Abreham Getachew
email: abreham.getachew@aau.edu.

The Role of Social Media in Citizen's Political Participation

Keywords: First Keyword, Second Keyword, Third Keyword

Social media is becoming important tool for political participation and engagement. Interaction in social media has a strong influence on the propensity to participate in politics. In this research, we argue that IS is in the right position to improve understanding of social media influence in political communication and participation. In this study, the role of social media for political participation is discussed and the result shows that social media plays great role in terms of replacing traditional media, facilitating political engagement, strengthening strategic collaboration as well as the potential to influence governments decisions in relation with politics. We employed qualitative research methodology and concept analysis technique to transcribe interview that can help to identify and arrange the ideas and views of interviewees. Our study explored how citizens engaged in politics through social media. Thus, the media industry, political consultants, politicians, and citizens will need to adjust their behaviors to leverage this new competitive environment abstract should summarize the contents of the paper in short terms, i.e.

Introduction

In recent years, there is a rapid development of a new information network and information technology which is commonly known as social media. Among the different social Media sites available, the widely used sites are Facebook, LinkedIn, and Twitter, each of which are used by hundreds of millions of people [START_REF] Alalwan | Social media in marketing: A review and analysis of the existing literature[END_REF]Dwivedi et al. 2015;Greenhow & Gleason,2014;[START_REF] Kapoor | Advances in social media research: past, present and future[END_REF][START_REF] Shiau | Co-citation and cluster analyses of extant literature on social networks[END_REF]2108). In past, social Medias are used for interpersonal communication and collaboration using Internet-based platforms. Based on the rapid growth of social Medias, users started to create contents on their own and express their opinion, engaged in political discussion or search for politically like-minded individuals (Dang-Xuan, 2013; Dwivedi and Kapoor, 2015;[START_REF] Grover | Polarization and acculturation in US Election 2016 outcomes-Can twitter analytics predict changes in voting preferences[END_REF][START_REF] Hossain | Sharing political content in online social media: A planned and unplanned behaviour approach[END_REF].

Political parties feel responsible in participating political discussions with citizens when the country is democratic. Very recent phenomenon is the rise of social media as a medium for political communication. For example, In the Netherlands, during the 485 national elections (2010), politicians with higher Social Media engagement got relatively more votes within most political parties (R. [START_REF] Effing | Social Media and Political Participation: Are Facebook,Twitter and YouTube DemocratizingOur Political Systems?[END_REF]. Political participation is defined as a behavior aimed at influencing the government and affecting their political decisions (Skoric,2016).Social media are also becoming an important part of the research for scholars interested in studying this new political phenomenon on the role of social media and interpersonal discussion in local participation (Kim et al.,2010 ); the effect of social media on political participation [START_REF] Stanley | The effects of internet use on political participation evidence from an agency online discussion forum[END_REF][START_REF] Habermas | Political communication in media society: Does democracy still enjoy an epistemic dimension? the impact of normative theory on empirical research1[END_REF]Mcclurg,2003); the effect of digital access on the prevalence of democracy (Rhue and sundararajan,2014;Rose and Saebo,2005); New Media and Internet Activism (Kahn and Kellner,2004); To date, Information Systems (IS) studies have investigate the role of Information system in social media use with engagement and its three sub-categories, that is, social capital, civic engagement, and political participation. (Boulianne,2015). Hofmann ( 2014) examine government rationale for using social media in case of Germany parliament member. Another studies [START_REF] Oh | Community Intelligence and Social Media Services: A Rumor Theoretic Analysis of Tweets During Social Crises[END_REF][START_REF] Wattal | Web 2.0 and politics: the 2008 US presidential election and an e-politics research agenda[END_REF] studied social media services during large scale social movement and revolutionary political change. Studies investigating social media and its role in political and participation are fairly limited or nonexistent in the extant IS literature [START_REF] Wattal | Web 2.0 and politics: the 2008 US presidential election and an e-politics research agenda[END_REF]Maghrabiand Salam 2013). This study observe developments in social media in the context of recent social movements and revolutionary political change occurring in many of the Middle Eastern and North African countries including Tunisia, Egypt, Lybia, Syria .In Ethiopia, the recent December 2015 ongoing Oromoprotest by students and farmers on the new master plan of Addis Ababa and around Oromia regions made headlines in the world news. This all have in common social networking. Ethiopian government blames opposition parties for facilitating and organizing the protest via Facebook. Recently Ethiopian government sent Zone nine bloggers into jail for accused of committing crime. But international organizations like Amnesty international (http://www.amnestyusa.org/news/press-releases/ethiopia-free-all-jailed-bloggersand-journalists -before-obama-visit) describes that blogging is right and not a crime and call Ethiopian government to unconditionally release bloggers and journalists in prison and to respect freedom of speech. We can understand from this social networking becomes hot issue and starting affecting Ethiopia political system. Identifying the theoretical implications of social media use and political participation is challenging for IS research. So it is critical for IS research to explore the role of social media for citizen's political communication and consequent revolutionary political change. These changes have significant implication for business organizations and their strategy as well as larger social and political relations. Thus, the goal of this study is to understand the role of social media for citizen's political participation and political communication. Particularly, this study will answer research question to how social media is used for citizens' political participation. This paper will makes a number of important contributions to both research and practice. The primary contribution of this paper is to articulate a vision for and a roadmap of the productive a read for researchers to begin looking for and testing fundamental theoretical differences introduced by social media. As previous studies have shown, in the last few years social media have become an important political communication 486 channel. It enables political institutions and citizen's to directly interact with each other. Therefore, political activities might gain more transparency and citizens might be more involved into political decision-making processes. The media industry, political consultants, politicians, and citizens will need to adjust their behaviors to leverage this new competitive environment.

Literature Review

Social media are new class of information technology that build on web 2.0 which support interpersonal communication and produce interactive user-generated content using Internet-based platforms (Greenhow & Gleason,2014).The quick development of social media is starting to displace traditional media and influence social and political action in which information are used to engage in participation.

The study by (Tank,2013) shown that social media has produced changes in the way people communicate than working in traditional Medias. Among the changes produced by social media, those who write and comment often use nicknames or pseudonyms. States the ability to stay unknown enabled people to overcome their psychological fear barriers to engage in a free exchange of their view (Maghrabi&salam, 2013) and sometimes it can also avoid responsibility. In addition, what is different in social media is the richness, variety and spreading speed of information as well as the society's most influential figures have merged and social media become public space. Despite the popular adoption of social media, their application for organizational purposes, the economic impact of social media on business could exceed $1 trillion, most of which is gained from more efficient communication and collaboration within and across organizations (Greenhow & Gleason,2014). The impact of social media on and for organizations, therefore, represents an important area for information systems research.

The relatively free domain of social media creates new opportunities for citizens to become involved in politics. Political science is one area in which information system's deep understanding of the effects of technological system, creation, use and management can be great value. Social media can be classified into different categories including collaborative projects, blogs, content communities, social networking sites, virtual game worlds, and virtual social world's .The most frequently researched social medium is the social networking site is Facebook [START_REF] Hofmann | Just because we can-governments rationale for using social media[END_REF]. Political parties' perceived use Facebook to afford facilitation of direct communication to promote political interests and enable dialogue (Jenson & Dyrby, 2013).

As the study is interested to explore how citizens are using social media for the political participation, studies related to social media and political communication were reviewed.

Rhue and Sundararajan (2014) examined the effects of digital access on the prevalence of democracy and its diffusion via trade, geographical and migration networks across 189 countries between 2000 and 2010. Digital access can be facilitated by both media freedom and internal political institutions, and that different digital technologies may have varying impacts while affecting diffusion via different political net-487 works. They conclude that different forms of information technology are likely to impact democracy in different ways, perhaps mediated by different political networks. Social media enable governments to provide the public with up-to-date information (Jaeger and [START_REF] Bertot | Using ICTs to create a culture of transparency: E-government and social media as openness and anti-corruption tools for societies[END_REF] since social media are close to real-time communication channels. Furthermore, Social Media is one of the fastest growing marketing platforms in the world [START_REF] Coursaris | A Social Media Marketing Typology: Classifying Brand Facebook Page Messages For Strategic Consumer Engagement[END_REF]. Although, in contrast to private sector companies, governments do not depend on selling goods, they can still 'advertise' their services and increase their reputation e.g. creating a sense of belonging among the citizens. However, until now the potentials of political discussions in social media could not be exploited sufficiently. (wattal et al., 2010).

