Zufan Abera; Moges, Amsalu Shiferaw & Kaasbøll, Jens Johan (2012). Revisiting the Quality of Health Extension Workers’ Training: Case study from Amhara Region, Ethiopia. Ethiopian Journal of Health Development.  ISSN 1021-6790.  25(3), s 201- 205
• Ngoma, Caroline Abdul; Kimaro, Honest Christopher; Igira, Faraja Teddy; Mukulu, John; Kaasbøll, Jens Johan; Yona, Alice; Mkabara, Naza; Sarikoki, Siaeli; Sangu, Immaculata; Njau, Cecilia; Mnaya, Adili; Mpoyo, Sofia; Mlongakweli, Zaina; Mwaga, William & Pilyimo, Rehema (2012). Challenges in Implementing a Computerized Name-based Information Tracking System: Practical Experiences from Maternal Health Care, In Paul Cunningham & Miriam Cunningham (ed.),  IST-Africa 2012 Conference Proceedings.  International Information Management Corporation Limited.  ISBN 978-1-905824-34-2.  Research paper.  s 1 - 9 Fulltekst i vitenarkiv. Vis sammendrag

  This paper presents challenges encountered in implementing a computerized name-based system for tracking information of pregnant women and children in rural clinics. Results indicate that the implementation of a computerized name-based system faces potential challenges that include; understanding the complexity of local healthcare practices within the community as well as correlating standardised and improvised data collection tools used in health facilities. Other challenges are; application of localised and standardised procedures in healthcare provision, replacing the paper-based system and lastly gradual learning curve during the implementation. These are initial findings drawn from a qualitative research study conducted in the Coastal region of Tanzania. This study intends to improve data reporting and utilisation of health facility services for pregnant women, children and other key community members.

• Pascoe, Luba; Lungo, Juma Hemed; Kaasbøll, Jens Johan & Koleleni, Ismael (2012). Collecting Integrated Disease Surveillance and Response Data through Mobile Phones, In Paul Cunningham & Miriam Cunningham (ed.),  IST-Africa 2012 Conference Proceedings.  International Information Management Corporation Limited.  ISBN 978-1-905824-34-2.  Research paper.  s 1 - 6 Vis sammendrag

  This study focuses on improving the routine reporting of health data by identifying the challenges associated with timely reporting of routine data from the primary health facilities to the district and determines how mobile phones can be used to overcome the problem and thus enhance information use for action at all levels of the health system. Findings have indicated that, timely reporting of routine health data face challenges such as poor infrastructure, remoteness of the health facilities from the district where they have to submit their reports as well as transport costs that health workers have to incur in order to submit their report. Facing these challenges, this research revealed that the use of mobile phone application built in the District Health Information System database can provide an easy, cost effective and reliable means for reporting of health data. Over a period of 5 months, the data completeness and timeliness improved from 50% to 89%. This implies that the routine reporting of around ten data elements through mobile phones is feasible. The study recommends rigorous supervision, which among other things checks for data quality and correctness. Key words: Integrated Disease Surveillance and Response, Routine reporting of health data,

• Damtew, Zufan Abera & Kaasbøll, Jens Johan (2011). Target Setting Procedures for Immunisation Services in Ethiopia: Discrepancies between Plans and Reality. Journal of Health Management.  ISSN 0972-0634.  13(1), s 39- 58 . doi: 10.1177/097206341001300103 Vis sammendrag

  This study identifies the problems related with target setting for immunisation service in Ethiopia. We adopted qualitative case study and drew concepts from institutional theory to collect data and analyse our findings. The findings showed that the plan of district health offices depends on the population data projected from census. Peripheral level health workers, on the other hand, enumerate the number of population in their respective localities. Subsequently, the ambiguity occurs from mismatch between the target from census and number of eligible children counted by health workers. Health facilities are expected to follow the target given from district health offices, which is higher than the local count in most cases. Thus, we found most peripheral level health workers considered that the inflated target given from the projected census lowers their achievements, since their performance should be calculated against the given target. This in turn affects the incentive given, thus, has implication on job satisfaction and performance. The need of considering the reality at the ground, rather than following only the formal institutional rules is emphasised in order to address the identified impediments.

• Klungland, Ingeborg M F & Kaasbøll, Jens Johan (2011). Non Governmental Organisations as Change Agents in Implementation of new Software in the Health Information System in Tanzanian Regions - Ways of Handling Conflicts, In Terje Fallmyr (ed.),  Proceeding from Norsk konferanse for organisasjoners bruk av informasjonsteknologi, 2011.  Tapir Akademisk Forlag.  ISBN 978-82-519-2845-8.  Research paper.  s 53 - 66 Vis sammendrag

  There is currently an ongoing process in Tanzania to strengthen the health management information system of the country. A consortium of several partners, including the Clinton Health Access Initiative (CHAI) are engaged in implementing the District Health Information System (DHIS) software. The likely way forward for the DHIS to be implemented in all regions of the country is based on the support of external organizations like CHAI. A study of the project in two regions, Mtwara and Lindi, was carried out mainly by qualitative interviews. Main findings of this study indicate that although many efforts have been made, and positive outcomes have been reached, some challenges are still left for the project to face. Findings are analyzed through Heeks´s (2002) ITPOSMO-model for assessing gaps between the design of an information system and the reality where it is to be implemented. There are many actors involved in the implementation of the DHIS in Mtwara and Lindi, all with their own goals. All though many goals are legitimate, they are not all compatible, constituting conflicts. Galtung´s (2000) conflict theory is used as an extension of ITPOSMO model, and for analyzing findings related to the many actors involved in the process. A specific way of handling conflicts in such projects, based on Galtung (2000) is recommended.

