Background : Mozambique: situated in southern Africa Borders countries: South Africa, Swaziland, Tanzania, Malawi, Zambia and Zimbabwe. Total area: 801,590

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<ul><li><p>Background:Mozambique: situated in southern AfricaBorders countries: South Africa, Swaziland, Tanzania, Malawi, Zambia and Zimbabwe.Total area: 801,590 sq Km11 provinces and 133 districtsPopulation: 16,099,246 (July 2002 est.) 72% of the population live in rural areasilliteracy: 60.5% of population</p></li><li><p>MozambiqueCapital: MaputoPop:+- 2 millions</p></li><li><p>Health StatusPopulation growth rate: 1.13%Birth rate 36.41 births/1,000 populationDeath rate 25.13 deaths/1,000 populationInfant mortality: 138.55 deaths/1,000 live birthsLife exp at birth:tot population: 35.46 years female: 34.65 years; male: 36.25 years </p></li><li><p>Socio, historic &amp; political context1458 1975: Colonial periodJune 25th, 1975 - Independence1975 1992: civil war destroyed most of the infrastructures (mostly health, education &amp; tele and communications)Trained people left the country; 5 doctors!!!Peace aggreement signed1992 .... National reconstruction (after war, floods, ....)</p></li><li><p>ICTs: Maputo50% of the ICTs and related technologies are located in Maputo;Survey: 3:1000 and 2: 10000 inhabitants share a computer and use internet respectively;</p></li><li><p>ChallengesHow implementation is related with communication practices?</p><p>What can we do about it?</p></li><li><p>Health system hierarchyHealth Information System</p></li><li><p>Health district: Xai-Xai</p></li><li><p>Health Information System (HIS)information flows between levels: paper-based (forms reports)data are collected at health facilities from communities, aggregated and collated at district levelscommunication did not always follow a fixed patterncommunications depended on many external conditions, often out of control of the health officers responsible for communication</p></li><li><p>HISThe information collected at facility levels and handle at district level consists basically of aggregating the forms from the health facilities into district forms, which are then submitted to the province.Lack of skill and training of the personnel of the district health data are not kept in a systematic way on a health facility basis.</p></li><li><p>HISBecause of these problems of communications, the weekly and monthly health reports were sent to the upper levels very lateLocal people showed little motivation and commitment to communicate with the upper levels</p></li><li><p>HISPMozambique in 1999Eduardo Mondlane University &amp; MISAUPilot districts: located in remote rural areas with relatively good infrastructureActions:ResearchTraining seminars</p></li><li><p>Communication at different levelsHealth unit health district</p><p>Health district province</p><p>Province MoH (MISAU)</p></li><li><p>Counter networks CastellsGlobalization and MarginalizationExclusion vs Inclusion</p><p>Health Information</p><p>Information &amp; Communication Technology</p></li><li><p>System Develeopment context &amp; implementationThe culture of communication Nature of work practicesMethods/processes of communicationConstraints to communicationExperience with new ICTsHow can new ICTs be integrated effectively into work practices at various levelsResistance to technology .. question of identity?</p></li><li><p>Expectations ...Assessment of current constraints to communication between district and provincial levels in HIS, and how these can be made more effective.Theoretical model to help understand the interaction between ICT and communication practices in the health districts.Help to produce social change on the ground in terms of improved information management in the district health system in Mozambique (???)</p></li></ul>