The first truly democratic election in South Africa, with no discrimination on race, was held in 1994. African National Congress (ANC) won the election and launched the Reconstruction and Development Program (RDP). This program was initiated as a broad program which involved many different parts of the South African society. The overall goal for the program was to remove the relics of the former apartheid regime and build a free and non-discriminating society.
The health system built during the apartheid regime was clearly discriminating on race. There were fourteen different departments of health at the central level. The “general” department, and “white”, “Asian” and “coloured” departments, and ten for “blacks”, “homelands” and “self-governing states”. To reform the health system several projects were initiated. HISP, which focuses on health information, was initiated to this end.
HISP was established as a collaborative research and development effort between University of the Western Cape, University of Oslo (UiO), and University of Cape Town. In 1996 HISP received founding from Norwegian Agency for Development Cooperation (NORAD) for a pilot project in three health districts in the Cape Town area. Two areas for research and development were identified. The first was to develop an Essential Data Set (EDS) and standards for primary health care data, the second was to develop what would become DHIS. The relative success of HISP compared to two other health information projects in South Africa lead to the official endorsement of HISP. In 1999 to 2001 the software DHIS along with the processes promoted by HISP were rolled out to primary health units in the whole of South Africa.
Since the time of the pilot phase in Cape Town countries outside South Africa have involved themselves in the HISP network. Mozambique have been involved since 1998, India since 2000, Malawi since 2000, Tanzania since 2001, Cuba since 2002, Mongolia since 2002, Ethiopia since 2002 and Vietnam since 2004. HISP is not Cuba and Mongolia at this time. HISP also has some relations with Nigeria and Botswana.
The South African version of DHIS was taken to different countries and adapted by PhD and master students and to a lesser extent ICT professionals, to the local requirement of the country. The way of entry into the different counties has been through two major entry points. The first through university collaboration, and attempting to build alliances with the health authorities. The second entry has been though the departments of health, typically with support from outside actors like donor agencies (Braa et al. 2004). The entry to Ethiopia has been through collaboration with Addis Ababa University (AAU).