IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v286y2021ics0277953621006237.html
   My bibliography  Save this article

Examining policy intentions and actual implementation practices: How organizational factors influence health management information systems in Uttar Pradesh, India

Author

Listed:
  • Meghani, Ankita
  • Rodríguez, Daniela C.
  • Bilal, Huzaifa
  • Tripathi, Anand B.
  • Namasivayam, Vasanthakumar
  • Prakash, Ravi
  • Peters, David H.
  • Bennett, Sara

Abstract

This study investigates the implementation of a recent health management information systems (HMIS) policy reform in Uttar Pradesh, India, which aims to improve the quality and use of HMIS data in decision-making. Through in-depth interviews, meeting observations and a policy document review, this study sought to capture the experiences of district-level staff (street-level bureaucrats) who were responsible for HMIS policy implementation. Findings revealed that issues of weak HMIS implementation were partly due to human resources shortages both in number and technical skill. Delays in recruitment and the presence of inactive staff overburdened existing staff and weakened the implementation of HMIS activities at the block- and district-levels. District staff also explained how inadequate computer literacy and limited technical understanding further contributed to low HMIS data quality. The organizational culture was even more constraining: working within a very rigid and hierarchical organization was challenging for district data staff, who were expected to manage day-to-day HMIS activities, but lacked the discretion and authority to do so effectively. Consequently, they had to escalate minor issues to district leadership for action and were expected to follow their supervisors' directives– even if they contradicted HMIS policy guidelines. High performance pressures associated with achieving top district rankings deviated focus away from HMIS data quality issues. Many district-level respondents described their superiors’ “fixation” with becoming a top-ranking district often resulted in disregard for the quality of data informing district rankings. Furthermore, the review of district rankings only partially encouraged district-level leadership to investigate reasons for low-performing indicators. Instead, low district rankings often resulted in punitive action. The study recommends the importance of incorporating the perspectives of district staff, and recognizing their discretion, and authority when designing policy implementation processes, and finally concludes with potential strategies for strengthening the current HMIS policy reform.

