Deconstructing the Dichotomous Relationship Between "IT analysts and End-users": A Case of Implementing Standard Indicators in Cameroon

TL;DR

This paper uses deconstruction to analyze the power dynamics between IT professionals and end-users in Cameroon’s health information system, revealing organizational conflicts hinder system adoption and highlighting the need for decentralized decision-making.

Contribution

It applies deconstruction to uncover organizational and power relations affecting health information system implementation in Cameroon, a novel approach in this context.

Findings

IT professionals hold more authority over end-users

Centralized decision-making causes conflicts

Organizational structure impedes local capacity building

Abstract

Diff\'erance and suppl\'ement are post-structuralist concepts for analyzing language in text and are most often associated with the work of Jacque Derrida. The findings after the implementation of standard health indicators in Cameroon show that staff at the peripheral level encounter multiple challenges, including lack of participation during the implementation process, and tension between staff at the peripheral level and IT staff at the central level, which result in non-use of the system. We use deconstruction to understand the root cause and the findings reveal that IT professionals and end-users are embedded in a relation of domination. That is, IT professionals are diff\'erance from end-users and end-users are suppl\'ement of IT professionals. Although end-users are portrayed as supplementary, they are supposed to manage the system, which is contradictory. This led to IT professionals having more privilege and authority over end-users. This dichotomous relation is a derivative of the organizational structure. The notion of portraying IT professionals in charge and having more authority over end-users is an avenue for conflict. The paper concludes that a HIS organizational structure where decision-making is centralized is a ground for conflict and a major roadblock of building local capacity and providing infrastructural support at the peripheral.