• Mahundi, Masoud; Kaasbøll, Jens Johan & Twaakyondo, H.M (2011). Health Information Systems Integration in Tanzania: Tapping the Contextual Advantages, In Paul Cunningham & Miriam Cunningham (ed.),  IST-Africa 2011 Conference Proceedings.  IIMC International Information Management Corporation.  ISBN 978-1-905824-24-3.  Research paper.  s 1 - 11
• Damtew, Zufan Abera; Kanjo, Chipo; Kaasbøll, Jens Johan & Williamson, Louisa Joan (2010). Using and sharing locally generated information for action: the case from three developing countries, In  IADIS International Conference Information Systems 2010.  IADIS Press.  ISBN 978-972-8939-09-0.  Article.  s 85 - 93 Vis sammendrag

  This paper argues that locally generated information is crucial in the work practices of health managers at all levels in the developing country context. Using case studies conducted independently in Ethiopia, Malawi and South Africa, the use and significance of local knowledge is analysed. We draw on concepts from knowledge literature and an interpretive approach to illustrate the importance of locally generated information and knowledge in the three contexts. We compare and contrast how low level health managers operate, their actions, practices, how they handle and utilise the locally generated information and knowledge for the benefit of the system. Our study shows that low level health managers tend to know their population. This implies knowing the different villages, communities, households or even patients in their clinics and their practices. This local knowledge is what they base their managerial work on. We suggest that this knowledge be formalized and used as input for district and higher levels to make planning and resource allocation. We emphasize the importance of deriving information for action in health using a bottom-up approach.

• Kaasbøll, Jens Johan; Galimoto, Marlen Stacey; Hamre, Gro Alice & Sandvand, Jon (2010). Competencies and Learning for Management Information Systems. Journal of Information, Information Technology, and Organizations.  ISSN 1557-1319.  5, s 85- 100 Vis sammendrag

  Previous research has established that users need competence in both computing and the context of the software. Information systems often fail due to low competence amongst users, and no study is known to provide a systematic account of the user competence needed. This research concerns competence needs amongst prospective users of a computerised management information system where there is no operational computer based IS from which to obtain data. The study shows that three subject matter areas of user competence are needed for people who will use computerised IS -- knowledge on how the domain is represented, work competence, and computer literacy. Work competence is mainly practice based, while the domain related knowledge and computer literacy are based on explicit concepts, grounded in science or technology. User training should therefore start with practice in the case of work competence, while presentation of principles, concepts, and structures would constitute a better starting point when teaching computer literacy and how the domain is represented

• Damtew, Zufan Abera; Kaasbøll, Jens Johan & Williamson, Louisa Joan (2009). From information for decision making to information for keeping core knowledge updated – health managers who know their population, In Elaine Byrne; Brian Nicholson & Fadi Salem (ed.),  Assessing the Contribution of ICT to Development Goals.  Dubai School of Government and International Federation for Information Processing.  ISBN 978-0-903808-05-7.  Research paper.  s 381 - 388 Vis sammendrag

  This study pointed out how health information is gained and applied for action. Computer support for health management consists of reports of health indicators, which are supposed to be used for deciding upon changes in the health services. Qualitative case studies of low level health managers of two developing countries, on the other hand, showed that instead of checking such information when decisions are made, health managers rather tend to “know their population and other health related issues” which means knowing the different villages, communities, households or even patients in small clinics. This tacit knowledge is what they base their managerial work on. Having such a conceptualisation of their prime tacit knowledge corresponds to findings from other practices. This embedded knowledge is developed through accumulation of learning from their routine practices and their close interaction with the community. Besides, geographical information stricture was implemented. This local knowledge can also be used by district and other higher health managers for different purposes.

• Kanjo, Chipo & Kaasbøll, Jens Johan (2009). Rules, Reality and Results: Inter-Institutional Coordination and Impact on Health Information Systems in Developing Countries, In Judith Molka-Danielsen (ed.),  Proceedings of the 32nd Information Systems Research Seminar in Scandinavia, IRIS 32, Inclusive Design.  Molde University College.  ISBN 978-82-7962-120-1.  A22. Vis sammendrag

  In the health organisation field, weak or lack of coordination between different players leads to inefficiency in the whole health information system. The Malawi health sector is no exception. It has a plurality of health service providers, as is the case in most low income countries, and these providers are separated into the traditional and modern sectors (ADF, 2005). The traditional health providers are considered as the informal health providers. This paper aims to identify the extent which the informal and formal health providers coordinate and how much information from the informal health providers, with specific focus on the traditional birth attendants, is integrated into the health management information system (HMIS). This will take into consideration the existing rules in the health care system and the reality on the ground in the rural areas. While the existing rules ban the operations of traditional birth attendants (TBAs), the masses see the TBAs as being responsive to their needs. This results in weak links in the HMIS as some information which could have been captured from the TBAs end up being missed as they fear to report data due to the set rules.

• Lagebo, Birkinesh Woldeyohannes & Kaasbøll, Jens Johan (2009). Lessons learned from Local Videoconferencing Tool for Training Health Staff, In Judith Molka-Danielsen (ed.),  Proceedings of the 32nd Information Systems Research Seminar in Scandinavia, IRIS 32, Inclusive Design.  Molde University College.  ISBN 978-82-7962-120-1.  A30.  s 1 - 18 Vis sammendrag

  Videoconferencing technology was used to train around 5000 health extension workers who reside at different places of the Oromia region, in Ethiopia. Case study is employed to identify challenges and opportunities of using the local videoconferencing tool for training health extension workers and take lessons to apply the tool for health management information system (HMIS) training. The vastness of the country with poor transportation facility made the video conferencing tool suitable for health workers‟ training in Ethiopia. The tool reduced some of the traditional class room based training problems such as time and fund constraint, and shortage of trainers. The absence of IT professional to handle the videoconferencing tool in some woredas(district) made the videoconferencing tool idle. The negative attitude of the woreda people towards the tool in relation to the per diem issue made them reluctant to provide support for the infrastructure. As a result the videoconferencing tool became non functional due to lack of minor accessories.

