Development of the National Health Information Systems in Botswana: Pitfalls,prospects and lessons

Background: Studies evaluating development of health information systems indeveloping countries are limited. Most of the available studies are based onpilot projects or cross-sectional studies. We took a longitudinal approach toanalysing the development of Botswana’s health information systems.Objectives: We aimed to: (i) trace the development of the national healthinformation systems in Botswana (ii) identify pitfalls during development andprospects that could be maximized to strengthen the system; and (iii) drawlessons for Botswana and other countries working on establishing or improvingtheir health information systems.Methods: This article is based on data collected through document analysis andkey informant interviews with policy makers, senior managers and staff of theMinistry of Health and senior officers from various stakeholderorganizations.Results: Lack of central coordination, weak leadership, weak policy andregulatory frameworks, and inadequate resources limited development of thenational health information systems in Botswana. Lack of attention to issues oforganizational structure is one of the major pitfalls.Conclusion: The ongoing reorganization of the Ministry of Health providesopportunity to reposition the health information system function. The currentefforts including development of the health information management policy andplan could enhance the health information management system.