Terje Aksel Sanner

A Post-development Perspective on mHealth -- An Implementation Initiative in Malawi

While the sheer number of mHealth implementations around the world have been increasing dramatically, authoritative voices on global health have tried to put the focus on quantifiable evaluations and comparisons of these projects (e.g. health outcomes, cost savings, efficiency) in order to channel donor funds and investments into proven and scalable solutions. Drawing on empirical data from an mHealth implementation in Malawi we argue that quantitative evaluation of health interventions often assumes a top-down and limited view on the developmental impact of mHealth. Through our action-research involvement with facility-based reporting of routine health data through mobile phones, we conclude that developmental impacts of mHealth are local and each locale experience a different developmental impact depending on the context of use and available resources. The paper contrasts global concerns for quantifiable development with local priorities with respect to mHealth projects and information system (IS) interventions in health more broadly.

ICT4D Sustainability as Generativity

In the wake of “the mobile revolution”, there has been an immense surge in mobile phone-based health innovations. Scholars and industry specialists have found a large portion of such innovations in less developed economies unsustainable beyond pilot projects. However, “sustainability” is a difficult aspiration to operationalize. Based on insights from recent literature on digital innovation, the paper suggests an alternative focus on generativity – a perspective on longevity that emphasizes the continuous facilitation of innovation over stewardship and control. To illustrate the relevance of generativity to ICT4D, the paper draws on examples from a mobile phone-based implementation to strengthen routine reporting of public health data in Malawi. By foregrounding generativity as an ICT4D aspiration, the paper begins to consider implications at the level of projects, national policy and international development collaboration.