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Abstract

Through the study of a long term, globally targeted effort to design health information systems in the Global South, we explore challenges to distributed participation within and across countries, and describe efforts at addressing these. Networked action research projects can enable pooling of resources, skills, best practices and tools, and cross-country collaboration does not have to preclude local ownership, as illustrated by the case material in this article. We highlight specifically the need for circulation of people, artefacts, and standards, to both support local practices and foster the capacity of all stakeholders to take active part in the design and implementation of information systems. The deep effects of global technological change call for a multilevel approach bridging local implementations with global research and participatory design efforts and co-evolution of standardised tools.

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