• Williamson, Louisa Joan & Kaasbøll, Jens Johan (2009). Health Information and Managerial Work: Exploring the Link, In Elaine Byrne; Brian Nicholson & Fadi Salem (ed.),  Assessing the Contribution of ICT to Development Goals.  Dubai School of Government and International Federation for Information Processing.  ISBN 978-0-903808-05-7.  Research paper.  s 291 - 304 Vis sammendrag

  Health information systems are tools to support management. Responsible for service implementation; yet tasked with monitoring performance of service delivery; PHC facility manager cadres lack the authority to take decisions about change in practices. It is thus relevant to explore the nature of management work at this functional level and how this work links to the information system created to support management processes. Three key questions were asked: what is the role of these managers; what is the context within which information is used; and, what information is relevant to support management practices. Within common core management tasks, a range of management roles were identified. These were largely utilised in processing information about operational issues that impact on service delivery. As in related empirical studies on management work, the findings revealed a high dependency on soft data obtained from informal information systems rather than that of the formal system; an information mismatch. Future challenges involve discussion on how to align this information mismatch.

• Damtew, Zufan Abera & Kaasbøll, Jens Johan (2008). Working towards precise and ambiguous targets: - the challenge for Health Extension Workers of Ethiopia, In Viveca Asproth (ed.),  Proceedings of IRIS 31.  The IRIS association.  ISBN 978-91-86073-12-1.  Kapittel. Vis sammendrag

  Immunization is one of the strategies designed to reduce mortality and morbidity of children. The health care system of Ethiopia concentrates its effort in order to ensure full immunization of all eligible children with national goal of 90% coverage. However, the planning system for immunization has drawbacks because of the ambiguity arising from the targets. Drawing from the institutional theory, we studied the problem associated with target setting. The plan of district health offices depend on the population data projected from census. Health extension workers, on the other hand, enumerate the number of population in their respective localities. Subsequently, the ambiguity occurs from mismatch between the target from census and the number of eligible children counted by health workers. In practice, they are expected to follow the target given from district health offices, which is high in most cases. Thus, we found that most peripheral health workers considered as the inflated target given from their higher level lowers their achievements. This in turn affects the incentive given, thus, has implication on job satisfaction and performance. The need of considering the reality at the ground, rather than following only the formal institutional rules is emphasised in order to address the identified impediments.

• Hamre, Gro Alice & Kaasbøll, Jens Johan (2008). Motivation and Demotivation: a Case Study of the Malawian Health Management Information System. Electronic Journal of Health Informatics.  ISSN 1446-4381.  3(2), s 1- 11 Vis sammendrag

  This paper addresses the problems of utilisation of health management information systems (HMIS) in developing countries due to the critical shortage of qualified and motivated human resources. The study employed qualitative research methods in an interpretive in-depth case study, and the study was carried out in two districts in Malawi. Analyses are based on motivational theory and the six categories of good and bad critical motivational incidents defined by Machungwa and Schmitt [1]. Gasser’s [20] theory of integration of computing and routine work was applied to address the secondary, and supportive, nature of HMIS computing work. This research suggests that motivational items identified by Machungwa and Schmitt [1] are chiefly relevant to the Malawian context, but since the HMIS work is of a secondary type compared to core health activities, the work motivation that comes from work itself has little motivating effects. Supervision visits and a recognition scheme were social arenas which motivated the health workers.

• Ngoma, Caroline; Kaasbøll, Jens Johan & Aanestad, Margunn (2008). From User Training to In-Service Support, In Paul Cunningham & Miriam Cunningham (ed.),  IST-Africa 2008 Conference Proceedings.  International Information Management Corporation Limited.  ISBN 978-1-905824-07-6.  51.  s 1 - 11
• Williamson, Louisa Joan; Kaasbøll, Jens Johan; Braa, Jørn & Sun, Violeta (2008). South-South collaboration: adapting information systems integration strategies in Namibia, In Paul Cunningham & Miriam Cunningham (ed.),  IST-Africa 2008 Conference Proceedings.  International Information Management Corporation Limited.  ISBN 978-1-905824-07-6.  Kapittel. Vis sammendrag

  The research tests the feasibility of an information systems integration strategy within the Namibian health care system. Early findings suggest that the transfer of ‘best practices’ may be inappropriate in different country contexts, or that previously considered ‘best practices’ are less than optimal. The adaptation process builds on a South-Africa - Namibia collaboration of sharing practices, experiences and expertise. The role of South-South collaboration in supporting adaptation interventions in offering opportunities to explore both feasibility and appropriateness of potential interventions is addressed. The finding emphasizes the usefulness of extending joint knowledge on how to develop information systems in the health sectors of African and Asian countries.

• Samuelsen, Terje & Kaasbøll, Jens (2007). Hvordan veiledning kan bidra til problemløsing og begrepsbygging innenfor objektorientert programmering, I:  NIK 2007 : Norsk informatikkonferanse.  Tapir Akademisk Forlag.  s 87 - 96 Vis sammendrag

  Selv om det har vokst fram en oppfatning om at studenter lærer programmering på laben og ikke i auditoriet, så vet vi lite om hvordan labveiledning bør foregå. I denne studien prøves det ut en alternativ måte å veilede på. Metoden er hentet fra Schoenfeld [13] for bruk i matematikken, der veilederen stiller 3 spørsmål som skal få studentene til å reflektere over sin framgangsmåte. Hos oss førte dette til at studentene raskt lærte å løse programmeringsproblemer og klarte å anvende objektorienterte begreper. Til forskjell fra tidligere forskning ble studentene raskt fortrolige med veiledningsformen.

