Health in Africa : Mobile phone is the cure ? - Al Dahdah, Marine
In 2014, almost seven billion people were mobile phone users, thus propelling mobile phone ahead of all Information and communication technologies (ICT). Whether it be Mobile Personal Health Record or confidential clinical data send via SMS, those devices are increasingly used to provide “better" health services in a context of reduced health expenditure and of increased involvement of patients. Substantial research has been conducted on eHealth – health on the Internet - in recent years, mainly regarding the nature and the value of health information on the web (S. Adams et Berg 2004; Eysenbach et al. 2002), the redefinition of the roles of lay and expert in health, the subsequent transformation of the patient-caregiver relationship (Akrich et Méadel 2010; Henwood et al. 2003; Wyatt 2005). Yet, very little research has been conducted on the use of mobile phone and wireless technology within health programs, called "mHealth" or mobile health, and especially in the global South, or in development contexts. However, the impact of mobile technologies on health care in such contexts raises critical questions that become particularly acute in the context of increased access to mobile phones in Africa. This new wave of mobile technology applied to health thus raises complex issues in terms of economic organization, governance, and control. Especially when millions of dollars are being invested in mHealth projects in developing countries where poor health systems are failing to meet the needs of the population and where the lack of legal framework may leave the door open to experiments (Petryna 2009; Rottenburg 2009; Geissler, Rottenburg, et Zenker 2012). It calls for anthropological and geopolitical questioning on the implementation in developing countries of projects that are sometimes entirely designed and funded by developed countries, programs within which the types of collaboration of developing countries, that is more or less voluntary, more or less committed, deserve to be further studied. These mobile technologies point out important issues in terms of data safety, confidentiality and "privacy" in the context of collection and analysis of health data that is “globalized”(mHealth Alliance et al. 2013; Rodrigues et al. 2001; Patrick et al. 2008). They also highlight the dynamics of how foreign ethical and financial practices adapt – or not - to local economic and political contexts, customs and traditions, health organizations and health professionals. Furthermore, mHealth participates to the economic and technological reconfigurations of Global health (V. Adams, Novotny, et Leslie 2008; Biehl et Petryna 2013; Atlani-Duault et Vidal 2013; Brown, Cueto, et Fee 2006; Fassin 2012). It raises major issues at the intersection of research on ICT, Anthropology of health and STS studies. The recent multiplication of mHealth worldwide illustrates the overall trend towards the globalization and technologization of biomedicine. The widespread idea that digital technologies improve the quality of care, reduce health disparities and optimize health systems takes shape in a diverse set of technical devices : mHealth, telemedicine, big data, etc. This communication offers an overview of this new field of mHealth and the various ways it contributes to the emergence of new global healthcare spaces and trends. It also aims to explore how mobile connectivity gives rise to new forms of power, of control and friction (Tsing 2005) through the study of a particular maternal mHealth project, we’ve conducted in Ghana. Finally, we propose to focus more specifically on the perceptions of the end-users - health professionals and pregnant women- of this technology as an expression of its effects.
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Keywords: conferencePaper