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This article presents results from a study on the use and appropriation of information and communication technologies (ICT) in Mozambique with a focus on the health sector. The three provinces of Gaza, Inhambane and Niassa were surveyed and two questionnaires addressing 1) computer users and their ability to manage ICT, and 2) health workers and their handling of health information, were used. Based on this study appropriate strategies for developing an ICT-infrastructure with the needs of the health sector as points of departure are discussed. The study is born out of a program to strengthen and further develop the health information and management systems at district and provincial levels as part of a process to support decentralisation of the health system in Mozambique. The study shows that computers and Internet are rapidly being spread to the provincial capitals and major districts in Mozambique. A main problem identified is the lack of ICT-skills and education and poorly developed infrastructure and networks of support. There are very few formal ICT companies providing hardware, and even less, software support. Maintenance and learning about ICT are to a large extent going on within informal networks of computer users in the provinces. A main finding in this study is that development of ICT capacity and information systems at district and provincial levels in Mozambique needs to be an integrated effort across sectors. A district health information system cannot be developed in a void. A general recommendation is to develop educational programmes ranging from training of ICT entrepreneurs and health workers and managers, to Masters and PhD programmes in ICT and health information systems. A specific recommendation related to health information systems development is to focus on the district level and to develop a strategy which encompasses and integrates all districts, both the advanced districts with computers and the majority of the districts where there are no computers.

Publisher: Wiley Online Library