• Samuelsen, Terje & Kaasbøll, Jens Johan (2007). Hvordan veiledning kan bidra til problemløsning og begrepsbygging innenfor objekt-orientert programmering, I: Frode Eika Sandnes (red.),  Norsk informatikkonferanse NIK 2007.  Tapir Akademisk Forlag.  ISBN 978-82-519-2272-2.  Kapittel.
• Stamatova, Elena Ivanova & Kaasbøll, Jens Johan (2007). Users’ Learning of Principles of Computer Operations. Issues in Informing Science and Information Technology (IISIT).  ISSN 1547-5840.  4, s 291- 306
• Granerud, Roar; Kaasbøll, Jens Johan; Borge, Richard; Holmboe, Christian & Smørdal, Ole (2006). Children's understanding of object-orientation, In Annita Fjuk; Amela Karahasanovic & Jens Johan Kaasbøll (ed.),  Comprehensive Object-Oriented Learning: The Learner's Perspective.  Informing Science Press.  ISBN 83-922337-4-3.  3.  s 27 - 48
• Kaasbøll, Jens Johan (2006). The learners’ environment in OO first: implications for sequence of teaching and tools, In Chunming Rong & Arne Løkketangen (ed.),  NIK'2006 : Norsk informatikkonferanse.  Tapir Akademisk Forlag.  ISBN 82-519-2186-4.  Kapittel.  s 167 - 176
• Kaasbøll, Jens Johan; Fjuk, Annita; Karahasanovic, Amela & Groven, Arne-Kristian (2006). Improvements of teaching and tools for learning object-orientation, In Annita Fjuk; Amela Karahasanovic & Jens Johan Kaasbøll (ed.),  Comprehensive Object-Oriented Learning: The Learner's Perspective.  Informing Science Press.  ISBN 83-922337-4-3.  Kap.11.  s 205 - 220
• Mirmotahari, Omid; Holmboe, Christian & Kaasbøll, Jens Johan (2003). Difficulties Learning Computer Architecture. Proceedings / ITiCSE.  1(1), s 247- 248
• Berge, Ola; Fjuk, Annita; Groven, Arne-Kristian; Hegna, Håvard & Kaasbøll, Jens Johan (2003). Comprehensive Object-Oriented Learning - an Introduction. Computer Science Education.  ISSN 0899-3408.  13(4) . doi: 10.1076/csed.13.4.331.17490
• Motschnig-Pitrik, Renate & Kaasbøll, Jens Johan (1999). Part-Whole Relationship Categories and their Application in Object-Oriented Analysis. IEEE Transactions on Knowledge and Data Engineering.  ISSN 1041-4347.  11(5), s 779- 797 Vis sammendrag

  Part decomposition and, conversely, the construction of composite objects out of individual parts have long been recognized as ubiquitous and essential mechanisms involving abstraction. This applies, in particular, in areas such as CAD, manufacturing, software development, graphics, and document processing. In this paper we investigate some of the existing proposals on refining the semantics of part-whole relationships. We suggest more precise and less redundant specification of static constraints such as exclusiveness versus sharing, existence dependence versus independence, and mandatory parts versus optional ones. Further, simple dynamic constraints that easily may be captured during the analysis phase are introduced. Although the approach appears generally applicable, the widely known OMT notation will be used to present our findings. A brief sketch of the formalization will complement the numerous examples and the update semantics given for the newly introduced categories of part-whole relationships.

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• Fallmyr, Terje; Fog, Jørgen; Kaasbøll, Jens; Netteland, Grete; Opdahl, Andreas Lothe; Munkvold, Bjørn Erik & Sindre, Guttorm (red.) (2014). NOKOBIT 2014, Norsk konferanse for organisasjoners bruk av informasjonsteknologi, Høgskolen i Østfold 17 - 19. november 2014. Norsk konferanse for organisasjoners bruk av informasjonsteknologi.  ISBN 9788251928458.  255 s.
• Fjuk, Annita; Karahasanovic, Amela & Kaasbøll, Jens (ed.) (2006). Comprehensive Object-Oriented Learning: The Learner’s Perspective. Informing Science Press.  ISBN 83-922337-4-3.  226 s.
• Fjuk, Annita; Karahasanovic, Amela & Kaasbøll, Jens Johan (ed.) (2006). Comprehensive Object-Oriented Learning: The Learner's Perspective. Informing Science Press.  ISBN 83-922337-4-3.  229 s.

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• Amrit, Chhetri; Iversen, Mari; Kaasbøll, Jens Johan & Kanjo, Chipo (2019). Evaluating mHealth Apps: From Front-End Usability to Three Front-Ends and one Back-End Affordance.
• Ayebazibwe, Immaculate; Kimaro, Honest Christopher & Kaasbøll, Jens Johan (2019). System Use And User Satisfaction In The Adoption Of Electronic Medical Records Systems: A Case Of Dhis2 Tracker Implementation In Tanzania.
• Kaasbøll, Jens Johan; Kanjo, Chipo & Kimaro, Honest Christopher (2019). Building Sustainable Collaborations and Academic Networks in Low Income Countries: Case of Master Programmes.
• Kaasbøll, Jens Johan; Kanjo, Chipo & Kimaro, Honest Christopher (2018). Sustainable Health Informatics Master Programmes In Low And Middle Income Countries. Vis sammendrag

