icegov2012 proceedings

elationships among network actors in each country contributes to
a set of contextual distances which represent the differences, in
kind or degree, between the international actors on a set of
influential dimensions: culture, politics, goals and intentions,
organizational factors, ability to form relationships, types and
extent of knowledge, types and extent of resources, physical
location, and available technologies [6, 7]. Variations on these
dimensions form the contextual differences in each country
which, in turn, influence the nature and performance of exchange
processes and interactions and, consequently, products and
performance of TPSKNs [6, 7].
Table 2. Factors related to organizational context
Factor Definition
Goals and
Interests
Trust
Refers to the extent to which participants’
goals and interests are consistent with one
another.
Refers to the degree of confidence or faith in
the intentions and behavior of others (or the
lack of such confidence or faith).
Executive Refers to the extent to which executives and
support and top-level managers from participating
organizational organizations are involved and willing to
commitment commit resources, provide incentives, and
offer direction.
Risks Refers to the extent to which participants
believe their environment, actions, or
relationships threaten something of current
or potential value to their organizations.
Costs Refers to the kind or amount of current or
expected resources and other investments
required of participating organizations.
Benefits Refers to positive results or returns, which
can be financial, societal, political, or
associated with mission performance.
Authority and
hierarchical
structures
Organizational
culture
Leadership
Organizational
rules,
procedures,
and regulation
Resources
Absorptive
Capacity
Refers to formal legal powers, legitimacy,
differences in hierarchical structures, and
formal control over actors and activities.
Refers to commonly accepted and shared
beliefs, values, and practices within the
organization.
Refers to participants’ behavior, such as
taking personal responsibility for actions and
outcomes, providing guidance or direction,
exerting influence, and giving rewards or
punishment.
Refers to the routine, formal policies
defining the ways in which organizations
accomplish their work.
Refers to the extent to which expertise,
funding, infrastructure, staff, technology, or
other suitable organizational assets are made
available.
Refers to the organization’s ability to
identify, assimilate, and exploit knowledge
from the environment.
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Table 3. Factors related to national context
Factor Definition
Culture
Laws and
policies
Refers to commonly accepted and widely
shared beliefs, values, and practices within a
country.
Refers to formally adopted requirements,
limitations, or obligations which shape and
Political
constrain work practices.
Refers to the support of elected officials and
support
government leaders.
Language Refers to the languages of the participants.
Geographic
location
Refers to geographic or geo-political
locations of the countries involved in the
collaboration.
This study relied on case study methods to identify the factors that
influenced technical, knowledge, and information exchange
during the collaboration between the United States (US) Centers
for Disease Control and Prevention (CDC) and the Kingdom of
Saudi Arabia (KSA) Ministry of Health (MoH) that led to the
adoption of the Hajj Mobile Disease Surveillance System (Hajj-
MDSS) in 2009. In the following two sections, A brief discussion
of the Hajj-MDSS case is provided followed by an overview of
the methods.
3. THE HAJJ-MDSS
The Hajj-MDSS initiative is led by the KSA MoH and US CDC.
It allows rapid detection of infectious diseases among Hajj
pilgrims and enhances prevention and control measures through
real-time surveillance information for public health decisionmaking.
The initiative was launched during the period when swine
flu (Pandemic Influenza A, H1N1) had been declared a global
pandemic. The conditions of the Hajj magnified the risks
associated with H1N1. The Hajj is one of the largest, most
culturally and geographically diverse mass gathering events in the
world, attracting more than 2.5 million people of different
nationalities, languages, races, and genders in Makkah. The
guiding vision was to ensure the well-being of Hajj pilgrims and
therefore maintain global public health security. When H1N1 was
declared a global pandemic in June 2009, the Saudi MoH
organized an international workshop of leading global public
health organizations including the World Health Organization
(WHO), the US CDC, and similar institutions in Europe,
Australia, and China. The goals were to pool public health
knowledge about mass gatherings and review the KSA
preparedness plans, focusing on prevention and control of H1N1
[23]. One recommendation was to implement a Mobile Disease
Surveillance System to monitor the epidemiology of swine flu
among Hajj pilgrims.
Immediately following the workshop, the Saudi MoH officially
requested a proposal from the CDC as it has prior experience
using and adopting such technology in many places around the
world. The Request for Proposal (RfP) was followed by extensive
knowledge- and information-exchange through four main phases.
First was the preparation phase, in which participants worked
toward creating a shared understanding and identifying the
responsibilities of each side. In the second phase, a group of
epidemiologists from the US CDC assisted their counterparts at
the Saudi MoH in developing and customizing the electronic