Another study [START_REF] Hofmann | Just because we can-governments rationale for using social media[END_REF], examined the challenges that influence governments' decision to use social media. One of the main obstacle for using social media in governments were privacy regulations or uncertainty about these regulations as well as missing personnel to maintain the social media sites. Before launching a social media site, governments observe and learn experiences of other government agencies social media activities. Social media can also be a "balancing force" to the traditional media [START_REF] Lin | More voices than ever? quantifying media bias in networks[END_REF]. Social media can provide an ideal environment for political expression and dissenting opinions. Other research by Skorick et. al. (2012) examines the relation between social media use and perceived constraints in a semi-authoritarian system in context of the 2011 Singapore general election. The study show that if government control the traditional media there will be more production and consumption of social media content, as well as increased visits to opposition party websites and Facebook pages. This relationship is stronger for younger citizens. The interactivity of social media and their relative freedom, citizens are motivated to use social media for political content production, consumption or for information about opposition parties. In addi- Although, all of this studies are helpful, they face some limitations. Previous studies focused on the influence of social media in election result and campaigns which is a single measure and cycle in time. Therefore, it is difficult to conclude the impact of social media in political participation and discourses. Again, those previous studies examines how a particular technology or web 2.0 can change politics. Another studies are needed to conclusively demonstrate the role of these new technologies in political communication and participation.

Research Method

Studies examining both social media usage and political participation generally employ a qualitative based research design and observation. In keeping with this methodology convention, the researcher will conduct semi-structure interview which helps to provide flexible and to deal deeper into interviewee responses and observations. 488

Interviewees were selected based on their potential to meet the research objective. Interview request were sent to bloggers who have many followers and most of them were show willingness and interviewed face to face and some of them responded online for our questions. Currently, Ethiopia is facing political crisis in different directions from Amhara ,Oromiya and Gambela regions. Due to this some of the interviewee were fear to share their experience and beliefs confidentially.

Most of the interviewees are students in Addis Ababa University. Study by [START_REF] Correa | Who interacts on the Web?: The intersection of users' personality and social media use[END_REF] show that since young citizens are highly using social media since they are grew up with these digital age. 14 Students and 2 politicians are selected and interviewed since they are young's, simplicity to meet and deal with them, peoples are always fear to discuss about political issues. Addis Ababa University is located in Addis Ababa city, capital of Ethiopia. In Ethiopian history, Addis Ababa university students have a unique place in Ethiopian politics and student's movement. Semistructured nature interview were conducted to interviewees face to face to investigate their motivation and usage of social media for political issues and participation. Each interview were takes 10-15 minutes in average. Each of the interview were recorded and transcribed. Concept analysis technique is applied to transcribe interview in order to identify and arrange the ideas and views of interviewees.

Result

In this study a total of 16 interviewee have been approached and the sociodemographic data is presented in table 1 below. The recent research work by Pew research center (Duggan,2015) describes that, among the many social Media sites, the most widely used site is Facebook. Based on our observation in campuses and Internet cafe's, we can proved the same is true for Ethiopians also. Our analysis revealed four distinct themes that identify the role of social media specifically Facebook in politics. 489

Social media replacing traditional media outlet

Social media are used for getting political related news leading to local traditional media such as FM radio's and TV channels. The interviewee with the code A3 share the following history "I got news from local media and Facebook but most often I got political related news from Facebook. Thus, for political information and news, No need of going to websites, buy newspaper, radios and televisions, the only thing expected from me is login to my Facebook address and see posts" when the student says " for political information and news, No need of going to websites , newspaper , radios and televisions ,the only thing expected from me is login to my Facebook address and see posts" -both social media and the local traditional medias are used by the citizens for news sources. When we comes to politics issues, traditional media and social media is separated. For political news and information citizens are preferring social media rather than the local traditional media. When we take the phrase "No need of going to websites, buy newspaper, radios and televisions" -shows social media provides news faster and less-costly than other mediums. Other interviewee also echoed the same opinion. Facebook is a preferred news medium for political and related issues.

Social media for political engagement

Social media is becoming a way of political engagement in different ways for Ethiopian citizens. One of the student code B4 relayed the following history: " I am following many political activists in my Facebook account. I did not post political articles whether good or bad about government. Politics is not medicine. Thus, am forced to stay by liking and commenting my sentiment in others post and sometimes if the posts inspiring me much, I click the 'share' button" Other interviewee also share the same history. The student use Social media for 'follow' political activists and get their updates. They did not post their thoughts but react the other posting by 'like' and 'comment' and also promoting or sharing other posts by using the 'share' button'. In another way, interviewee explained that Social media is created convenient environment for expressing views and thoughts about political issues. This sentiment mostly expressed by social science students. The interviewee with C3 said the following: "I myself write and post my political thoughts about different issues in regular basis. By some means I would like my voice to be heard. You do not feel insecure to write and post political issues because one can use pseudo names for instance "Enat Hagere"". Students are using Facebook for participating and engaged in the political situations by posting their thoughts. It is also possible to stay unknown and post in Facebook, this helped student's to get confidence to post and share their thoughts. 490

Social media for strategic collaboration

This is another theme of social media which is citizens building connections and strategic collaborations. Social media helps peoples to get distant families, friends may be separated for long time. The student with the code C1 speaks as follow: "I find old friends may be from home town, previous work area in order to keep our friendship and connections. So that you can share your experience and discuss on communal issues" When the interviewee said "I find old friends may be from home town......... discuss on communal issues". Social media is a cornerstone to strengthen connection based on their commonalities or interests.

Social media influence government action

Social media have the potential to empower people to implement and exercise political reforms in response to people need. For example the student with the code 3a said: "You can observe the current situation in Ethiopia Oromo protest, which is organized and catalyzed by social media. Following the Protest, Ethiopian government forced to withdraw the master plan" It is known that Ethiopian government announce the rejection of master plan which was the main reason to promo protest.

Discussion

Social media become a common media for political news and become replacing traditional media such as newspapers, TV channels and Radios. The interviewees agreed the overriding reason of social media for political news over traditional media is a potential to provide a simple, less-cost and real-time news and information from online user generated content. The necessary question here is why these media become different from traditional media only in politics issues. State Television called EBC (Ethiopian Broadcasting Corporation) in its 24 hour transmission talk about development in daily basis siding with the ruling government. Most of the time political critic's news and issues is not transmitted in the channels. International organizations like Amnesty international and world Human right watch accuses Ethiopian government to freedom of expression. Ethiopia is one of three countries in the world with the highest number of journalists in exile (https://www.hrw.org/worldreport/2015/country-chapters/ethiopia). Before Facebook is become active in Ethiopia, peoples preferred and listen radio's which broadcast from outside the country such as VOA (Voice of America) and Amharic-German radio which is broadcasting from Germany. But in nowadays, anyone can use his/her mobile or tablet to get any news from the social media. Even those traditional media are also available in social media by having Facebook pages. Anyone can get those local traditional media news as well as political activists and Diaspora based media which is always eager and interested to transit news by protesting the current Ethiopian government. Thus, Social media in Ethiopia become a preferred media outlet which can present political 491 news from the government supporters as well as from opponent of government. The news and information broadcasting by social media are supported by multimedia like picture, video and audio. This may help peoples to enrich with adequate information and one can take the best over it. Social movement is not individual action rather it is a collective action of peoples who have mutual interests (MaAdan, 1982). Social media have the potential to build this connection. Most of the peoples and Ethiopian government also agreed that social media facilitates the current protest by using the hash tag #OromoProtest and "Say No" slogans. We observed that, those peoples in Oromia region were moving on streets by handling and shouting slogans to slogans on the web specifically Facebook. Facebook users were changed their profile picture and post the "Say No" slogans during the protest. In Protest, social media had made power to many well educated men and women to insist political and social changes in the country and become the new-fangled influencer. For instance, we can notice many face book posts that were directly blaming federal polices and government in general, and videos that encourage all Oromos to stand for his right. Most of the posts have words like "we Oromos" "Stand Oromo" to call their friends worldwide to break silent and speak out against social injustice and brutality. Thus, social media used to support increased mutual understanding and collaboration in political discourse in a society. Protest activities in social media is more likely to produce a positive effect. Again, within the area of protest activities, many different kinds of activities demonstrations, boycotts and petitions are shown, making. This study shows social media plays a positive role in citizen's political participation. Ethiopian government was described that the protest is catalyzed by propaganda in social media.