  We present the process, outcomes and lessons learnt in sustaining Master Programmes implemented across a number of low and middle-income countries in collaboration with the University of Oslo (UiO) where the Health Information System Programme (HISP) is hosted. UiO has been engaged in supporting health information systems in developing countries for two decades. One necessary component has been educating health informatics specialists, of which research education was deemed necessary. This led to introduction of 9 Master programmes in 6 countries between 2001–2014. STRATEGIES AND CHALLENGES The programmes have gone through three stages: 1) planning and application for funds; 2) implementation with project funding; 3) continued implementation after project closure. The three stages and the assessment of programme outcomes were guided by the Collaborative Governance Model. 1. STRATEGY FOR BUILDING LOCAL COMPETENCE A strategy was devised to have lecturers from UiO and other partners teaching and supervising in the programmes together with local lecturers at the start of Stage 2 and phasing out the international support when the local lecturers could take over. Some lecturers from the partner universities would at the same time be enrolled in PhD studies at UiO to build their capacity. A number of thesis supervisors were recruited from local organisations to reduce the burden of the faculty members and to broaden the scope of topics. This plan worked until there were local lecturers with sufficient background to take over the courses. In some instances, the locals were not up to it, and these course modules were thus abandoned in Stage 3. 2. CHALLENGES The planning Stage (1) encountered two main challenges; lack of local competence to run the programmes, and challenge with funding after the initial support ceased. In Stage 2, two other challenges surfaced; where it was noted that students were not having time for thesis work and another hiccup was the locals being overburdened by both trying to teach in the master programme whilst doing their own PhD. Since teaching is a short horizon activity, this was often prioritized, and the PhD was consequently delayed. Fortunately, UiO could extend their PhD scholarship (Norwegian State Educational Loan Fund rates, not salaries) until they completed. When Stage 3 arrived, enough local competence had been built to continue the teaching. UiO staff have contributed in supervising a few master students of mutual interest in Stage 3. 3. SUSTAINED FUNDING The initial funding covered salaries for partner university staff, scholarships for 4-8 students per cohort and running costs, including UiO staff travels. The partner universities needed 15-20 tuition fee paying students per cohort for sustainable funding in Stage 3. To achieve sufficient number of applicants, the partner universities had a deliberate strategy where they announced the programmes with tuition fees from the start of the project. The number of applicants were around twice the number of scholarships, hence the universities received additional income from the start of Stage 2. The students and graduates spread information about the programmes through word of mouth, and this has secured the number of fee paying students after the initial funding ceased. 4. FULL TIME WORKING STUDENTS Nearly all students enrolled work full time, and have immediate and extended families take care of. Coursework force most of them into a structured setting such that they pass their exams. Finding time needed for concentrating on thesis writing has been difficult and impossible for some students. Completion time is therefore extended in some cases up to four years and a significant portion of the students only end up with a diploma confirming their coursework. One way of improving completion has been to organize one week thesis workshops where the students work intensively, discuss with each other and with supervisors. Additional retreats

• Kanjo, Chipo; Msiska, Brown Chawanangwa & Kaasbøll, Jens Johan (2018). Complimenting DHIS2 Tracker browser app with medical sensors for maternal health care delivery.
• Kanjo, Chipo; Msiska, Brown Chawanangwa & Kaasbøll, Jens Johan (2018). Complimenting DHIS2 Tracker browser app with medical sensors for maternal health care delivery. Vis sammendrag

  The EU Horizon funded project mHealth4Afrika (2015-2019) aimed at developing a system to support quality community-based primary maternal healthcare delivery at semi-urban, rural and deep rural clinics for 4 African countries; Ethiopia, Kenya, Malawi and South Africa. In its initial phase, mHealth4Afrika developed an antenatal care system only. Currently, it has been expanded to all reproductive health services (maternity, postnatal, and under five). Other than the timely capturing of data and systematic storage of important data points in the patient electronic record; mHealth4Afrika utilises sensors. The sensors are used to identify non-communicable diseases (hypertension, diabetes) at the point of care and facilitate triage (not currently practiced at clinic level). mHealth4Afrika therefore contributes with a custom browser app and sensors. Unlike the standard Tracker Capture app, the mHealth4Afrika app has a user interface adapted to the workers in health clinics. The app has been developed by the University of Malawi and Nelson Mandela University. A basic design feature of DHIS2 is a separation between input and output. Input is done in a data capture app, and output is presented in reports apps and the dashboard the next day, after the system has run analytics during the night. Much as the separation of input and output works for routine reporting, point-of-care systems require patient outputs to be displayed immediately. The alerts and other program rules provide some output at the data entry screen, but display of graphs and other visuals are to be done with separate apps. Point-of-care systems need a user interface more like a spreadsheet than that of searching and retrieving. The mHealth4Afrika app mixes input and output, eg, displaying oxygen saturation (SpO2) and pulse rate While there is a general shortage of medical equipment in resource poor settings, some sensors are reasonably priced and useful for maternal health. The sensors as shown in fig 3 have been identified for use: Visiomed sensors for blood pressure, Oximeter (foxygen and pulse rate), and temperature. The sensors uploads data to an Android app, which forwards the data to the DHIS2 through its API.

• Rolland, Knut-H.; Kaasbøll, Jens Johan; Karlsen, Anniken Th; Eikebrokk, Tom Roar & Netteland, Grete (red.) (2018). Vol. 26 No. 1 (2018): Proceedings from the annual NOKOBIT conference held at Svalbard the 18th-20th of September 2018. Vis sammendrag

  Siden 1993 har NOKOBIT vært en nasjonal konferanse innen informasjonsvitenskap/informasjonssystemer. Den tar opp aktuelle temaer knyttet til utvikling, implementering og bruk av IKT i organisasjoner, samt samfunnsmessige problemstillinger ved IKT. Alle artikkelbidrag går gjennom blind-review. Aksepterte bidrag blir publisert og er meritterende på nivå 1.

• Rolland, Knut-Helge Ronæs; Netteland, Grete; Kaasbøll, Jens Johan; Karlsen, Anniken Th & Eikebrokk, Tom Roar (red.) (2017). Proceedings from the annual NOKOBIT (&UDIT) conference held in Oslo the 27th-29th of November 2017. NOKOBIT - Norsk konferanse for organisasjoners bruk av informasjonsteknologi. 1. Vis sammendrag

