Developing decentralised health information systems in developing countries –cases from Sierra Leone and Kenya

Health service provision is a public concern that mostly takes place at community level, through primary health care. Using cases from Sierra Leone and Kenya, this study shows how country health information systems, producing simple information products such as quarterly bulletins and league tables being distributed widely, have enabled the communities to be engaged in improving the health status of the population. The community based information systems were part of a national system and the usefulness of comparing local data with data from other communities and from across the country in pursuing equity in health services provision is demonstrated. A community based information system is thus benefiting from being part of and integrated with the larger national system. The article presents and discusses community based participatory approaches to developing information systems which are enabling the community to take ownership and ‘cultivate’ culturally appropriate systems. Illustrated by the cases, the article argues that modern ICT and Internet based technologies, and even ‘cloud’ based infrastructures, are indeed appropriate technologies even at community level in rural Africa.