Application of activity theory to examine the implementation of e-health in Namibia

ABSTRACT Despite the investment and efforts to improve the health systems through the e-health solution, systems and activities remain fragmented, which hamper service delivery. These challenges persist because either the factors that influence the implementation of the e-health solutions are not known or they remain speculative. Empirically, this study reveals the factors that influence the development of e-health solutions in the country. It is an interpretivist study in which the semi-structured interview technique was employed to collect data and relevant documents authored by different health stakeholders, such as Ministry of Health and Social Services (MoHSS), Office of the Prime Minister (OPM) and from public and private health facilities in the country were gathered. The activity theory (AT) underpins the study, meaning it guided the analysis, from which eight factors: (1) disparity, which affects transparency; (2) isolation; means that e-health solutions are currently stand-alone; (3) governance; which includes standardization, policies, and principles; (4) requirements that cover functions and technology specifications; (5) know-how; entails skillset and human capacity; (6) interoperability; exchange and information use between IT solutions; (7) synchronization of data and processes; and (8) heterogeneity were found to be the main influence on the implementation of e-health solutions in the country.