Technology and Practice: Implementing ICT4D in low and middle income

countries - A sociotechnical approach

PJ Wall – Doctoral Researcher

8th November 2013

Trinity Development Research Week 2013

ICT4D Failure

Failure rates in ICT4D are very high

Becoming increasingly evident just how difficult it is to sustain mHealth projects beyond pilot

implementation [1-3]

ICT4D Failure

The technology, by and large, “works”

So, it must be about something other than the technology ...

Community Health Workers

CHWs using the mobile phones in Mattru

– October 2013

Issues with the phones

Hardware & Software

• The mHealth hardware & software

• Power supply and charging the phones

• Mobile signal

Community Health Workers

Community Health Workers

Mobile phone “charging station” in Mattru

– October 2013

Community Health Workers

Cell towers in Mattru

– October 2013

Other issues with the phones

Other issues

• Society, culture, power, politics

• Illiterate users

• Local capacity

• Creation of networks of stakeholders

• Business models for scaling and sustainability

A Socio-technical View

All technology is embedded in a social and cultural context, making the transfer of just the technology

problematic

The assumption that technology will simply fit into any environment and be easily adopted by the user has

been described “fallacy” [4]

A Socio-technical View

Implementers are likely to have to negotiate a multiplicity of

interacting socio-technical factors that are both within and

outside their control [5]

Socio-technical Theory

Many people have written about socio-technical theory:

• Albert Cherns [6] • Chris Clegg [7]• Enid Mumford [8-9]

A Socio-technical View

Joint optimization of “technical” and “social” subsystems

• People given the opportunity to participate in the design process• Design is an extended social process and is socially shaped [7]• “Multifunctional” workforce [6], and “multidisciplinary” education [7]• The “need to be able to learn on the job and to go on learning” [6]• System capable of self-modification, of adapting to change and of

making the most use of the creative capacities of the individual [6]• The means of undertaking tasks should be flexibly specified [7]• Iterative processes and “incompletion” [6]

Initial Findings?

What are the initial findings from the Sierra Leone mHealth initiative?

• People given limited opportunity to participate in the design process• Training was provided in operating the phone, but not as yet in

anything beyond this• Additional training planned• MoU on use of the phone• Problems with solar chargers means that CHWs may have to use

charging stations to charge the phones• Some evidence of iterative processes

A final thought …

Maybe ICT4D implementation, scaling, and sustainability is about more than just socio-

technical theory

We may need new ways of understanding ICT4D ...

References1. Anderson, R., and N. Perin. Case studies from the Vital Wave mHealth Report 2009. Available from

http://homes.cs.washington.edu/~anderson/docs/2009/mHealthAnalysis_v1.pdf.2. Curioso, W. H., and P. N. Mechael. 2010a. "Enhancing 'M-health' with south-to-south collaborations." Health Aff (Millwood) no. 29

(2):264-7. doi: 10.1377/hlthaff.2009.1057. 3. Curioso, W.H., and P.N. Mechael. 2010b. "Enhancing 'M-Health' with South-to-South Collaborations." Health Affairs no. 29 (2):pp.

264-267. 4. Shozi, N.A., D. Pottas, and N. Mostert-Phipps. 2012. "A Socio-technical Perspective on the Use of Mobile Phones for Remote Data

Collection in Home Community Based Care in Developing Countries." In e-Infrastructure and e- Services for Developing Countries, edited by R. Popescu-Zeletin, K. Jonas, I. Rai, R. Glitho and A. Villafiorita, 135-145. Berlin: Springer Berlin Heidelberg.

5. Manda, Tiwonge Davis, and Terje Aksel Sanner. 2012. Bootstrapping Information Technology Innovations Across Organisational and Geographical Boundaries: Lessons from an mHealth Implementation in Malawi. Paper read at IRIS. No. 35. Tapir Akademisk Forlag.

6. Cherns, A., 1976. The Principles of Sociotechnical Design. Human Relations, 29(8), pp.783– 792. 7. Clegg, C.W., 2000. Sociotechnical Principles for System Design. Applied Ergonomics, 31, pp.463 – 477. 8. Mumford, E., (1995), Effective Systems Design and Requirements Analysis: The ETHICS Approach, London, Macmillan9. Mumford, E., (2003), Redesigning Human Systems, Hershey, IRM Press