Identities: The Missing Link between IT Affordances and Institutions for Better Health Care in Developing Countries

Using a case study of health information systems (HIS) in Kenya, we seek
to better understand how HIS afford or constrain the action of local actors
in provisioning health care in developing countries. We developed a
theoretical perspective based on institutional theory that served as a lens
to interpret the relationship between institutions and users’ perceptions of
IT constraints and affordances. We found how identities constitute sensemaking
devices through which users make sense of the cultural resources
available in their institutional environment and use them to shape their
perception of IT affordances. In addition, we found how contradictions
between users’ perceived IT affordances constituted the source and means
of identity work processes through which users either modified or
reinforced their identities. The paper contributes toward an increased
understanding of how IT affordances (or constraints) link to institutions,
thereby influencing processes of institutional change and socio-economic
development.