ICTworks

I’ve been working or interested in the space of ICT for Development (ICT4D) for about a decade now. During this time, I’ve seen a lot of exciting changes, but nothing has been exciting or frankly paradigm shifting as the wide spread growth of GSM (Global System for Mobile Communications) networks and emergence of applications that leverage the now ubiquitous mobile phone to deliver services by leveraging their ability to deliver and collect data.

Achieving limited scale, chasing sustainability

Richard Heeks of the University of Manchester, and one of the premiere scholars in the ICT4D space, describes this shift aptly as a transition from ICT4D 1.0 to 2.0. According to Heeks, the field of ICT4D emerged really as an artifact of the telecenter model which was used successfully to extend basic ICT services at the periphery in North America and Europe.

Starting in the mid-1990s, telecenters provided a relatively quick and measurable way (# computers bought, # people trained) to show change in access (digital divide) and capacity building (Microsoft UP). Telecenters helped “prime the pump” in areas of ICT access market-failure.

They were also costly in that they pushed earlier and arguably more successful forms of ICT4D like community radio to the periphery, in an attempt to overcome the basic untenable economics of a rural telecenter, namely:

The field became fixated on achieving two holy-grails, requisite in every proposal, but nearly always unattainable: sustainability and scalability. User fees – necessary if you ever wished to achieve sustainability – were always a struggle, as they often shut the desired audience out.

At Geekcorps Mali, our approach was: through great engineering feats attempt to somehow lower the costs of access, while hopefully creating sustainable “business models” in the process. This resulted in us creating a “sneaker-net” approach to providing basic asynchronous ICT services to rural villages: a complete offline Wikipedia that fit on a CD-ROM, and severely restricted bandwidth throttling to allow community radios to access the Internet (via prepaid RBGAN) for $2-3 a day.

While clever, our solutions could simply not overcome the maddening math nor achieve the requisite access levels to scale. Luckily, we, like all successful groups in the field, excelled at anecdotal evaluation. We knew that what we were doing was so hard, no one could produce consistently better results (that would make us look bad). Anecdotal evidence was not only accepted but encouraged by donors – it was the only way we could make them look good!

At the Millennium Villages Project, with the help of groups like Inveneo, we’ve been able to take advantage of the advent of low cost and low power computers, long range wifi-networks and, increasingly, GSM-based data to deliver ICT services in a much more affordable way. Sustainability is still a real challenge, but the cost to value ratio of a school computer lab is shrinking to the point where you are starting to see governments and local communities invest more on their own to promote ICT access.

The revolution that has allowed ICT services to transition to a point of real uptake and impact – or as Heeks describes, from a tool of development to a “platform for development” – is the mobile phone.

Realizing Potential

Mobile phones have made the uptake of ICT services achievable because they have become incredibly available. Mobile phones have gotten to a price point where even the most poor can afford them — and GSM networks, financed a dollar at a time through prepaid scratch cards, are increasingly ubiquitous.

Voice remains the killer app. The ability to communicate freely connects families, strengthens social networks, reduces travel, overcomes illiteracy and provides safety. With voice, many solutions for issues like the “market price” problem can be human engineered, as that information is now only a phone call away to a trusted source in a bigger market.

Access to voice has already had a transformative effect for much of the world’s poor and will only increase as the price of making a call decreases through price-wars and increased operator competition – something we’re already starting to see play out in south-east Asia.

Mobile phone based applications and service

Mobile phones themselves are increasingly being used as a platform on top of which applications using SMS or EDGE/3G are being used to collect data and facilitate service delivery. More recently, I’ve been actively involved in the rapidly growing field of mHealth, where we focus the use of this platform on improving health.

For now, my colleagues and I, along with groups like UNICEF and FrontlineSMS, have focused on applications in health that make clever use of SMS. This allows us to leverage basic phones that are already in most people’s pockets and work in environments where there is still no GSM data connectivity.

I’ve been part of two particular SMS health projects that have convinced me of the viability of this approach.

About a year ago in Kenya, we launched ChildCount+, which helps community health care workers register children under-5 and pregnant mothers in their communities and facilitates monitoring their health. Within three months of use, the CHW team was able to register 95% of the 10,000 children in their cluster and have been using the system to log over 30,000 routine nutrition screenings, detect approximately 3,000 cases of malaria and identify over 500 cases of acute malnutrition.

In Uganda, we worked with the ministry of health to convert the form, used for clinic based weekly disease reporting, to one that can be SMSed in. In the 180 clinics spanning two districts where the system has been tested, we’ve been getting roughly a 90% reporting rate. This has allowed the ministry not only to get an accurate view of levels of malaria, but also see where key drugs are out of stock.

In ICT4D, where the direct beneficiaries were usually counted in the hundreds. The speed of uptake of these services and their seemingly replicable scale is really exciting and representative that real change is at hand. Reduced SMS cost and an increased shift to data should hopefully help to improve the viability of these services in the future.

A limiting factor, to scale up, will remain the local technical capacity to support and “own” these systems over time. To achieve this, it’s important first to ramp up efforts to strengthen university computer science departments. Second, it’s important to provide space for young programmers to hone their skills, develop their ideas and establish the relationships that will form the identify of a tech community.

It’s exciting to see that innovation labs like the iHub in Nairobi, Hive in Kampala and Limbe Labs in Cameroon are starting to emerge to address this need.

Please keep in mind

Technology makes it increasingly easy to be removed from the field and practice “armchair development”. We also need to remember we are only creating tools for people to use to help create solutions to their problems.

Fields like mHealth also suffers from “technocentricity”. Technologists and not health experts are still seen as primarily driving the field. The fact that I’m a respected figure in the mHealth community is testament to this.

Finally, there is a growing of m-hype which we should be aware and cautious of. The potential for mobile services, however, is undeniable and we will ultimately figure out the right mix. The good news is that the math is finally starting to add up.

This article was originally published on NTEN as The Math Is Starting to Add Up: The Promise of Mobile