Computerisation has transformed much of the world, but its history has been marked by frequent and profound failures. In health, the stakes of such failures are especially high. No less is this the case for the many low- and lower-middle-income countries that are turning to digital technologies to address weaknesses in their healthcare systems, including in disease surveillance, diagnostics, treatment services and logistics. In Tanzania, for instance, many of these technologies break down, do not work as intended, struggle to reach those that need them most and, as a result, worsen inequities.
One popular strategy to reduce the likelihood of these failures is to loosen the dependence on imported foreign technologies by instead fostering ‘local innovation’. Today, Tanzanian data scientists, healthcare workers and patients are innovating for and in the domain of health. BytesBodies will draw on social anthropology and allied disciplines to help understand the people, institutions, practices, values, and relationships that shape this phenomenon. It will explore three domains: the design of digital health by Tanzanian data scientists experimenting with artificial intelligence and machine learning; the way patients and healthcare workers informally innovate with mobile phones; and the international and national policy-making world which is attempting to foster ‘local innovation’.
The project will help shape discussions within the field of digital health as well as the related areas of digital innovation. By engaging with policy-makers at national and international levels, the project will provide crucial, applicable insights. Such insights will be made more relevant and impactful by collaboratively engaging with Tanzanian data scientists, recognising them not simply as technical actors but as reflective and critical actors in their own right.
The project will be carried out by the University of Dar es Salaam, Tanzania and the University of Oslo, Norway.
The WHO says harnessing the power of digital technologies is essential to achieve universal health coverage. Recently, there have been large investments in the development of digital technology to improve healthcare in low- and lower middle-income countries. But there are concerns that high costs, weak regulations and design that is poorly suited to local social and cultural contexts challenge the potential of the digital revolution to improve health equity. These concerns have led to global initiatives to foster ‘local innovation’ to meet the needs of end-users and health systems rather than those of outside foreign experts or private investors. We unpack what ‘local innovation’ means in practice, asking if ‘locally’ created digital health is a donor-driven technological band aid to intractable health system challenges or whether it offers opportunities for appropriate technological solutions that strengthen healthcare systems, outcomes and equity?
We address such questions through a study of local innovation of digital health in Tanzania, the third most innovative country in sub-Saharan Africa. We will study the efforts, ingenuity and critical reflections of Tanzanian actors creating digital health solutions – government officials, data scientists, healthcare workers and patients – and analyze these in relation to the innovation and capacity building policies of donors, international partners and private investors.
We move beyond critiques of foreign expertise or the depiction of African populations as recipients of foreign technology transfer. Drawing on health policy research, social anthropology and science and technology studies, we will use ethnographic methods to examine how technologies are designed, used, and governed from Tanzania. We will make an important contribution to policy audiences in Tanzania and internationally, and to cutting-edge social scientific conversations around digitalization, technology and science.