Relational Mechanism in Community-Based Health Information System Governance: Implications for Alignment and Community Health Outcomes

Résumé

Background – Effective governance of Health Information Systems (HIS) is critical to improving health outcomes, yet the practices underlying the CBHIS governance relational mechanism and their relationship with alignment and community health outcomes remain poorly understood. This study sought to identify these practices and examine their interrelationships with alignment and community health outcomes.

Methods – A mixed-methods study employing a convergent parallel design was conducted across two purposively selected sites with established experience in CBHIS implementation and use. Quantitative data were collected using 164 semi-structured questionnaires and analysed using Partial Least Squares Structural Equation Modelling (PLS-SEM). Qualitative data were thematically analysed using ATLAS.ti (v24).

Results – Validity and reliability testing identified nine practices associated with the CBHIS governance relational mechanism, while qualitative analysis revealed two additional practices, collectively constituting core governance practices required for alignment. The study also validated six indicators measuring community health outcomes. Results showed a positive and statistically significant relationship between the CBHIS governance relational mechanism and community health outcomes, with the exogenous construct exerting a positive influence on the endogenous construct, confirming the model’s predictive relevance.

Conclusion and Practical Implications – The study identifies key practices underpinning the CBHIS governance relational mechanism that are critical to achieving alignment. The findings further demonstrate that the deliberate design and implementation of these governance practices can substantially enhance community health outcomes. Accordingly, health informatics practitioners and policymakers should institutionalise these relational governance practices to strengthen CBHIS effectiveness and improve health outcomes at the community level.

Keywords: Alignment, Community-Based Health Information System Governance Relational Mechanism, Community Health Outcomes, Health Information System, Governance