ABSTRACT
Many countries in the Third World and in the former Soviet bloc are in the midst of a process of decentralising their public sectors as well as their newly privatised private sectors. Within the health sector many see IT as a crucial factor in the ongoing process towards a decentralised and primary health care based health sector (e.g. Rodrigues et al., 1995; Wilson et al., 1989). However, the introduction of decentralised IT does not necessarily lead to decentralisation (Madon, 1993; George et al., 1991) or empowerment of local users (Walsham, 1992). Moreover, the introduction of IT in the Third World has proven to be difficult (Odedra, 1990; Braa, 1996). Within this broader context, this chapter presents and discusses a longitudinal study carried out over three years on the introduction and use of IT in general and within the health sector in particular at peripheral levels in Mongolia. One objective of the study was to find out whether the introduction of computers had any impact on the new structures of decentralised management and on the use of information at local level. Computer usage in other sectors was compared with the health sector in order to identify conditions specific to the health sector. Another objective has been to develop a strategy for design of information systems to support the new decentralised health structures and a primary health care approach in Mongolia.
