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Health Information Systems Challenges: A Perspective from Rural Indonesia.
Joyce Chu1, Putu Aryani2, Na Liu1
1The University of Sydney.
Studies in Health Technology and Informatics
|November 14, 2025
Summary
Health information systems (HISs) in rural Indonesia underperform due to data integration issues, resource limits, and stigma. Systemic design flaws, not technology, hinder equitable mental healthcare delivery.
Area of Science:
- Health Informatics
- Mental Healthcare Systems
- Socio-technical Systems Theory
Background:
- Persistent underperformance of health information systems (HISs) in rural Indonesian mental healthcare settings.
- Challenges exist despite national digital health initiatives aimed at improving healthcare delivery.
Purpose of the Study:
- Investigate the socio-technical factors contributing to HIS underperformance in rural Indonesian mental healthcare.
- Identify critical misalignments hindering the effectiveness of HISs in this context.
Main Methods:
- An eight-month exploratory qualitative study.
- Utilized focus groups, in-depth interviews with diverse stakeholders (healthcare providers, community health workers, residents), and a literature review.
- Employed thematic analysis to identify key socio-technical issues.
Main Results:
- Identified three critical socio-technical misalignments: data integration issues (fragmented tools, lack of interoperability), resource constraints (technical, human, budgetary), and cultural/social stigma.
- Stigma impedes help-seeking, data accuracy, and holistic care delivery.
- Underperformance stems from systemic design breakdowns, not solely technological limitations.
Conclusions:
- HIS underperformance is a result of systemic design breakdowns, not technological failures.
- Advocates for a situated, multi-stakeholder approach to co-design context-sensitive, user-centered HISs.
- Emphasizes integrating informal work systems to build foundations for equitable mental healthcare in resource-limited settings.
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