Developing capacity for maintenance of HIS in the context of loosely coordinated project support arrangements

Over the paper decade the health sector has witnessed significant investments towards development of digital health information systems (HIS) infrastructure. Despite the promise and enthusiasm surrounding such efforts, challenges remain regarding how to enhance prospects for long-term maintenance. Observed challenges arise from lack of technical, financial, and human resources. Due to the inadequacy of aforementioned resources, most resource-constrained countries are overly reliant on loosely coordinated and discretely arranged short-term project-based support arrangements. Project-based interventions largely ignore long-term change processes and development of local capacity for implementation and maintenance of digital health infrastructure. This paper discusses possible strategies on how to enhance organizational implementation and maintenance capacity, in the context of changing project support arrangements.