This thesis investigates free and open source software (FLOSS), and FLOSS in the context of developing countries. The research is based on two action research case studies. Both case studies are done within the Health Information Systems Programme (HISP) network. HISP is a research and development network focusing on promoting effective use of information in the health systems of developing countries.

The first case study was conducted in the Tigray region of Ethiopia. In this case study a team of researchers used action research to configure and adapt District Health Information Software (DHIS) to the local context of the Tigray health system. DHIS is a flexible health information system used to collect routine data from health systems. DHIS is distributed under a FLOSS license. I participated in this team as a software developer.

In the second case study I participated in the development of DHIS 2 which is a total reimplementation of DHIS based on a platform of FLOSS technologies. DHIS 2 is developed using distributed voluntary development and licensed under a FLOSS license. In other words DHIS 2 is developed using a community model commonly used by large scale FLOSS projects. I participated in this project as a FLOSS developer, and I focused on the extensibility of DHIS 2. I created a throwaway prototype of a plug-in framework.

Through this two case studies I investigate FLOSS and how FLOSS can benefit and are benefiting both Ethiopia and the HISP network. I argue that the access to source code facilitates technology transfer/translation of information and communication technologies (ICT). Context dependent software like health information systems need to be adapted to each local context in order to be useful and effective, having access to source code is a life saver in this process.