The connection and collaboration may be based on ethnic group or political attitude or other interests. Which can simply lead to protests or social movement. The government was said the protest in not about political and not asking justice it is just terrorists action against our country for disturbing the peace. But after the issue become world news like Aljezira, CNN AND BBC world. The government responded that the master plan case is postponed and it is just in the discussion phase for the implementation by following the reports started out from European Union (EU) and the United States government call Ethiopian government to peacefully solve the problem. Finally, as the protest in the social media gets stronger and the protest behavior is changed time to time the government finally announce that the master plan case is rejected. Social media can have the power to change government decisions.

Conclusion

The relationship between information technologies and politics has begun to be explored. Previous IS researches in this area has investigated the role of social media during events like voting or crises generally ignored or very limited in the role that IS play in general politics. This research explore to what extent social media is used by citizens for political participation and engagement. Thus, the study revealed four main distinct themes that 492 indicates how citizens are using social media for political communication and participation, such as, social media is replacing traditional media for political news, facilitates citizens political engagement, strengthening strategic collaboration, and also social media influences government decisions. This identifies the role of social media specifically Facebook in citizens political participation. The study employed qualitative approach for understating social media role in getting political news, participation as well as strengthening connection and collaboration and also influence government actions and decision making. There is still much to learn about IS impact on epolitics. This study provide a step toward a better understating of political engagement in social media. The primary purpose of this research is to lay the base for much needed study on the role of social media in political engagement, especially, for Africa continent democracy and freedom of speech is still in the infant age. The interactions through the internet contribute to the emergence of democracy in society [START_REF] Wattal | Web 2.0 and politics: the 2008 US presidential election and an e-politics research agenda[END_REF].

Future IS researchers will investigate the bigger role of Information Systems and Technologies in politics in order to make business organizations advantageous and benefit the larger society.

  tion, wattal et al.(2010)examine the influence of the Internet on politics, specifically, on the 2008 US election campaigning using Internet-based technologies such as Web 2.0. The study discussed how these technologies can change the nature of competition in politics and replace or complement traditional media.

Table 1 .

 1 Socio-demographic data of the interviewee

	Job of interviewee	No. of interviewee	Sex
			Male	Female
	Natural science stream	7	4	3
	student
	Social science stream	7	5	2
	student
	Politicians	2	2	0


Varelle Fossi Maffock

Samuel Fosso Wamba
email: s.fosso-wamba@tbs-education.fr

Jean Robert

Kala Kamdjoug

Maffock Fossi

Varelle
email: fossivarelle@gmail.com

Pr Kala Kamdjoug

Impact of Business Intelligence on Firm's Performance in Cameroon

Keywords: Business Intelligence, Enterprise Performance, TAM, IS Success Model

des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.

Introduction

The term Business Intelligence (BI) refers to technologies, applications and practices for the collection, integration, analysis and presentation of business information. BI includes a variety of tools, applications and methodologies that enable organizations to collect data from internal and external sources; prepare it for analysis; develop and run queries against such data; and create visual supports to make the analytical results available to corporate decision-makers and operational workers. BI is defined as "a combination of processes, policies, culture and technologies for gathering, manipulating, storing and analyzing data collected, in order to communicate information, create knowledge, and inform decision making" [START_REF] Foley | What is Business Intelligence?[END_REF].

As Golfareli and Rizzi (2009) put it, "The potential benefits of business intelligence are accelerating and improving decision-making, optimizing internal business processes, increasing operational efficiency, driving new revenues and gaining competitive advantage over business rivals." Thanks to BI systems, companies can easily identify market trends and spot various business challenges, they said. For [START_REF] Foley | What is Business Intelligence?[END_REF], "BI helps report business performance, uncover new business decisions regarding competitors, suppliers, customers, financial issues, strategic issues, products and services". And Regarding the adoption of this technology, these authors estimate that BI is implemented by 80% of U.S. companies in the U.S.A. and by 50% of European firms. Out of these BI adopters, 89% of them believe that they might lose their market if they don't adopt BI [START_REF] Columbus | % of enterprises see big data analytics changing their industries competitive landscapes in the next year[END_REF]. Cameroonian companies have been following this global trend as an increasing number of them are adopting BI tools for improved performance; they include mobile service providers MTN Cameroon and Orange Cameroun, as well as Jumia or Afi-kMarket for e-commerce.

Generally, the BI is marginally used by organizations in Cameroon economic context. But, we can notice that there is effective used of BI by Cameroonian branches of Foreign Companies like Orange, MTN, Jumia or AfrikMarket.

Yet, a number of impediments to adopting BI tools exist, including their heavy cost and the ambiguity about how the adoption of BI impacts firm performance [START_REF] Akter | How to improve firm performance using big data analytics capability and business strategy alignment[END_REF][START_REF] Ramanathan | Adoption of business analytics and impact on performance: A qualitative study in retail[END_REF][START_REF] Sharma | Transforming decision-making processes: A research agenda for understanding the impact of business analytics on organizations[END_REF][START_REF] Trailor | Perception, reality, and the adoption of business analytics: Evidence from North American professional sport organizations[END_REF][START_REF] Yeoh | Extending the Understandng of Critical Success Factors for Implementing Business Intelligence Systems International Funders for Indigenous Peoples[END_REF]. Under such circumstances, a company planning to adopt BI should fully grasp the advantages and significant value added of BI adoption. There is a wide range of studies on BI's impact on enterprise's performance worldwide [START_REF] Sharma | Transforming decision-making processes: A research agenda for understanding the impact of business analytics on organizations[END_REF][START_REF] Trailor | Perception, reality, and the adoption of business analytics: Evidence from North American professional sport organizations[END_REF]. However, the Cameroonian context is still under investigation and there remains a long way to go; and this explains the significance this study on the "Impact of business intelligence on company's performance" in Cameroun. The purposes of this study is to show how BI adoption in an enterprise could lead it to a better performance and also to serve as example to others in this economic context. As a reminder, the following research questions will be answered herein:

-How does BI impact on enterprise performance? -What are the key drivers of BI leading to increased enterprise performance?

Conceptual Model and Hypotheses

For this study, the hypothesized variables and their relationships in the model are being derived from the available literature, and the model is being drawn on TAM, Extended TAM and IS success Model. We combine these models to catch entirely BI success in both individual and organisational level. And variables, from these models, will helps use to have a better measure of firm's performances. Our different constructs and hypotheses are as follows: 230 H15: The Attitude Toward Using BI will have a direct positive impact on the Intention to Use Intention to use BI: It is "the degree and manner in which employees utilize the capabilities of an e-government system" [START_REF] Petter | Information Systems Success: The Quest for the Independent Variables[END_REF].

H23: Intention to Use will have direct positive effect on Use. Satisfaction: it is defined as the "system user's satisfaction with regard to system speed, number of functions, quality and format" [START_REF] Lin | Antecedences to continued intentions of adopting elearning system in blended learning instruction: A contingency framework based on models of information system success and task technology fit[END_REF].

H22: Satisfaction will impact positively Job Satisfaction and Intension to Use.

Use of BI: it examines the actual use of BI, the extent of use of BI in the users' work, and the number of system applications used in the users' work [START_REF] Doll | The Measurement of End-user Computing Satisfaction[END_REF].

H24: The Use of BI will impact the Satisfaction. H30: The Use of BI will impact the Job Satisfaction.

Job satisfaction: it is concerned with examining the successful interaction between BI and its users [START_REF] Seddon | An Empirical Evaulation of User Information Satisfaction (UIS) Measures for Use with General Ledger Account Software[END_REF].

H26: Job Satisfaction will positively impact the Satisfaction. H27: Job Satisfaction will positively impact the Job Performance. Job Performance: it examines the impact of IS on the users' performance [START_REF] Doll | The Measurement of End-user Computing Satisfaction[END_REF].

H28: Job Performance will have a positive direct impact on Financial Performance.

H29: Job Performance will have a positive direct impact on Market Performance.