  NOKOBIT (Norsk Konferanse om Organisasjoners Bruk av IT) er en etablert nasjonal konferanse for formidling av forskningsresultater rundt informasjonsteknologi i en organisatorisk sammenheng. Proceedings inneholder 18 fagfellevurderte artikler som ble presentert på NOKOBIT i Oslo 27.-29. november 2017. Vi mottok i utgangspunktet 24 innsendte bidrag, og etter fagfellevurdering ble 18 artikler valg ut til publisering i dette tidsskriftet. Nummeret inneholder også 6 av artiklene som ble presentert på UDIT, en samlokalisert konferanse om Utdanning og Didaktikk i IT-fag. Samlet mottok UDIT 17 bidrag og publiserer 11. Disse bidragene ble fagfellevurdert av en egen programkomite for UDIT. UDIT har også denne gangen 3 korte praksisbidrag som ikke har vært gjennom fagfellevurdering, men som har blitt godkjent av redaksjonskomité. Øvrige bidrag på UDIT ble publisert i tidsskriftet til NIK. NOKOBIT’s redaksjonskomité ønsker å gi en spesiell takk til den lokale arrangementskomiteen ved Westerdals Oslo ACT: Siri Fagernes, Tor-Morten Grønli, Knut H. Rolland og Wanda Presthus. Samt Andreas Biørn-Hansen, som har bidratt sterkt med tilrettelegging av websider og annet praktisk håndverk. Redaksjonskomité for tidsskriftet i 2017, har bestått av • Knut Helge Rolland, Universitetet i Oslo • Grete Netteland, Høgskolen i Sogn og Fjordane • Jens Kaasbøll, Universitetet i Oslo • Anniken Karlsen, NTNU • Tom Roar Eikebrokk, Universitetet i Agder

• Tronerud, Kristoffer; Vassbotten, Martin Theodor; Kaasbøll, Jens Johan & Sæbø, Johan Ivar (2017). Usability for Novices and Experts: a layered design in a case study in Malawi, In Paul Cunningham & Miriam Cunningham (ed.),  IST-Africa 2017 Conference Proceedings.  IIMC International Information Management Corporation.  ISBN 978-1-905824-56-4.  Artikkel.  s 1 - 9 Vis sammendrag

  This paper presents initial findings from a project in Malawi to develop and implement a simple application for making league tables in the health sector. League tables, sometimes also called scorecards, are tables that compare various entities according to several indicators, and rank them from best to worst performers. Prior work in Malawi has suggested that these tables would be useful at both national and local levels, and should therefore be customizable so that different users can make their own tables, based on the health indicators of their choice. A main finding from this project is that usability and learnability for novice users must be balanced against the request for more advanced features from expert users. This was achieved through designing the app with a novice and an expert layer. The expert layer concerned configuration of the league tables. Configuration or customization is a general functionality in many applications and may thus be segregated in an expert layer.

• Sindre, Guttorm; Eikebrokk, Tom Roar; Karlsen, Anniken Th; Kaasbøll, Jens Johan; Netteland, Grete; Opdahl, Andreas Lothe & Rolland, Knut-Helge Ronæs (red.) (2016). NOKOBIT - Norsk konferanse for organisasjoners bruk av informasjonsteknologi, Proceedings fra NOKOBIT 2016, Bergen, 29.-30. november 2016. NOKOBIT - Norsk konferanse for organisasjoners bruk av informasjonsteknologi. 1.
• Sindre, Guttorm; Fog, Jørgen; Kaasbøll, Jens Johan; Netteland, Grete; Opdahl, Andreas Lothe; Munkvold, Bjørn Erik & Karlsen, Anniken (red.) (2015). NOKOBIT - Norsk konferanse for organisasjoners bruk av informasjonsteknologi, Proceedings fra NOKOBIT 2015, Ålesund, 24.-25. november 2015. NOKOBIT - Norsk konferanse for organisasjoners bruk av informasjonsteknologi. 1.
• Kaasbøll, Jens (2014). Evaluation of longitudinal processes consisting of many projects.
• Kaasbøll, Jens (2014). Implementation and implementation research in District Health Informatics.
• Saugene, Zeferino & Kaasbøll, Jens (2014). Foregrounding invisible work practices: The customization of generic software systems.
• Shidende, Nima Herman; Chawani, Marlen Stacey & Kaasbøll, Jens (2014). Challenges in participation and implications on human development: Experiences from Health Information Systems implementations in Tanzania and Malawi.
• Øgland, Petter; Kaasbøll, Jens; Henfridsson, Ola & Bratthall, Lars (2013). Mechanism design for total quality management: Using the bootstrap algorithm for changing the control game. Series of dissertations submitted to the Faculty of Mathematics and Natural Sciences, University of Oslo.. 1428. Vis sammendrag

  As society continues to develop in technological ways, side-effects of yesterday’s solutions are becoming today’s problems and systems tend to fail in increasingly spectacular ways. The more severe the consequences of organisational failure are, the greater is the need for approaches like total quality management (TQM) to control the organisation from a holistic perspective, but to design and implement optimal control can be difficult, and about 80% of all TQM implementation projects tend to fail. High failure rates in environments characterised by technological complexity and social distrust can be understood through game theory. Management and workforce are involved in a control game, and the TQM designer is playing a game with the organisation as a whole in trying to change the economic mechanisms that define the control game. The goal is to design mechanisms that make the control game align with TQM philosophy, but the easiest and most stable solution to this game often end up being both TQM designer and organisation developing policies and quality systems while forgetting to implement or only pretending to do so. By thinking more widely about the quality management system supporting the TQM policy as information infrastructure (II), however, and making use of the Monopoly game model for understanding the growth and development of II, the II design strategy known as the bootstrap algorithm (BA) becomes an interesting option to explore. The hypothesis in this study is that the BA is an optimal strategy for gradually changing the game in a manner that will lead to sustainable TQM at the highest level of excellence. The claim is analysed by looking at twenty years of information systems action research that involves three Norwegian public sector organisations. The outcome of research reports experiences in BA design using Total Systems Intervention (TSI) implementation methodology. Although the research focuses on challenges and weaknesses in the practical BA designs, resulting in problems and partial failures in TQM implementation, the outcome supports the BA hypothesis. The analysis is based on considering three levels of gameplay. On the shop floor level, an audit game is played out between the TQM auditor and IT personnel. The “what gets measured gets done” motivational theory is a key to success for TQM implementation on this level, but depends on having established management commitment by winning the trust game on higher organisational levels. As the trust game is not a single-shot game, various techniques have to be used to gain trust in various situations for various elapses of time. Different game models are introduced and discussed for elaborating useful ways of thinking about different conflicts and challenges. The highest level of gameplay is the mechanism design game where the TQM designer fights the resistance of the organisation by trying to change the strategy sets and payoffs of the trust game and audit game in order to increase the basis of attraction for the game equilibrium that suggests walking the TQM talk and reducing the basis of attraction for TQM talk without walk. The research makes contributions to II/BA and TSI theory through the Monopoly model of II dynamics, the reformulation of the BA as a genetic algorithm, and by suggesting game theory as an overall theoretical framework for TSI action research. The implications for practice are reduced failure rates for TQM implementation.

