The Sierra Leone HIS Case:

In this article we describe and reflect on an ongoing project to develop an integrated Health Information System (HIS) in Sierra Leone. We emphasise the complexity of such an enterprise and on challenges faced while building a Health Information Infrastructure in the context of a developing country. The main contribution of the paper is the design of a change strategy towards an integrated HIS in Sierra Leone which is influenced by the information infrastructure theory. Key elements of the strategy are to facilitate a gradual change process building on the existing systems and practices (the installed base), to bootstrap political will to change through pilot projects and quick wins, and to apply a flexible standardisation approach to integration to smoothen the change experience for users and stakeholders.