Suggested Citation

  • Meghani, Ankita & Rodríguez, Daniela C. & Bilal, Huzaifa & Tripathi, Anand B. & Namasivayam, Vasanthakumar & Prakash, Ravi & Peters, David H. & Bennett, Sara, 2021. "Examining policy intentions and actual implementation practices: How organizational factors influence health management information systems in Uttar Pradesh, India," Social Science & Medicine, Elsevier, vol. 286(C).
    • Handle: RePEc:eee:socmed:v:286:y:2021:i:c:s0277953621006237
    DOI: 10.1016/j.socscimed.2021.114291
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953621006237
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2021.114291?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Hennie Boeije, 2002. "A Purposeful Approach to the Constant Comparative Method in the Analysis of Qualitative Interviews," Quality & Quantity: International Journal of Methodology, Springer, vol. 36(4), pages 391-409, November.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Komppula, Raija, 2014. "The role of individual entrepreneurs in the development of competitiveness for a rural tourism destination – A case study," Tourism Management, Elsevier, vol. 40(C), pages 361-371.
    2. Saint Ville, Arlette S. & Hickey, Gordon M. & Phillip, Leroy E., 2017. "How do stakeholder interactions influence national food security policy in the Caribbean? The case of Saint Lucia," Food Policy, Elsevier, vol. 68(C), pages 53-64.
    3. Martha A Abshire & Marie T Nolan & Sydney M Dy & Joseph J Gallo, 2020. "What matters when doctors die: A qualitative study of family perspectives," PLOS ONE, Public Library of Science, vol. 15(6), pages 1-12, June.
    4. Ejiogu, Amanze & Ambituuni, Ambisisi & Ejiogu, Chibuzo, 2021. "Accounting for accounting’s role in the neoliberalization processes of social housing in England: A Bourdieusian perspective," CRITICAL PERSPECTIVES ON ACCOUNTING, Elsevier, vol. 80(C).
    5. Antony S. Cheng & Lisa Dale, 2020. "Achieving Adaptive Governance of Forest Wildfire Risk Using Competitive Grants: Insights From the Colorado Wildfire Risk Reduction Grant Program," Review of Policy Research, Policy Studies Organization, vol. 37(5), pages 657-686, September.
    6. Tineke Schoot & Ireen Proot & Marja Legius & Ruud ter Meulen & Luc de Witte, 2006. "Client-Centered Home Care," Clinical Nursing Research, , vol. 15(4), pages 231-254, November.
    7. Martínez Álvarez, Melisa & Borghi, Josephine & Acharya, Arnab & Vassall, Anna, 2016. "Is Development Assistance for Health fungible? Findings from a mixed methods case study in Tanzania," Social Science & Medicine, Elsevier, vol. 159(C), pages 161-169.
    8. Claire L O’Reilly & Diane Paul & Rebecca McCahon & Sumitra Shankar & Alan Rosen & Thomas Ramzy, 2019. "Stigma and discrimination in individuals with severe and persistent mental illness in an assertive community treatment team: Perceptions of families and healthcare professionals," International Journal of Social Psychiatry, , vol. 65(7-8), pages 570-579, November.
    9. Damian, April Joy & Gallo, Joseph J. & Mendelson, Tamar, 2018. "Barriers and facilitators for access to mental health services by traumatized youth," Children and Youth Services Review, Elsevier, vol. 85(C), pages 273-278.
    10. Keith A. Houghton & Christine Jubb & Michael Kend, 2011. "Materiality in the context of audit: the real expectations gap," Managerial Auditing Journal, Emerald Group Publishing, vol. 26(6), pages 482-500, June.
    11. Cartwright, Severina & Davies, Iain & Archer-Brown, Chris, 2021. "Managing relationships on social media in business-to-business organisations," Journal of Business Research, Elsevier, vol. 125(C), pages 120-134.
    12. Sandy Lewis & Carla Romano & Geert Bruecker & James W. Murrough & Richard Shelton & Jaskaran B. Singh & Carol Jamieson, 2019. "Analysis of Clinical Trial Exit Interview Data in Patients with Treatment-Resistant Depression," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 12(5), pages 527-537, October.
    13. Snejana Bacheva & Daniela Petrova & Iavor Bachev, 2019. "The Joint Audit in Bulgaria – Issues and Prospects," Economic Alternatives, University of National and World Economy, Sofia, Bulgaria, issue 4, pages 615-626, December.
    14. Bell, Charles, 2020. "“Maybe if they let us tell the story I wouldn’t have gotten suspended”: Understanding Black students’ and parents’ perceptions of school discipline," Children and Youth Services Review, Elsevier, vol. 110(C).
    15. Franklin Riley & David K. Allen & Thomas Daniel Wilson, 2022. "When politicians and the experts collide: Organization and the creation of information spheres," Journal of the Association for Information Science & Technology, Association for Information Science & Technology, vol. 73(8), pages 1127-1139, August.
    16. Renée Otmar & Susanne D. Reventlow & Martha Morrow & Geoffrey C. Nicholson & Mark A. Kotowicz & Julie A. Pasco, 2012. "A Cultural Models Approach to Osteoporosis Prevention and Treatment," SAGE Open, , vol. 2(4), pages 21582440124, November.
    17. Paola A. Torres-Slimming & Carlee Wright & Cesar P. Carcamo & Patricia J. Garcia & IHACC Research Team & Sherilee L. Harper, 2019. "Achieving the Sustainable Development Goals: A Mixed Methods Study of Health-Related Water, Sanitation, and Hygiene (WASH) for Indigenous Shawi in the Peruvian Amazon," IJERPH, MDPI, vol. 16(13), pages 1-17, July.
    18. Lakind, Davielle & Atkins, Marc & Eddy, J. Mark, 2015. "Youth mentoring relationships in context: Mentor perceptions of youth, environment, and the mentor role," Children and Youth Services Review, Elsevier, vol. 53(C), pages 52-60.
    19. Stålhammar, Sanna, 2021. "Polarised views of urban biodiversity and the role of socio-cultural valuation: Lessons from Cape Town," Ecosystem Services, Elsevier, vol. 47(C).
    20. Iavor Bachev, 2019. "Combating Financial Statement Fraud – an Analysis and Model for the Republic of Bulgaria," Economic Studies journal, Bulgarian Academy of Sciences - Economic Research Institute, issue 3, pages 42-71.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:286:y:2021:i:c:s0277953621006237. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.