Communications of the Association for Information Systems


Antibiotic resistance (ABR) presents a widespread, complex threat to global health and achieving universal health coverage. A key global and national priority to address this challenge is by creating a digitally enabled evidence base to make visible this problem and strengthen policy and practice interventions. The invisibility of the ABR problem is particularly acute in low and middle-income settings, where digitization in this domain is in its infancy, and there is a high prevalence of infections and severe constraints of capacity and infrastructure. How can a digital ABR reporting system be introduced, routinized, and stabilized in such a context that the ABR challenge can be better managed, is the focus of this paper. The paper combines IS concepts from requirement analysis and implementation research together with concepts from institutional theory, to develop an analytical framework that makes the following contributions: i) how can new practices relating to a digital intervention be routinized into everyday work; ii) how can these routinized practices be translated into stabilized institutional work to ensure their sustainability over time; and iii) what is the work required to bridge the gaps between the formal institutions that accompany the new digital system and the informal constraints that are experienced in implementing them.



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