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A doctor and patient using the electronic immunisation registry system Nurses registering children for an immunisation programme
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There’s room for all types in the ICT4D scrum

Programme evaluator Terri Collins is excited about the emerging opportunities around ICT in the development sector – especially now that digital systems are maturing. You don’t need to be a techie to make an impact in technology.

Information and communications technology (ICT) in the development sector – often referred to as ICT4D – has come a long way in recent years. As the software and systems continue to mature, new doors are opening for donors and contractors to change the way they bring digital innovation to low-income countries in areas such as health and education.

For example, many programmes tended to be front loaded. The energy went into the design, initial deployment and early implementation of the technology. Due to budgets and time constraints, the responsibility of sustaining improvements and scaling up would then fall on the recipients, with varying degrees of success.

Today, we’re seeing a paradigm shift, where the focus is spreading to the back end, to deal with the legacy of rapid software innovation, such as data stewardship, security and privacy. For these mature software systems to achieve sustainable outcomes, there is a growing realisation that the capacity of both recipients and donors will need to grow in step. Technology is an enabler, not the answer itself.

In the past, the eagerness to bring in technology has led to low service integration on the ground. There are reports of community health workers with six mobile phones, provided by six different organisations, who each ask them to capture data to fuel real-time decisions. Or nurses walking for several miles a day to send updates because their health centre has a patchy internet connection or faulty solar panels. By contrast, there are some fascinating advances in frugal design, whereby technology runs on low bandwidth and smaller batteries.

The need for context-led digital intervention is a growing theme. Programme design has often taken place in Europe or North America, without the designers experiencing the local terrain or social practices first hand. The mechanism (technology) or desired outcome were the drivers, rather than intimate knowledge of the challenges, limitations and most pressing needs. By creating closer connections between those with delivery and domain knowledge, and those with the technology skills, we can design programmes together that respond to local constraints in a highly customised way.

As a social anthropologist, who has always sat on the lower branches of the technology tree, I never imagined myself entering the digital conversation. Yet, during recent evaluations of immunisation programmes in low-income countries, I’ve seen clear opportunities for non-techies like me to play a valuable role in shaping the local improvisation that will be a pillar of mature digital systems in ICT4D.

One of the many buzz phrases that I have learned recently is agile scrum process: a fluid approach for coders to work together and share learnings in a flexible way. This agility is critical for ICT4D programmes that seek to become sustainable and scalable. Programme design should make provision for adaptation and system maintenance. This may not sound as appealing as a smart app or real-time dashboard monitoring, but without this responsive mind-set and rigour, the technology won’t achieve its full potential.

As a sport for multi-disciplinary players of all shapes and sizes, rugby feels like a good metaphor. It’s about making the hard yards. Adapting to the state of the game. The good news for anthropologists like me is that you don’t need to be a digital heavyweight to join the ICT4D scrum.

Please see our white paper on ICT and immunisation, where Dr Terri Collins compares her experiences developing and evaluating technology solutions for immunisation programmes in Tanzania and Pakistan below.

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