Financial performance: it is concerned with Customer retention, Sales growth, Profitability, and Return on investment. [START_REF] Akter | How to improve firm performance using big data analytics capability and business strategy alignment[END_REF] Market performance: it refers to the entering of new markets, the introduction of new products or services more quickly than competitors, and to the implementation of the best success rate for new products or services and market shares. [START_REF] Akter | How to improve firm performance using big data analytics capability and business strategy alignment[END_REF]

Moderating constructs

Experience: is define as previous contact or easy use of IS technologies [START_REF] Venkatesh | A theoretical extension of the technology acceptance model: Four longitudinal field studies[END_REF] H7, H8: "The direct effect of Subjective norm on intentions may subside over time increased system experience" [START_REF] Venkatesh | A theoretical extension of the technology acceptance model: Four longitudinal field studies[END_REF].

Voluntariness: "extend to which potential adopters perceive the adoption decision to be non-mandatory" [START_REF] Venkatesh | A theoretical extension of the technology acceptance model: Four longitudinal field studies[END_REF] H9: Voluntariness will significantly impact the relationship between Subjective Norms and the Intention to Use.

Our proposed research model for this study adapted from IS Success Model [START_REF] Delone | Information Systems Success: The Quest for the Dependent Variable[END_REF], TAM model [START_REF] Davis | Perceived Usefulness, Perceived Ease of Use, and User Acceptance of Information Technology[END_REF][START_REF] Davis | User acceptance of computer technology: A comparison of two theoretical models[END_REF] and extended TAM [START_REF] Venkatesh | A theoretical extension of the technology acceptance model: Four longitudinal field studies[END_REF] is being designed as follows:

Fig. 1. Research model

Methodology

A mixed methods research is used in this paper to test and analyze the adopted model research. [START_REF] Venkatesh | A theoretical extension of the technology acceptance model: Four longitudinal field studies[END_REF][START_REF] Caruth | Demystifying Mixed Methods Research Design: A Review of the Literature[END_REF] defined the mixed methods research as a method combining quantitative and qualitative conceptions in the same research study, and which is developed in response to the observed limitations of such conceptions. For our model, we started with a quantitative study, which was followed by a qualitative study in order to better understand and justify result of the quantitative research. This study was carried out in an enterprise that used BI tools like MTN Orange Jumia AfrikMarket. The first step of the study will consist on conducting multiples interviews to obtain viewpoints about BI and Cameroonian Enterprise performance; this will be follow by a pre-test phase, and after with a pilot study and will proceed with collect of data in those enterprise by using Google forms. This approach is recommended by Frippiat and Marquis [START_REF] Frippiat | Web Surveys in the Social Sciences: An Overview[END_REF]. Its main advantages are twofold: (1) the possible to surpass the geographical constraints and (2) the wider follow-up of BI development. Our structural research model will be tested with SmartPLS 3.2.7 software.

Expected Contribution

This research is expected to help understand the impact of Business Intelligence on Companies performance in the Cameroonian environment. The purposes of this study is to show how BI adoption in Cameroon economic context could lead firms to a better performance and serve as example for others in the same economic context. To achieve our goal (give answer to all our questions), we used a mixed research method to allow a better contribution to the existing literature on Business Intelligence and Enterprise Performance.

While this study is just at the step of reviewing literature, it harbors some limits. Firstly, as the study was conducted in the Cameroonian context, there is some geographical limitation, coupled with the fact that the country has few companies that are already implementing BI tools. As a result, it will be difficult for us to collect data. Secondly, given the magnitude of our proposed research, the target population may not give objective answers to questions (in our forms), which could distort our final results. Lastly, studies about BI and Firm's performance in Cameroon and surrounding countries remain inadequate in terms of number. In order to remediate with that, we will carry a complementary qualitative study which can be a case of study on one of those companies which use BI in Cameroon.

Core constructs

Subjectives Norms: A person's perception that most people who are important to him/her think he/she should or should not perform the behavior in question. [START_REF] Ajzen | Understanding attitudes and predicting social behavior[END_REF] H1: Subjective Norms will impact on image. H2: Subjective Norms will impact on Perceived Usefulness.

Image:

The degree to which the use of BI is perceived as being able to enhance one's status in one's social system [START_REF] Venkatesh | A theoretical extension of the technology acceptance model: Four longitudinal field studies[END_REF].

H3: Image will have positive effects on Perceived Usefulness. Output Quality: Is about how BI will impact one's ability to well perform a job. [START_REF] Venkatesh | A theoretical extension of the technology acceptance model: Four longitudinal field studies[END_REF] H4: Output Quality has a positive impact on Perceived Usefulness. Result Demonstration: is about how easy is to show the benefits of accepting BI. [START_REF] Ajzen | Understanding attitudes and predicting social behavior[END_REF] H5: Result Demonstration will have positive effects on Perceived Usefulness. Job Relevance: the adequate application of BI in the job to do. [START_REF] Venkatesh | A theoretical extension of the technology acceptance model: Four longitudinal field studies[END_REF] H6: Job Relevance will have positive effects on Perceived Usefulness. Perceived usefulness of BI: is "the degree to which a person believes that using a BI system would enhance his or her job performance" [START_REF] Davis | Extrinsic and intrinsic motivation to use computers in the workplace[END_REF].

H11: Perceived Usefulness will significantly impact the Attitude Toward Using BI H14: Perceived Usefulness will significantly impact the Intension to Use BI. Perceived ease of use: is defined as "the degree to which a person believes that using a particular system would be free of effort" [START_REF] Davis | Extrinsic and intrinsic motivation to use computers in the workplace[END_REF].

H12: Perceived ease of use will positively impact Perceived Usefulness of BI H10: Perceived ease of use will positively impact the Attitude Toward Using BI.

Service Quality: Service quality refers to through the following attributes: tangible, reliability, responsiveness, assurance, functionality, interactivity, and empathy [START_REF] Delone | The DeLone and McLean Model of Information Systems Success: A TenYear Update[END_REF][START_REF] Lin | Assessing citizen adoption of e-Government initiatives in Gambia: A validation of the technology acceptance model in information systems success[END_REF][START_REF] Pituch | The influence of system characteristics on e-learning use[END_REF]. H20: Service quality will impact the Intension to Use BI. H21: Service quality will impact the Satisfaction. System Quality: it is "concerned with whether or not there are bugs in the systems, the consistency of the user interface, ease of use, response rate in interactive systems, documentation, and, sometimes quality and maintainability of the of the program code" [START_REF] Seddon | A Partial Test and Development of the DeLone and McLean's Model of IS Success[END_REF]. H17: System Quality will impact the Intension to Use. H19: System Quality will impact the Satisfaction. Information quality: it is "concerned with such issue as timeliness, accuracy, relevance, and format of information generated by BI" [START_REF] Seddon | A Partial Test and Development of the DeLone and McLean's Model of IS Success[END_REF]. H16: Information Quality will impact the Intension to Use. H18: Information Quality will impact the Satisfaction. Attitude toward using BI: evaluation of an attitudinal object either representing a positive or negative valence [START_REF] Ajzen | Understanding attitudes and predicting social behavior[END_REF][START_REF] Berger | The eff ect of advertising on attitude accessibility, attitude confidence, and the attitude-behavior relationship[END_REF][START_REF] Fazio | How do attitudes guide behavior? The handbook of motivation and cognition foundations of social behavior[END_REF][START_REF] Dwivedi | An empirical validation of a unified model of electronic government adoption (UMEGA)[END_REF][START_REF] Dwivedi | Re-examining the unified theory of acceptance and use of technology (UTAUT): Towards a revised theoretical model[END_REF][START_REF] Rana | Citizens' adoption of an electronic government system: towards a unified view[END_REF][START_REF] Rana | Adoption of online public grievance redressal system in India: Toward developing a unified view[END_REF].


Woldeyohannes Birkinesh

Lagebo

DEVELOPMENT OF RESILIENT HEALTH INFORMATION INFRASTRUCTURE IN COMPLEX, DYNAMIC AND RESOURCE CONSTRAINED HEALTH CARE CONTEXT

Keywords: Implementation, e-HMIS, HIS, Resilient, Standardization, Information infrastructure

This research concerns the standardization strategy and organizational resilience behavior and action while designing and implementing HIS in low resource country context. Considerable IS research have been conducted to understand HIS standardization strategy and organizational resilience independently. This paper employed holistic approach, drawing up on organizational resilient and standardization literature based on interpretive case study approach, explores the process of electronic health management information system(eHMIS) design, implementation in low resource country to understand the interplay between organizational resilience and standardization strategy. The major research question guiding this study is how e-HMIS design and implementation process addressed the continuous change of health care in resource constrained context with a focus on resilience and standardization strategy.

