Table 2.

Overview of findings

Infrastructural challenges	Inflated expectations	Unstable governance, changing objectives and components over time	Multiple stakeholders with conflicting agendas	Evaluation and learning
Basic information infrastructures (Wi-Fi, EHRs) and data quality are crucial, but often an afterthought	Ambitious, politically driven implementation timelines	Changing ministers and senior managers; re-structuring of change management bodies	Change is technology-driven with limited attention to implications for adopters, system needs and priorities	Limited by a lack of baselines and consequent inability to assess outputs and impacts
Lack of forward planning	Programmes launched too quickly and ended too quickly	Tension between adhering to the overall goal and flexibility to respond to changing needs	Ongoing tension: national and local priorities	Evidence that the sharing of learning can accelerate adoption
				Limited learning between successive programmes