Tool, weapon, or white elephant? A realist analysis of the five phases of a twenty-year programme of occupational health information system implementation in the health sector

Table 6 Summary of contexts and mechanisms needed for successful outcome at different levels

	Man	BC	FS	NHLS
Micro
Commitment to health and safety including adequate staffing to plan, implement and evaluate interventions	+	-	+	+
Meso
Clear governance (access, use of data)	+	-	+	+
Good labour relations so neither side is motivated to use the IS as a “weapon” rather than “tool”	+	-	-	+
Macro
Enabling political environment	+	-	+	+
Sustainable local IT capacity (so system does not become white elephant)	-	+	-*	+

* based on the analysis conducted for this study, efforts are now underway to implement mechanisms for sustaining needed capacity, in the form of international networks and regional WHO Collaborating Centres taking on leadership roles in their jurisdictions.

ISSN: 1472-6947