Introduction

Health Information System (HIS) is considered as a strategy to address the health care delivery problem through equitable health resource allocation and setting priority [START_REF]Design and implementation of health 35[END_REF]. HIS is conceptualized differently in various IS research, a patient level data is often termed as electronic medical record(EMR); a system that handles aggregated data based on every day care provision is termed as HMIS and there are also other systems such as HRMS, Financial system, Drug and logistics system. This study concerns the health management information system (HMIS) which collects and aggregates routine data from health facility level and sends to the next higher level woreda, zonal, regional and MOH on periodic basis like on weekly, monthly, semi-annually and annual basis. Managers at various administration levels used this aggregated data for resource allocation and planning purposes. Managers at various administration levels are supposed to use this data for resource allocation and planning purposes.

Despite lack of technology, technical knowledge and skill, low economy and lack of information infrastructure in resource constrained countries, huge IT investment has been made in health care industry to reap the fruits of ICT [START_REF] Avgero | Information systems in developing countries: a critical research review[END_REF]. Such IT investment in low resource countries is often supported by donor agencies [START_REF]Design and implementation of health 35[END_REF] which is susceptible for sustainable failure. However, IT investment in healthcare industry in general and in developing countries in particular does not yield the expected results [START_REF] Avgerou | Information Technology in context; Studies from the perspectives of developing countries[END_REF][START_REF] Braa | A study of the actual and potential usage of information and communication technology at district and provincial levels in Mozambique with a focus on the health sector[END_REF][START_REF] Avgerou | Power, rationality, and the art of living through socio technical change[END_REF][START_REF] Cho | Contextual dynamics during health information systems implementation: an event-based actor-network approach[END_REF][START_REF] Heeks | Health Information Systems: Failure, Success and Improvisation[END_REF][58][START_REF] Chandwani | Telemedicine in India: current state, challenges and opportunities[END_REF][START_REF] Dwivedi | A generalised adoption model for services: A cross-country comparison of mobile health (m-health)[END_REF]. The inherent complexity and changing nature of health care is considered as a reason for viable results of IT investment in the sector in addition to various contextual challenges such as political, technological, social, resource etc.. Such inherent complexity and the continuous change of health sector challenged the developed countries HIS development and implementation efforts to produce many fragmented system which in turn require them huge investment to make it interoperable. Developing countries should take lessons from developed countries to prevent from overcrowded with multiple fragmented systems while also addressing the changing need of the sector due to the fact that ehealth initiatives are still at infancy stage in developing countries.

The strategies, decision and actions taken during design and implementation will have significant impact to influence the development and evolution of [START_REF] Hanseth | Flexible generification: ICTstandardization strategies and service innovation in health care[END_REF][START_REF] Dwivedi | A generalised adoption model for services: A cross-country comparison of mobile health (m-health)[END_REF] HIS. Contemporary research is swinging in top-down and bottom-up approach to design and implement HIS in such dynamic and diversified context [START_REF] Mekonnen | An institutional analysis on the dynamics of the interaction between standardizing and scaling processes: a case study from Ethiopia[END_REF]. Some criticized the formal traditional top down approach due to the fact the approach hinders innovation in such changing world where as others justified the importance of top down approach to maintain communication and coordination amongst heterogeneous health sectors actors with considerable resource [START_REF] Hanseth | Flexible generification: ICTstandardization strategies and service innovation in health care[END_REF]. Furthermore, scholars in developing countries favor top-down approach due to the fact that many developing countries followed strict hierarchical system. However such hierarchical approach is highly criticized as it constrains innovation and generativity to address the emerging needs. Balancing standard and generativity in HIS design and implementation is the current challenge of IS research. Contemporary research disclosed that successful HIS should constituent both stability and flexibility features to create interoperable system and also to address emergent future needs. Accordingly, IT initiatives now a days have adopted architectural and central IT governance approach in many IS design and implementation endeavor to address both stability and flexibility [START_REF] Hanseth | Flexible generification: ICTstandardization strategies and service innovation in health care[END_REF]. Recent research result extends the architectural and central IT governance approach by identifying stable and unstable system elements (ibid). For stable system elements, top-down approach has been suggested where as for unstable elements bottom up strategy. Although literatures depict how to balance generativity and stability conceptually, there are few empirical research carried out in developed countries to explicate the issue [START_REF] Grisot | Infrastructures in healthcare: The interplay between generativity and standardization[END_REF][START_REF] Neilson | Towards a Design Theory of Usability and Generativity[END_REF]. Research depicts how standard enables generativity through negotiation without constraining communication and coordination [START_REF] Grisot | Infrastructures in healthcare: The interplay between generativity and standardization[END_REF][START_REF] Hanseth | Flexible generification: ICTstandardization strategies and service innovation in health care[END_REF]. Such kind of empirical research is crucial to understand how to maintain a balance between standardization and generativity.

In line with these studies, drawing from organizational resilience, generativity and standardization literature, this paper seeks to contribute for this discourse by surfacing the e-HMIS implementation process in resource constrained setting. The results of the research surface key activities, strategies and decisions taken during implementation process which enable or constrain the establishment of resilient health information infrastructure. A system which has both stability and generativity feature in this paper is considered as resilient HIS.

The overall objective of this study is understanding the relationship between standardization and genrativity in e-HMIS development and implementation in Ethiopia. To realize this objective, I formulated the following major and specific research questions. :-How e-HMIS implementation process manages the continuous change of the health care context while maintaining coordination and communication? The study guided by interpretative case study using the concept of strategy and organizational resilience.

The next section is organized as follows. Section 4 discusses the theoretical foundation which is followed by research methodology in section 3. Section 5 presents the research setting followed by Analysis and discussions of the study in section 6. Finally conclusion will be presented in section 7.

Theoretical Foundation

HIS requires stability and homogeneity to enable coordination and communication amongst heterogeneous health stakeholders, health programs. HIS also need variability and evolveability feature to meet the anticipated and unanticipated future needs of the sector. However, excessive variability results fragmented systems. Similarly, excessive stability can render an irreversible system [START_REF] Hanseth | Developing information infrastructure: the tension between standardization and flexibility[END_REF] which is a challenge for addressing emergent needs of the industry respectively. Thus, maintaining a balance between stability and evolvability while designing and implementing HIS is a central challenge to HIS infrastructure.

Standardization Strategy

Standardization strategy is ways for developing new standards and how actors play a role, interact and change through the process of standardization. In this study eHMIS is considered as standard and strategy followed to develop and implement eHMIS. There are two major types of standardization process, top down and bottom up, in developing and implementing new standard [START_REF] Hanseth | Developing information infrastructure: the tension between standardization and flexibility[END_REF]. The top-down standardization process is a formal standardization process which is characterized as stable, specification driven and often guided by standardization committee(ibid…). It is also widely used in various sectors mainly in telecommunication and engineering field. The top down standardization has four sequential stages as definition, development, implementation, diffusion and use.

On the other hand the bottom up standardization process follows evolutionary or experimental standardization approach [START_REF] Hanseth | Developing information infrastructure: the tension between standardization and flexibility[END_REF]. Internet development and use is categorized under this evolutionary model which has the stages of proposed model as development, draft model which is testing and full or standard which is acceptance [START_REF] Abbate | Inventing the Internet[END_REF]. The existing standardization system which was initiated and used in 19 th century is not appropriate to meet the complex demands of the 21 st century [START_REF] Taylor-Powel | Analyzing Qualitative Data[END_REF]. The twenty one century standardization requires flexible standard that meets the current need. The trends of standard changes from stable to flexible due to the global process [START_REF] Brunsson | The contemporary expansion of standardization[END_REF].

Pollock and his collegues [START_REF] Pollock | Global software and its provenance: generification work in the production of organizational software packages[END_REF] suggested generfication model which focuses on developing general software to address the interest of more users as much as possible. However this model is challenged as it requires more local appropriation [START_REF] Avegrou | New socio-technical perspectives of is innovation in organizations[END_REF]. Other researchers claimed flexible standards for complex technological system in such more dynamic world that changes over time [START_REF] Braa | Developing Health Information Systems in Developing Countries: The Flexible Standards Strategy[END_REF][START_REF] Hanseth | Developing information infrastructure: the tension between standardization and flexibility[END_REF]49]. Van den Ende et al [49] argue that the more flexible standard is easy to adopt and more successful. Hanseth and his colleagues [START_REF] Hanseth | Developing information infrastructure: the tension between standardization and flexibility[END_REF] explicate how standard can be changed easily, if it is simple and used it for many actors if it incorporates all stakeholders' interest. The simplicity emancipates from the standard definition, if the standardization process follows the top down approach, that will ended up with complex standard which is less flexible, where as if it is bottom up, it is more flexible as it is seen in internet development and use [START_REF] Hanseth | Developing information infrastructure: the tension between standardization and flexibility[END_REF]. Braa and his colleagues [START_REF] Braa | Developing Health Information Systems in Developing Countries: The Flexible Standards Strategy[END_REF] also suggest ' flexible standards strategy' for health care based on their action research done in a number of developing and middle income countries in Africa and Asia.

