The role of communication practices in the strengthening of counter networks: Case experiences from the health care sector of Mozambique

In this article we provide a theoretically informed empirical analysis of the introduction and use of information and communication technology (ICT) within the primary health care (PHC) sector of Mozambique. The theoretical lens for this analysis is developed from Manuel Castells' (1996, 1997, 2001) ideas on the network society and counter domination. These ideas help us to conceptualize the communicative action required to strengthen the PHC sector as a “counter network,” which has the normative aim to strengthen the health information system (HIS) as a key strategy to improve health care delivery. Taking an informational perspective, the role of communication is highlighted as playing an important constitutive basis in the strengthening of this network. These conceptual ideas are applied to the empirical analysis of an ongoing project (the Health Information Systems Programme or HISP), and to analyze some key constraints and strategies for strengthening these networks. This study makes key contributions to both the theoretical and practical domains of HIS in developing countries. © 2005 Wiley Periodicals, Inc.