Challenges to information systems implementation and organisational change management: Insights from the health sector in Ecuador

Major challenges remain in Latin American countries experiencing Healthcare Reform. Among these challenges, the implementation of decentralised organisation and management seems to be a central problem. Besides top-down, prescribed initiatives for reorganisation such as decentralised organisational structures, the organisational challenge of implementing information systems and strengthening the management capacity of district health providers and district health authorities remains neglected, or at least undervalued. The objective of this paper is to illustrate a substantive process theory of IS implementation, situated within the context of a case study. The case study is based on a national information systems initiative to support the decentralisation and modernisation of management functions in health districts of the Ministry of Public Health in Ecuador.