• Chawani, Marlen Stacey; Mwakilama, Shawo; Kanjo, Chipo & Kaasbøll, Jens Johan (2011). A SCRUTINY OF THE INTEGRATION STATUS AND STANDARDIZATION PROCESS OF ELECTRONIC MEDICAL RECORD SYSTEMS IN MALAWI. Vis sammendrag

  Achieving integration remains a challenge in many developed countries partly attributed to the presence of many different EMR systems which makes standardization and achieving interoperability a difficult and complex undertaking. Unfortunately, there is a lack of literature on whether and how developing countries in Africa are addressing issues related to integration of EMRs in their HIS agendas. A study was therefore conducted to assess the integration status, efforts and strategies in the implementation of EMR systems in Malawi in order to identify integration strategies and processes appropriate for the Malawian context. Thus, this paper presents the integration status and standardization efforts in Malawi and makes recommendations on how to progress towards standardization.

• Kanjo, Chipo & Kaasbøll, Jens Johan (2011). Data, Information, and Knowledge: The Greatest of All is Knowledge.
• Kanjo, Chipo & Kaasbøll, Jens Johan (2011). Influence of Information Generated from Traditional Practices on Health Information Systems.
• Kaasbøll, Jens Johan (2009). Integration and scaling of health information systems to strengthen vaccination services delivery in India.
• Galimoto, Marlen Stacey; Kaasbøll, Jens Johan; Hamre, Gro Alice & Sandvand, Jon (2008). Competencies and learning for management information systems – the case of a health information system in Malaŵi. Vis sammendrag

  Previous research has established that users need competence in both computing and the context of the software. Information systems often fail due to low competence amongst users, and no study is known to provide a systematic account of the user competence needed. This research concerns competence needs amongst users of a management information system where there is no operational IS from which to obtain data for the MIS. The study shows that three subject matter areas of user competence are needed for IS, domain knowledge, work competence and computer literacy, and numeracy is a fourth area needed for MIS. Nonaka’s (1994) model of organisational learning distinguishes between tacit competence learnt through internalisation and socialisation and explicit knowledge developed through externalisation and combination. Work competence, being management in this case, is basically tacit competence, while domain knowledge, computer literacy and numeracy are based on explicit concepts. User training should therefore start with practice in the case of work competence and presentation of concepts in the three other subject matter areas.

• Mørch, Anders Irving; Nygård, Kathrine Amundsen; Kaasbøll, Jens Johan & Mushtaq, Shazia (2008). Multiple Design Techniques for Participatory and Evolutionary Design.
• Lagebo, Birkinesh & Kaasbøll, Jens Johan (2007). ICT solutions for human resource capacity building in the Health Sector: case Ethiopia.
• Samuelsen, Terje & Kaasbøll, Jens (2007). Hvordan veiledning kan bidra til problemløsing og begrepsbygging innenfor objektorientert programmering.
• Kaasbøll, Jens Johan (2006). Conceptual influence from computer science.
• Kaasbøll, Jens Johan & Lagebo, Birkinesh Woldeyohannes (2006). Factors Influencing User Training and Possible Strategies to Remove Obstacles.
• Kaasbøll, Jens Johan; Arntzen Bechina, Aurilla Aurelie; Sanders, David & Reagon, Gavin (2004). Health Information Systems Programme.
• Kaasbøll, Jens Johan; Berge, Ola; Borge, Richard Edvin; Fjuk, Annita; Holmboe, Christian & Samuelsen, Terje (2004). Learning Object-Oriented Programming. Vis sammendrag

  Loud discussions concerning various ways of teaching object-orientation have taken much empirical evidence for any position. This paper reports qualitative observations object-oriented programming in an introductory course. The students were found well with the object-oriented concepts, and they had learnt procedural programming when modelled the real world domain to be represented in the program, they imagined coded it without explicit analysis and design. Their problems may be attributed to the high complexity generated by the five different attention the students have to cope with. In addition to representing the problem domain program execution, they have to design the other components of the program, like file handling, and relate these to the reality model. Three ways of improving teaching are suggested, making the areas of attention and them more explicit for the students, forcing modelling by means of a tool, and reducing means of programming environments that visualize objects and their behaviour.

• Kaasbøll, Jens; Berge, Ola; Borge, Richard; Fjuk, Annita; Holmboe, Christian & Samuelsen, Terje (2004). Learning Object-Oriented Programming. Vis sammendrag

  Loud discussions concerning various ways of teaching object-orientation have taken place without much empirical evidence for any position. This paper reports qualitative observations of learning of object-oriented programming in an introductory course.The students were found to cope reasonably well with the object-oriented concepts, and they had learnt procedural programming first. However, when modelled the real world domain to be represented in the program, they imagined the model and coded it without explicit analysis and design. Their problems may be attributed to the high complexity generated by the five different areas of attention the students have to cope with. In addition to representing the problem domain in the program execution, they have to design the other components of the program, like user interface and file handling, andrelate these to the reality model. Three ways of improving teaching are suggested, making the areas of attention and the ways to relate them more explicit for the students, forcing modelling by means of a tool, and reducing complexity by meansof programming environments that visualize objects and theirbehaviour.