The recent research result has also identified three standardization strategies in relation to service innovation based on a 20 year longitudinal research in Norwegian health care development and use [START_REF] Hanseth | Flexible generification: ICTstandardization strategies and service innovation in health care[END_REF].

The identified strategies are Anticipatory, Integrated solution and Flexible Generification. The anticipatory standardization strategy characterized by top-down and specification driven is considered as the official and dominant strategy. Anticipatory standardization strategy can develop many standardization strategies which might not be feasible to implement. The remaining two, integerated solution and flexible generification strategies, are an emergent strategies [40] based on their empirical material. The integerated solution focus was on user requirements and functionality which is 'user-driven 'rather than specification driven. Thus this standardization process includes more active user involvement and designing integrated solution which satisfy the users' requirements. However, in spite of the effectiveness of the integerated solutions, it was time taking and a slow process. The third strategy is flexible generification which has focused more on developing working solutions based on users' practices and needs based on input-output legitimacy. The researchers found that flexible generification is suitable for successful HIS implementation in such turbulent area of health sector. They suggested standards to be more generic at the same time simple and flexible to adapt the changing needs of the sector [START_REF] Hanseth | Flexible generification: ICTstandardization strategies and service innovation in health care[END_REF]. Accordingly, contemporary research disclosed that successful HIS should constituent both stability and flexibility features to address the emergent future needs. IT initiatives now a days have adopted architectural and central IT governance approach in many IS design and implementation endeavor to address both stability and flexibility [START_REF] Hanseth | Flexible generification: ICTstandardization strategies and service innovation in health care[END_REF]. Recent research result extends the architectural and central IT governance approach by identifying stable and unstable system elements (ibid). For stable system elements, top-down approach has been suggested where as for unstable elements bottom up strategy. In line with these studies, this study seeks to explore the strategies, activities; decisions that have taken during the e-HMIS implementation process to reveal its role for maintaining the balance of generitivity and standardization. In addition to the standardization strategy, literatures now a days due more attention for organizational resilient for successful HIS implementation in such changing environment [START_REF] Cho | Contextual dynamics during health information systems implementation: an event-based actor-network approach[END_REF] .

Organizational Resilience

Literatures now a days due more attention for organizational resilient for successful HIS implementation in such changing environment [START_REF] Cho | Contextual dynamics during health information systems implementation: an event-based actor-network approach[END_REF]. HIS resilience consists both the stability and evolveability features [50]. The organizational resilience rooted from psychology [START_REF] Coutu | How Resilience Works[END_REF] at individual level and later extensively used at organizational level [START_REF] Riolli | Information System Organizational Resilience[END_REF]. Organizational resilience is suitable to explore how actors act in the process of IT implementation. According to the literatures, resilience refers to the capability of individuals, groups, or organizations to adapt quickly to changes in their environments [START_REF] Hamel | The Quest for Resilience[END_REF][START_REF] Riolli | Information System Organizational Resilience[END_REF]. Literatures provide different definition for the organizational resilience, this study considers resilience as a process capability in overcoming barriers to change and in developing multiple sources of competitive advantages [START_REF] Reinmoeller | The Link Between Diversity and Resilience[END_REF]. This approach has three advantages first, resilience is related to the process of change. Second, resilience is multi-faceted, rather than single quality. Thus, organizations may possess some resilient capabilities and not others. Third, in a process perspective, resilience becomes a capability that may be related to both successful and unsuccessful adoption behaviors. On one hand, resilient organizations may able to adopt an innovation and quickly recover from the interruption and return to serving its mission. On the other hand a resilient organization may able to absorb or reject an innovation without any significant change. The concept of resilience can be used to explore how initial adopted system abandoned after certain period of time through a process point of view. In addition to this, the concept can also be used to explore the human agency adoption practice how specific and complex interactions between different levels of adoption behavior including individuals, groups and organizational unit [START_REF] Klein | A Set of Principles for Conducting and Evaluating Interpretive Field Studies in Information Systems[END_REF]. The resilience framework can be characterized by time periods, types of systems, types of events, required system actions, and qualities that must be preserved for the system to be considered resilient [START_REF] Mallak | Putting Organizational Resilience to Work[END_REF]. In this study eight years is the time period of eHMIS implementation, the system is eHMIS, actors action is considered as needed system action, sustainable eHMIS use for data collection, reporting, analysis and use for local action is considered as qualities that must be preserved to be resilient.

A knowledge of how standardization strategy influence or impede health workers, programs and public health care settings behavior and actions towards change is a vital knowledge to devise appropriate strategy that can develop organizational resilience that is capable of addressing such changes. This study seeks to investigate the relationship between standard strategy and organizational resilience. The overall objective of this study is how standard strategy influence or enhance organizational resilience and its impact on eHMIS implementation. To realize this objective, I formulated the research question as How the standardization strategy facilitates or embeds organizational resilience within public health care settings?

Interpretive Case Study Research Methodology

The research is designed as a single case study with multiple sites involved. In this research, the case is defined as the DHIS implementation in public health care settings and allows examining relationships at different levels of analysis within the DHIS implementation context; national level, regional health bureau, zone health office, wereda health office, and health facility level. The approach will allow me to investigate the case at hand in depth to provide a rich understanding of the case. Case study research can be positivist, interpretive, or critical, depending upon the underlying philosophical assumptions of the researcher. This study will adopt interpretive approach to investigate the DHIS implementation as the study tries to understand the technical, social, cultural, organizational situations of the HIS implementation in relation health care context that various from health facility to health facility, administration level to level etc. Interpretative understand phenomena through the meanings and interpretations that people assign to them and their understandings of the social and organizational context [START_REF] Updegrove | Breaking down trade barriers: avoid-ing the China syndrome[END_REF]. It thus has the potential to produce deep insights into the processes of IS development and implementation and how these influence and are influenced by the context [START_REF] Updegrove | Breaking down trade barriers: avoid-ing the China syndrome[END_REF]. A case study is suitable in answering questions of 'how' and 'why' [START_REF] Updegrove | Breaking down trade barriers: avoid-ing the China syndrome[END_REF]. It also addresses contextual and complex conditions and not just isolated variables, and rely on multiple sources of evidence [START_REF] Van Den Ende | The paradox of standard flexibility: the effects of co-evolution between standard and interorganizational network[END_REF]. Thus, case study is well suited to study the development, implementation, and use of the introduction of IT in organizational contexts [START_REF] Benbasat | The case research strategy in studies of information systems[END_REF]. The research will be designed as a single case study with multiple sites involved.

3.1.

Data Collection Method

The study conducted through an in-depth review of secondary data including the organizations' strategy documents and different rules, guidelines, registers pertinent to health service delivery and resource allocation, and official reports from the different health facilities. In addition, the majority of primary data will be collected through semi-structured interviews with key informants (such as health workers, IT technicians, persons dealing with statistics, health managers and planners), and the observation of work practices surrounding the collection, processing, use and transmission of data. Thus gathered data will be triangulated with these data collection methods. Seventeen informants have been interviewed from the public health hierarchy(national, regional, sub city and health facility). All interviews have been conducted using recorder as well as taking notes. There are some interviewee has been interviewed twice so as to clarify and in need of additional data after transcription. Thus gathered data will be triangulated with each other. Interview took from 40 up to 60 minutes.

