Intervention Breakdowns as Occasions for Articulating Mobile Health Information Infrastructures

Abstract

This study investigates a mobile health project launched in Malawi and considers its sustainability in light of activities that occur in the pilot stage. It has been said that most projects of this nature fail during piloting hence it is pertinent to review the activities in this early stage. The study follows a grounded theory inspired research approach and is focused on the day to day breakdowns that occur in the pilot, what they reveal, and how the resolutions relate to the project's goals. It is found that when breakdowns occur, an articulation process to sustain the intervention becomes visible. Breakdowns can reveal tensions in the technical design and organisational context thereby offering opportunities for action in order that an intervention is sustained. The ensuing activity, for analytical purposes, is termed articulation work, and its variety and limitations are explained. In this study we discover two categories of articulation work, technological and human. Further to this, we argue that these two categories of articulation work can be further analysed into different dimensions, based on the levels of organizational involvement required to resolve them: (i) localised; (ii) multiple levels within a single organization; (iii) and multiple levels inter‐organizational.

Enacting technology

“…long-term maintenance and continuity. Second, combination of the perspectives compensates for aforementioned limitations to individual perspectives (see table [2][3][4][5]. Third, my approach, responds to calls for development of integrated theoretical and methodological frameworks, to allow for more nuanced analysis of how digital infrastructures emerge and in turn affect innovation outcomes (see: Yoo et al, 2010;.…”

“…The goal was to eventually have a design which was robust and could operate within Malawi, with aligned external dependencies. In this study we discover two EJISDC (2014) 63, 3,[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] The Electronic Journal of Information Systems in Developing Countries www.ejisdc.org 11 categories of articulation work, technological and human. Technological articulation pertains to technical work that is done to ensure the work of mobile data entry gets back on track.…”

“…This paper is a revision of an earlier paper (Matavire and Manda, 2013) submitted to the 12 th IFIP 9.4 conference, held in Ocho Rios, Jamaica in May 2013.…”

“…Breakdowns can be localised, such as those within the Ministry of Health, or manifest in cross-organisational relations. The latter is evidenced in how breakdowns within our mobile EJISDC (2014) 63, 3,[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] The Electronic Journal of Information Systems in Developing Countries www.ejisdc.org 14 service provider, with regard to addressing issues impacted the pilots, showing the boundaries of articulation. The varied nature and extent of breakdowns has an implication on the type of articulation work required to resolve them.…”

Impact of odour-baited mosquito traps for malaria control : design and evaluation of a trial using solar-powered mosquito trapping systems in western Kenya

“…Not only time could be saved, costs could also be decreased considerably and data quality increased. Another study in Malawi investigated how the use of computer technology and software could best be organized to create a feasible system of health data collection and management (Matavire & Manda, 2014). A governmental initiative in Kenya in 2006 marked a first step towards a digitalized health management (Odhiambo-Otieno, 2005).…”