Recently, Spatial Data Infrastructures (SDIs) has been a rapidly expanding field and broadly assumed to underpin the development of information society and the knowledge economy. In this paper, we argue that the anticipated benefits of SDIs have largely not yet been generally realized in practice due to a lack of a robust theoretical framework as well as insufficient empirical research to guide the implementation efforts. We posit that learnings from the allied discipline of Information Infrastructures, which has matured during the 1990s in response to the proliferation of distributed, complex, and heterogeneous networked systems, can provide a useful theoretical lens to inform the emerging domain of SDIs. We focus on three key concepts identified in the domain of information infrastructure theory, viz. the installed base, reflexive standardization, and cultivation approach to design, to develop a theoretical framework, which is then applied to analyse the ongoing initiative to establish National Spatial Data Infrastructure (NSDI) in India. This analysis helps us to provide the basis to articulate a potential research agenda—for both theory and practice—which, we believe, offers the promise to better conceptualize and implement SDIs, particularly in developing country settings like India.

In this article we consider the notion of digital global public good and articulate our understanding of it. Against this conceptual foil, we examine the development of DHIS2, a global health platform inspired by public goods, focusing on the paradoxes that arise in the scaling process. We find that the scaling dynamics played out differently at the macro and micro levels, giving rise to the following paradoxes: addition of new functionalities to cater to the universe of users across the world (macro level) works counter to the needs of users in particular locations (micro level); responsiveness to the requests of the donors with a global view (macro level) distorts the production process, as the voices of users, situated in remote locations in developing countries, are not adequately heard; the system needs to be simultaneously relevant across the global (macro level) and the local (micro level), when the former calls for decontextualization and the later (re)contextualization. We then discuss challenges these paradoxes create with regard to attaining non-rivalry and non-exclusion, the defining characteristics of a public good.

Globally, there is acceptance of the role of strengthened health information system (HIS) to inform evidence‐based decision‐making and improve health services delivery. Within the context of increasing demands to generate data of high quality for monitoring progress towards SDGs, we review challenges and approaches in adopting a regional‐based approach to strengthen HIS within the WHO Eastern Mediterranean Region and its 22 member states. The HIS situation in the WHO Eastern Mediterranean Region is mixed: While some countries have developed robust HIS, others lag behind on both technological and institutional dimensions. Technically, most countries have not capitalized on the benefits of ICT advancements such as the internet, cloud, and mobile computing. As a result, systems remain manual or standalone; and data are not shareable. Institutionally, systems are broadly fragmented, with non‐standardized data, weak human resources capacity, and limited evidence of data being used to inform action. In order to consolidate efforts to enhance HISs, we recommend leveraging upon innovative information and communication technology (ICT) solutions for data capturing, processing, analysis, and reporting at either the individual or aggregate levels. Countries need to develop similar such processes in their contexts, while ensuring that they learn and build upon from their neighbors—building network of networks.

Objectives: Health systems are shifting from traditional methods of healthcare delivery to delivery using digital applications. This change was introduced at a primary care centre in Chandigarh, India that served a marginalised population. After establishing the digital health system, we explored stakeholders’ perceptions regarding its implementation.Methods: Ethnographic methods were used to explore stakeholders’ perceptions regarding the implementation of the Integrated Health Information System for Primary Health Care (IHIS4PHC), which was developed as a patient-centric digital health application. Data were collected using focus group discussions and in-depth interviews. Participatory observations were made of day-to-day activities including outpatient visits, outreach field visits, and methods of health practice. The collected information was analysed using thematic coding.Results: Healthcare workers highlighted that working with the digital health system was initially arduous, but they later realised its usefulness, as the digital system made it easier to search records and generate reports, rapidly providing evidence to make decisions. Auxiliary nurse midwives reported that recording information on computers saved time when generating reports; however, systematic and mandatory data entry made recording tedious. Staff were apprehensive about the use of computer-based data for monitoring their work performance. Patients appreciated that their previous records were now available on the computer for easy retrieval.Conclusions: The usefulness of the digital health application was appreciated by various primary healthcare stakeholders. Barriers persisted due to perceived needs for flexibility in delivering healthcare services, and apprehensions continued because of increased transparency, accountability, and dependence on computers and digital technicians.