Modes of Analysis: Hermeneutics

Hermeneutics approach is selected for the study at hand. Hermeneutics is primarily concerned with the meaning of a text or text-analogue (oral or written text). The basic question in hermeneutics is: what is the meaning of this text? [START_REF] Radnitzky | Contemporary Schools of Metascience[END_REF]. Taylor says that:"Interpretation, in the sense relevant to hermeneutics, is an attempt to make clear, to make sense of an object of study. This object must, therefore, be a text, or a text-analogue, which in some way is confused, incomplete, cloudy, seemingly contradictory in one way or another, unclear. The interpretation aims to bring to light an underlying coherence or sense" [START_REF] Taylor-Powel | Analyzing Qualitative Data[END_REF]. Hermeneutic clarifies the different views of the organizations stakeholders which are often incomplete, cloudy and contradictory. The major objective of hermeneutic analysis is to make sense of the whole and the relationship between people, the organization and information technology. Accordingly, hermeneutics approach is followed to interpret, describe and analyze the data.

E-HMIS implementation

Like any other developing countries, the introduction of ICT in Ethiopia health care setting has been facilitated by donor agencies and NGos. HIS implementation was first introduced in Ethiopia by different NGOs in different health programs in cooperation with regional health bureaus [31]. However, such varies efforts created redundancies and duplication of effort in health programs and even with in regions. Thus, in 2006, FMOH criticized such dispersed regional efforts that created fragmented systems for the country and launched HMIS reform at national level in cooperation with its partners (donors and NGOs). Comprehensive and standardized national HMIS for evidence based planning and management of health services was designed and implemented at national level [START_REF]Health Management Information System (HMIS)/ Monitoring and Evaluation (M&E) Strategic Plan for Ethiopian Health Sector[END_REF]. The MOH partners, Tulane University and John Snow, developed and implemented two different software in different regions of the country, Tulane developed and implemented Electronic Health Management Information System (E-HMIS) in all regions except SNNPR where John snow implemented another software which does the same process data collection, process, analysis and reporting. These two systems have been in use in their respective regions till December, 2017. Having two systems with in a country created a challenge to generate a country level health report. MOH took considerable investment to integrate the reported data with two different systems at national level. Furthermore, the continuous change of health care which requires change in system, system failures required being at each site for maintenance and to incorporate changes made in the system. Such handling software maintenance and incorporate changes made in the system consumed a huge investment. Due to these problems, starting from 2015, MOH have sought solutions to address these problems. This paper focuses on e-HMIS which was working for about five years in all regions of Ethiopia till December 30, 2017.

The study will uncover the whole process of eHMIS implementation from software selection, customization, training, use and support. The study includes how the software was selected and designed, how the training and support was organized, and finally the use which includes how data is gathered first from the health facilities (clinics, health centers, and district hospitals), captured in the software, flows to the wereda, zone, the regional and the national levels. Thus, the study requires multi-level analysis which enabled an understanding of the various vertical and horizontal flows of information, resources, rules, plans, and support.

TUTAPE (Tulane University's Technical Assistance Program for Ethiopia) developed Electronic

Health Management Information System Software in partnership with CDC and the Fedeeral Ministry of Health Ethiopia (FMOH) [START_REF]Health Management Information System (HMIS)/ Monitoring and Evaluation (M&E) Strategic Plan for Ethiopian Health Sector[END_REF] using c-sharp, and sql technologies for application and database respectively. Developers used the designed standard data collection tools such as talley sheets, registers, indicators and various reports as an input to design and develop eHMIS.

The system was first tested in Addis Ababa, later in eastern shoa zone of Oromia, and Tigray regions. At these testing stages, different system problems and bugs such as summation problem, report missing, and variable missing were identified for software maintenance. The software development took more than a year to deploy at sites. The software was revised three times through out its five years life time due to new users' requirement, missed indicators, reports, summation problems and so on. All these revisions required the presence of implementer at each physical point to incorporate or install the revised system.

A five day eHMIS training was given in cascading format in 21 health science colleges which were equipped with necessary equipment such as computer, projector. First, a five day master training of trainers was given for forty trainees which was conducted in Adama. Trainees from Federal Ministry of health, all regional health bureaus, and implementing partners participated in the master of training of trainees. These master of TOT provided the EHMIS training to zonal or sub city level TOT who were expected to provide training and for zonal level users. Ultimately, end user training was given for trainees comprised of health facilities who are actually use the system for data entry, and reporting

The initial training given for master of TOT did not enable trainers at the level providing support to end users. Thus most of the support requests were forwarded to upper level region till national level FMOH that brought a great workload on Tulane staff and also took significant period of time to get on time support. As a result, Tulane prepared and provided a 20 days troubleshooting and maintenance training for all regional and sub city HIT staff that highly minimized the support requests came to Tulane and FMOH. However, trainers did not have access to source code to continue learning about systems such as how to modify, insert new requirement including adding and modifying data element, indicator.

FMOH purchased 4000 computers, some servers to make the sites ready for system installation and use. The system was cloned in all 4,000 computers at Ministry of health and distributed to all sites including regions, zones, wereda/sub city, and health facilities found within country. However, maintenance and reinstallation required at sites due to database failure, system revision due to minor mistakes for instance missing indicators, data element and also new requirements need software installation. Thus installation consumed huge amount of time, and finance particularly when they made system revision. eHMIS had made three revision.

Analysis and Discussion

The analysis have been made as mentioned earlier first by interpreting the data gathered by using hermeneutics approach to come up with concepts generated from the data and establish pattern and finally map it with the standard strategy and organizational resilience concepts.

Top-down eHMIS strategy

The case description as shown in section 5.1 has revealed how top down approach or centralized approach was followed for all eHMIS initiation, development, implementation and use. The topdown standardization process is a formal standardization process which is guided by standardization committee [START_REF] Hanseth | Flexible generification: ICTstandardization strategies and service innovation in health care[END_REF]. The HMIS steering committee chaired by FMOH, selected system developer organizations through some criteria. The top down standardization approach has been characterized as stable, and specification driven [START_REF] Hanseth | Flexible generification: ICTstandardization strategies and service innovation in health care[END_REF]. Similarly in this case, the standard data collection tools and reports, indicators were given as a specification to develop eHMIS. The centralizing approach except providing the same specification to guide the system development, it did not give a room for system developer organizations to discuss about how to develop the system. As a result both partners ended up with two different eHMIS systems with huge investment which has predominantly the same function. These two eHMIS became uncompatible at national level to prepare a national level report. Thus FMOH invested additional time, effort and finance to develop a system that can integrate and analyze a national level data and generate report. Furthermore, in order to change a single data element, data set or organizational unit, it required to change on source code which is not accessible to public organizations as well as it requires high tech knowledge and skill. Standard's simplicity depends on the approach to defining a standard, if it is top-down it is less flexible where as if it is bottom up, it is more flexible [65]. As eHMIS development followed top down approach it requires high tech knowledge and skill for system change. The top down approach which has its roots of the 19 th century is not appropriate to meet the demands of the 21 st century which is complex and more dynamic [49]. Similarly, eHMIS was not cope-up with highly dynamic situations of the health sector as it was stated above in the case study section 5.2.1. Thus the strategy did not allow them to modify the system with existing limited system knowledge and skill. This research finding is similar to [START_REF] Hanseth | Flexible generification: ICTstandardization strategies and service innovation in health care[END_REF] anticipatory standardization strategy which is not feasible to implement or take considerable time. Researchers suggested standards to be more generic at the same time simple and flexible to adapt the changing needs of the sector [START_REF] Hanseth | Flexible generification: ICTstandardization strategies and service innovation in health care[END_REF][START_REF] Brunsson | The contemporary expansion of standardization[END_REF][START_REF] Braa | Developing Health Information Systems in Developing Countries: The Flexible Standards Strategy[END_REF]. Thus HIS managers, designers and implementers should consider the flexibility and simplicity of the standard for successful HIS design and implementation in such changing environment.

Regarding training, training was also organized at central level without making ground level assessment. This centralized training by focusing more on training specification includes training content, duration, number of trainees, training place and fund) missed key HMIS and HIT trainees in the first round master of TOT which slowed down the implementation of eHMIS. System installation and support was also organized at region level which required the presence of Tulane staff at all sites which also taken considerable time due to the vastness of the sites and the large number of support requests.

Although actors at sub city and region level had involved in many implementation activities such as conducting training, installing the software and providing support to end users, their role was limited to accompanying Tulane staff and facilitating this activity rather than discharging the activity by their own. This was mainly because system related knowledge, skills, set up files and the source code was under the control of the Tulane university. In general, the system development and implementation was primarily dominated by FMOH and Tulane University where as the public actors at region, sub city and health facility were just facilitating the implementation process. Standard's simplicity depends on the approach to defining a standard, if it is top-down it is less flexible where as if it is bottom up, it is more flexible [START_REF] Hanseth | Developing information infrastructure: the tension between standardization and flexibility[END_REF].

