Distributed IS Development in the Global South FOSS practices in the HMIS arena

1. Distributed IS Development in the Global SouthFOSS practices in the HMIS arena Knut Staring

2. Research questions • RQ0What are the obstacles to creating FOSS open, distributed production model to the development and implementation of Global Software for public sector information systems in the South? • RQ1 How may these obstacles be overcome? • RQ2 (future) Can the collaborations move beyond DHIS?

3. Method • Longitudinal action research • Tied to teaching • Extensive travel and close interaction with developers and users • Meetings, mailing list archives, history of source code, wiki, issue tracker, logs from instant messaging • Clustered around events

4. Frame: Biography of Artifacts (BoA) • follow the trajectory of a group of artefacts and associated practices over time • applied to follow a particluar system, but also a broader class of technologies, as well as the technological field and societal practices within which a class of systems is embedded • multiple time frames and perspectives

5. Free and Open Source Software • A platform for bringing users and producers together in novel, distributed innovation processes • A paradigm for online, collaborative, distributed work, often referred to as the ‘bazaar’ model of development, characteristic of the network society and potentially transferable to other domains of knowledge and areas of production • An engine and platform of development and empowerment of the public sector

6. FOSS and Global SW in the North    • facilitated by Internet collaboration among large groups without market or hierarchies • Key premise: existence of excess capacity • source code has accumulative snowballing effect • Modules • independently and incrementally produced • fine-grained • low cost quality-check and integration • Two extremes: • Proprietary generification processes (Pollock et al, 2007) • CBPP: fluid, open, boundary object with some infrastructural characteristics (Darking and Whitley 2007).

7. Maps Export Analysis, Filters, Pivot Import IXF

8. Networks of Action – NoA Abandoning singular action research projects in favor of a network of sites Generating local, self-sufficient learning processes Nurturing a robust, heterogeneous collection of actors Aligning interventions with surrounding configurations of existing institutions

9. Biography of DHIS • DHIS 1 born out of Scandinavian AR and PD background in mid 1990’s – university collaboration, rapid prototyping in pilot districts, post-apartheid • Growing up as SA NoA by turn of millennium • Spreading wings as NoA: Mz, Malawi, Cuba ++ • Second generation from 2004 • Spreading development (GSD) from 2006 • Starting to play with the other kids on the block: EC,Debo,GIS • WHO, HMN, OpenMRS from 2007

10. Myanmar Tajikistan Uganda Kerala Gujarat Namibia Botswana Delhi Vietnam South Africa Mozambique Nigeria Malawi NORWAY Zanzibar DHIS 2 Zambia WHO/HMN Sierra Leone DHIS 1 Burkina Faso Mali

11. Global toolbox design Innofusion of a boundary object Local innovations Global standards in-country design process #2 in-country design process #3 in-country design process #1 in-country design process #1 In-country design

12. Roles • Implementer: a health information systems professional who focuses on installing and configuring software and systems to meet the needs of a particular health system requirement with little or no programming of the actual software application (Seebregts et al 2009) • Local users and Local implementers • National implementers and developers • Global health experts, implementers and Core developers

13. Implementers as intermediaries

14. Circulation: People, knowledge, BO • Capacity building • Training of health workers • Graduate course, Masters, PhD • Extensive 2-way circulation of people and artifacts • Small base of contributors • Standard frameworks alienating local teams • Local modules bypassing API • Skewed use communication tools

15. FOSS in public health care in the South Little excess capacity Generative generification Modularization crucial, but costly – and local hacks must be “tamed” Heterogeneous granularity – presupposes shared conceptualization and skills Big focus on implementation – not just software Integration of modules mainly working as people moved – and benefits seen to outweigh costs Parallel development and duplication conforms to CBPP – again: costly

17. Findings • Neither star nor unstructured assemblage • Strong regional hubs around a central repository and core standards - filter user input • “Fractal Chunkiness”– as observed in other FOSS networks • Enables distribution of integration efforts and increased generification • Quick seeding (a HISP failure) – of technically simple, but visible solutions • Global network gives nodes potential to grow into influential hubs • Developers bring modules with them as they move: • Congruence between modular makeup and organization -circulation of both people and software modules balancing generification and localization • Long-term cultivation of existing structures to achieve critical mass

18. Conclusion FOSS in the HMIS Agora • Macro trend: FOSS • UN/HMN focus on collaboration • Spreading both risk and innovation • Costly but necessary to extend NoA to software development • Seek federation to strengthen the NoA