Midwives with mobiles: A dialectical perspective on gender arising from technology introduction in rural Indonesia

Abstract

Mobile phones were introduced to rural midwives in tsunami-affected Indonesia, allowing them to contact medical experts and communicate with patients. Ninety-two interviews were conducted with midwives, coordinators, doctors, and village representatives. This study applies a dialectical perspective to supplement the analytical frame of the ICT for healthcare development model , by addressing the multidimensionality of benefits and barriers. The theory of dialectical tension (Baxter and Montgomery, 1996) situates the conceptual discussion around the struggles between autonomy and subordination within gender roles, personal growth versus technological competency, and issues of economic and resource control in traditional hierarchies. We find that midwives engage in legitimization strategies, develop peer support, and focus on strategic issues to develop the capacity for agency and autonomy, despite socio-organizational barriers. Specific recommendations are offered, focusing on the resourcefulness and desire of women.

Migrant mothering and mobile phones: Negotiations of transnational identity

“…The tensions of the dialectic ensure that women, through continuous reinvention and renegotiation, arrive at a position entirely novel to the one from which they begin the journey (Townsend, 1999). We agree with Madianou's (2012) observation that ICTs play a key role in the negotiation of the "accentuated ambivalence" (p. 292), but simultaneously point to the role of ICTs in creating an emergent gender consciousness (Chib & Chen, 2011;Foss & Foss, 2009), with the evolution of the multifaceted personality that encompasses various aspects of empowerment of the woman.…”

Mobile Communication

“…Mobile-based medicine (or m-health) allows local health care givers, who are in many cases women (Chib and Hsueh-Hua Chen, 2011), to get advice from more central health care providers and it also can streamline reporting in health information systems. Rather than relying on cumbersome paper-based systems that needs manual aggregation, mobile handsets allow the development of broad-scale health reporting systems (Asangansi and Braa, 2010).…”

The Use of Mobile Phones in Rural Javanese Villages: Knowledge Production and Information Exchange Among Poor Women with Diabetes

“…Instead, messages flow from SMS to discussion during arisan and pengajian, to health information sessions during the posyandu meeting. Texting creates a self-empowerment process that helps these women develop a strategy to maintain their multiple roles and sense of self-reliance (Chib & Chen, 2011) while dealing with hardships at the same time. Using common language, these women access the information they need and negotiate it with mantri-their main health supporter-and with other diabetics.…”

“…The rapid growth of mobile telephony is often held to create an opportunity for the emergence of mHealth-the use of mobile communication devices for health services and information, in improving the access and quality of health services, and overall health outcomes in many parts of the world, including facilitating diabetes self-management (Chib, 2010;Chib & Chen, 2011;Chigona, Nyemba-Mudenda, & Metfula, 2013;Kratzke, Wilson, & Vilchis, 2013;Klasnja & Pratt, 2012;Kreps & Neuhaser, 2010;Soegijoko, 2009). In Indonesia, mHealth designers have produced apps such as Dokter Diabetes and Xanesha Diabetic Analytic Console to encourage individuals with diabetes to self-manage their illness.…”