The great legitimizer: ICT as myth and ceremony in the Indian healthcare sector.

Purpose — The purpose of this paper is to explore how and why information and communication technologies (ICT) are enrolled in the Indian healthcare sector for reasons over and above perceived efficiency gains. Design/methodology/approach — The paper explores qualitative field data collected in the Indian states of Karnataka and Andhra Pradesh, and the city of New Delhi from an epistemological perspective of interpretivism. New institutional theory is employed to illustrate the mythical and ceremonial roles that ICT for development play in legitimizing development initiatives. Findings — The analysis challenges the simplistic view that implementing health management information systems will translate directly to efficiency gains. Research limitations/implications — This paper furthers the theoretical understanding of how ICT, as social and material phenomena, function empirically beyond instruments of technical rationality. One limitation of the research is the relatively short duration of the fieldwork. A wider scope in the metrics used to evaluate success in development initiatives that implement ICT is called for. Practical implications — Practical implications of this paper focus on the need to move away from simple deterministic visions of ICT for development towards an approach based on acknowledging outcome indeterminacy with regard to the consequences of ICT implementation in the Indian healthcare sector, and thus the need for genuine feedback loops. Originality/value — This paper will be valuable to institutional and information systems theorists, and development practitioners. A framework is provided to unpack the institutional context that drives some of the inefficiency in the Indian healthcare sector. [ABSTRACT FROM AUTHOR]