• Nhampossa, Jose Leopold; Kaasbøll, Jens Johan & Braa, Jørn (2004). Participation in the information system adaptation process in the public sector in Mozambique.
• Berge, Ola; Borge, Richard; Fjuk, Annita; Kaasbøll, Jens & Samuelsen, Terje (2003). Learning object-oriented programming. Vis sammendrag

  Loud discussions concerning various ways of teaching object-orientation have taken place without much empirical evidence for any position. This paper reports qualitative observations of learning of object-ori-ented programming in an introductory course. The students were found to cope reasonably well with the object-oriented concepts, and they had learnt procedural programming first. However, they modeled the real world domain to be represented in the program by imagination and through coding. Their problems may be attributed to the high complexity generated by having to relate to four – six areas of attention. Three ways of improving teaching are suggested, making the areas of attention and the ways to relate them more explicit for the students, forcing modeling by means of a tool, and reducing complexity by means of programming environments that visualize objects and their behavior.

• Kaasbøll, Jens Johan & Borge, Richard Edvin (2003). What is "OO first"?.
• Kaasbøll, Jens Johan & Samuelsen, Terje (2003). The use of Language in Object-oriented Teaching.
• Kaasbøll, Jens & Samuelsen, Terje (2003). The use of language in object-oriented teaching.
• Berge, Ola; Borge, Richard Edvin; Fjuk, Annita; Kaasbøll, Jens Johan & Samuelsen, Terje (2003). Learning Object-Oriented Programming, In Dag Frette Langmyhr (ed.),  Norsk informatikkonferanse NIK'2003.  Tapir Akademisk Forlag.  ISBN 82-519-1916-9.  KAPITTEL.  s 37 - 47 Vis sammendrag

  Loud discussions concerning various ways of teaching object-orientation have taken place without much empirical evidence for any position. This paper reports qualitative observations of learning of object-oriented programming in an introductory course. The students were found to cope reasonably well with the object-oriented concepts, and they had learnt procedural programming first. However, they modeled the real world domain to be represented in the program by imagination and through coding. Their problems may be attributed to the high complexity generated by having to relate to four ? six areas of attention. Three ways of improving teaching are suggested, making the areas of attention and the ways to relate them more explicit for the students, forcing modeling by means of a tool, and reducing complexity by means of programming environments that visualize objects and their behaviour.

• Kaasbøll, Jens Johan & Nhampossa, Jose Leopoldo (2002). Transfer of public sector information systems between developing countries: south-south cooperation. Vis sammendrag

  Technology transfer from north to south has been studied in several research projects. This paper describes a case of transfer of technology from one developing country to another. It describes the process of selection, installation, assimilation and adaptation of a district health information system for Mozambique based on the South African health information system. While north-south transfer has been hampered by problems related to economic and cultural differences, one might hope that south-south transfer avoids these problems. The case shows that also transfer between two neighbour countries in the south entails problems of assimilation and adaptation. A model of donor funded transfer is adapted to fit the observed case.

• Muquingue, Humberto; Kaasbøll, Jens Johan & Berg, Ole Trond (2002). The status of health management and information management in the Mozambican health districts: overview and preliminary findings. Vis sammendrag

  An old tradition in the Mozambican health system is the appointment of doctors to perform both clinical and managerial tasks in the health districts. As a consequence, a paradox embedded with conflict and potential arises when we take into account the often neglected but essential role of the districts in the health information system and the diverging perspectives of medical duty and management responsibility. Although doctors might be comfortable with clinical data, there might be problems with the collection and use of health managerial information therefore putting at stake the critical role of the health sector in the larger socio-economical development of the country. In addition, with the health sector reform and the deployment of ICT, news forms of pressure and intensification are brought to the paradox. In this paper we provide a descriptive and analytical account of the relationship between health management and health information in the typical Mozambican health district. The place of information as a tool for health management and as an indicator of the doctor's personal interest and involvement with the district setting is also discussed.

• Kaasbøll, Jens Johan (2001). Computerized health information systems for increased local training and responsibility.
• Kaasbøll, Jens Johan (2001). Research on third world problems. Vis sammendrag

  Target groups. Action research. Development of sustainable systems under difficult circumstances

• Kaasbøll, Jens Johan (2001). Supporting IT users.
• Kaasbøll, Jens Johan (2001). Supporting IT users.
• Kaasbøll, Jens Johan (2000). Forslag til ny læreplan for informatikk studieretningsfag.
• Kaasbøll, Jens Johan (2000). Learning and Teaching Programming.
• Kaasbøll, Jens Johan (2000). Learning and supporting the use of computers.
• Kaasbøll, Jens Johan (2000, 11. januar). Velger vi for komplisert teknologi?. [Radio].  Oslo : NRK P2.
• Kaasbøll, Jens Johan (1999). Brukergrensesnitt.
• Kaasbøll, Jens Johan (1999). Design og evaluering av brukergrensesnitt.
• Kaasbøll, Jens Johan (1999). Informatikk studieretningsfag. Klikk: Magasin om utdanning og læring. Vis sammendrag

  Vi foreslår at departementet setter igang arbeidet med å lage en ny læreplan for studieretningsfaget IT i den videregående skolen.

• Kaasbøll, Jens Johan (1999). Kommentarer til den eksisterende læreplanen i IT.
• Kaasbøll, Jens Johan (1999). The ¿information¿ concept in FRISCO compared to empirical studies of information in decisionmaking. Vis sammendrag

  The Framework of Information System Concepts has been based on assumptions of rationality. Three findings from studies of people¿s use of information in organizations are presented: expertise, cognitive illusions, and information as signal and symbol. FRISCO with a few extensions could be used for describing these phenomena. However, the essence of social phenomena can get lost in a framework of predefined concepts. The small extensions undertaken indicate that FRISCO is easily extendible.

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