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The four system changeover approaches description, advantages, disadvantages and the implications of using each of these approaches at Health Centres to change from the existing manual system to the new CHIS are as follows-: Direct Cutover -: In simple words direct cutover approach is a direct approach where old system is cut and over write by new system. The direct cutover approach causes the changeover from the old system to the new system to occur immediately when the new system becomes operational. This is a least expensive method among all four but involves high risk of data loss. With the direct cutover method, company cannot revert to the old system as a backup option. Direct cutover involves more risks of total system failure and if there is a system failure in health centre then it will be difficult to store information of child who visits health centre and this will result in improper storage of data. But as there is lack of funds, this approach will be a possible option because of its low cost application among all four approaches. Parallel Operation -: Parallel word is use when two things run simultaneously, so here two operations run simultaneously. The parallel operation changeover method requires that both the old and the new information systems operate fully for a specified period. When users, management, and the IT group are satisfied that the new system operates correctly, the old system is terminate. Parallel operation is having very low amount of risk as if the new system does not work correctly, the company can use the old system as a backup. But it is the most costly changeover method. Data have to be input in both systems. Users must work in both system and result in increased workload and processing delays. Because of its high cost it would not be a suitable approach for health centre even though it’s the safest approach as it is having back up. Pilot Operation -: The pilot operation changeover method involves implementing the complete new system at a selected location of the company. The group that uses the new system first is called the pilot site. The old system continues to operate for the entire organization including the pilot site. After the system proves successful at the pilot site, it is implemented in the rest of the organization, usually using direct cutover method. Pilot operation is combination of parallel operation and direct cutover methods. Pilot site assure the working of new system and reduces the risk of system failure. This is also less expensive than the parallel operation as only at one section both system works for limited period. This is less expensive and safer approach as its combination of both direct cutover and parallel operation. It will save money of health centre and also keep their data safe with smooth working. Phased Operation -: Phased operation works in different phases or stages. Implementation of new system in modules or stages is phased operation. This is also a combination of direct cutover and parallel similar to pilot operation. But in this approach the entire system is provided to some users instead a part of system to all users. In phase operation the risk of errors or failures is limited to the implemented module only and also phased operation is less expensive than the full parallel operation. But in some cases, phased operation can cost more than a pilot approach where the system involves a large number of separate phases. Health centre involves various phases such as registration, measuring weight, treatment, vaccination, diagnosis and more. Because of the involvement of so many phases it would be difficult and costly to apply phased operation approach. Recommendation From the above discussion about all four possible approaches, it is very clear that data cutover and parallel operation approach alone is not suitable for the CHIS because of drawbacks like high risk or high cost but the combination of both approaches namely pilot operation and phased operation approaches is more fruitful. Still phased operation is not most suitable approach as we know there are lot of phases involve in our information system and also lack of fund is there. So conclusion is pilot operation is the most recommended approach for the CHIS because this method is cheaper and safer method. Any one of the health centre can implement the new system and after the system proves successful, it will be used by other health centres by using direct cutover. 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