Stakeholders Resilience towards eHMIS

Resilience refers to the capability of individuals, groups, or organizations to adapt quickly to changes in their environments [START_REF] Coutu | How Resilience Works[END_REF][START_REF] Hamel | The Quest for Resilience[END_REF][START_REF] Mallak | Putting Organizational Resilience to Work[END_REF][START_REF] Riolli | Information System Organizational Resilience[END_REF]. Resilient organizations may able to adopt an innovation and quickly recover from the interruption and return to serving its mission. On the other hand a resilient organization may able to absorb or reject an innovation without any significant change. In the case at hand, FMOH, regional health bureau, Tulane University and other partner organizations including CDC, ITECH have shown considerable organizational resilient to thrive technical and organizational problem faced during implementation and to continue implementing and using the system. For instance they hired new staff to strengthen HMIS at lower levels, bought UPS, install antivirus and used various technical measures to safe the system from failure, organize extensive trouble shooting training to build lower level HIT capacity. Direction had been given to send monthly data only in eHMIS. All these actions were taken by the organizations to continue implementing and using the system. However, some of the resilient behavior was not adequate and some required significant investment, and others ended up with limiting eHMIS use to merely for data entry and reporting which missed the main goal of eHMIS which is using data for local action.

Despite all actors enthusiasm and resilient behavior towards eHMIS implementation and use, their resilient behavior was not extended eHMIS use from data entry reporting to the level of data use at all stage, enable to use local capacity for extending, modifying system and even to handle some support, rather it continued to rely on system developer organization for the day to day support issues and system changes.

The Interplay between eHMIS strategy and Organizational Resilient

Regardless of all public level actors enthusiasm and resilient actions towards the system as mentioned in section 6.2, the centralized strategy did not extend further the created resilient action to facilitate the development and implementation of sustainable eHMIS. The administrative institutions considerable resilient action had not been extended from purchasing hardware, developing a software, organizing and conducting training and issuing rules not to the level owning system knowledge and skill, owning system source code and using eHMIS data for local action.

The top down approach did not provide suitable platform to foster learning with in public health institutions rather it centralized high level system knowledge, skill and system under the control of system developer organization. Neither the cascading training nor extensive troubleshooting training focused on limited system knowledge and skill did not allow learning and sharing deep level system knowledge and skill from system developers to public health institutions. As a result, HIT staff at various administration offices had invested unnecessary time, money and effort in surfing external resources to use such centralized knowledge and skill as it is mentioned in case description section. Second, it took considerable time to get technical support. Third, the topdown approach did not allow public HMIS and HIT staff to access the source code of the system which should have facilitated owning deep level system knowledge and skill to own system support as well as to handle system change as result the public HIT and HMIS staff heavily relied on system developer organization knowledge and skill mainly for system change. Moreover, FMOH had invested other considerable amount of money to develop and integrated data analysis tool at national level due to absence of access to source code. This finding is also in congruence with in congruence with Hanseth and Bygstad which showed how the traditional, top-down IS strategy can came up with multiple standardization, yet it was difficult to implement and slow [START_REF] Hanseth | Flexible generification: ICTstandardization strategies and service innovation in health care[END_REF]. Issuing rules not to accept paper based monthly report though enhanced the end users' eHMIS use only to the level of data entry and reporting, yet it missed the major objective of eHMIS which is using data for local action. This finding is similar to Hanseth & Bygstad [START_REF] Hanseth | Flexible generification: ICTstandardization strategies and service innovation in health care[END_REF] stated as the top-down approach merely automates the existing paper based system to computer system which is merely reduced time, not change the way HMIS was organized and use.

As described above in this analysis section, the topdown approach enabled all actors to be resilient at certain level yet not facilitated the exhibited resilient action. These resilient actions taken by all actors had also brought negative consequences. First, it required huge investment. Second it limited eHMIS to merely for data entry and reporting. Third public HIT and HMIS staff system knowledge and skill was not in a position of owning system support and modification activity rather they had been heavily relying on system developer organizations staff. Fourth the public organizations at any level did not have access to system code till the termination of eHMIS. Lastly, it missed the main objective of eHMIS development and implementation which is using generated data for local action. This finding is similar Cho and his colleagues [START_REF] Cho | Contextual dynamics during health information systems implementation: an event-based actor-network approach[END_REF] results stated "while resilience facilitated swift and successful adoption, it also created tensions that endangered further diffusion and the long-term sustainability of the tele-health innovation" [START_REF] Cho | Contextual dynamics during health information systems implementation: an event-based actor-network approach[END_REF]. Furthermore, the strategy did not extended or foster the exhibited resilient behavior and action.

Thus, the above mentioned situations (frequent support requirement and its investment, the dynamic nature of the health care which required system revision and installation to each site, absence of system ownership to make modification, absence of the required system knowledge and skills at public HIT and HMIS staff) challenged FMOH to continue its resilient behavior towards eHMIS, rather switched to look for other better alternative. Thus despite, considerable resilient behavior was seen at all end users and public health administration offices and also partner organizations for effective implementation of eHMIS, FMOH by considering the consequences of eHMIS implementation decided to replace eHMIS with DHIS-2 which is an open source web based software.

The case analysis has vividly depicted how the top down eHMIS development and implementation strategy facilitated to develop organizational resilience with all stakeholders at certain level where as at the same time limited the organizational resilience action. This limited organization resilience action might deteriorate the developed organizational resilience through time. This interplay between eHMIS strategy and organizational resilience has shown its considerable impact on the development and implementation of sustainable eHMIS system. For instance the centralized cascading training resulted for missing key trainees, inadequate training and increases implementation cost where as the organizational resilient action of the actors 'trouble shooting and maintenance training' which was derived from the reality exhibited in institutions facilitated learning and minimizing implementation cost and time at certain level. Furthermore, the top down approach issued guideline to use merely eHMIS for data reporting though it enhanced users eHMIS use by showing resilient action by using sub city computer for data entry and reporting yet this resilient action limited the purpose of eHMIS merely to data entry and reporting. The top down strategy adopted in the case at hand case even if it created resilient action yet it was unable to facilitate the resilient action by availing more conducive environment. Thus appropriate strategy should be devised that not only to develop organizational resilient behavior and action but also fostering the organizational resilient actions by providing suitable environment. This case slightly indicated the bottom-up approach might help in developing organizational resilience and also facilitating further the organizational resilience.

Conclusion

The standardization strategy and resilience concept is used to understand and depict the interplay between IS implementation strategy and organizational resilience in shaping the development and implementation of eHMIS. The study identified how top-down or centralized HIS standardization strategy at the beginning created organizational resilience behavior and actions at all levels. However, the created organizational resilience behavior was not reinforced by providing system level ownership and the required system knowledge and skill. The developer organization who monopolizes the system ownership, resource and knowledge and skills did not enable them to address the users' frequent and emergent needs. It took them considerable time and resource to fix minor users' problem at lower levels. Consequently, the created organizational behavior became limited to generate the required organizational resilience behavior and actions mainly at lower levels to address the emerged users' need. Lately sub-city focused deep level training minimized the frequent users' support and helped to continue using the system. However, the negative consequences of organizational resilience and top-down strategy which requires huge running cost and time also deteriorated the upper level resilience towards the system that leads to terminate the use of eHMIS.

Thus the study by relating organizational resilience and standardization strategy depicted how their interplay shape the eHMIS design, implementation and use. The study depicts how topdown strategy is unable to create sustainable organizational resilience behavior and action to address the emerged needs of the users. Thus the research suggested for implementers to employ appropriate strategy which emphasizes both in creating and sustaining organizational resilience behavior and action that can address the emergent needs of the users at lower levels. In this case, sub city(wereda) level focused strategy produced viable results in sustaining the organizational resilience behavior and action which can address the emergent needs of users.

Table 1 .

 1 Details of Informants

	Sn Specialization	Organization	No	of	No	of
			Respondents	interviews
	1 HMIS Head	FMOH	1		1
	2 HMIS staff	FMOH	2		2
	4 HMIS head	AAHB	1		1
	5 Support staff	Yeka Subcity	3		5
	6 Data clerks/ HIT	Health facilities	3		3
	7 Health professionals Health facility	3		3
	Total		15		20