Translation of Digitally Enabled Health Initiatives for Human Development

Abstract

Access to digital technologies alone is insufficient to achieve desired improvements in low- and middle-income countries (LMICs). Historically, efforts have focused on exporting solutions from Western settings to LMICs, with limited attention to local social, economic, political, and infrastructural contexts. Such approaches result in failure to achieve expected development outcomes, frustrating local users and posing a high risk for short-lived initiatives. Moreover, they remain inadequate for realising global aspirations for human development as envisioned by the United Nations. This thesis reimagines current approaches to digital development by proposing a translational approach that offers a promising path for the design and local embedding of digitally enabled health initiatives. Chapter 2 provides a conceptual review of human development, leading to a conceptual leap that emphasises translating Information System (IS) artifacts and associated knowledge to better support aspirations for human development. In Chapter 3, a four-phase research design is developed to guide the translation-focused design of digitally enabled health initiatives. Locally anticipated outcomes in Ecuador and Papua New Guinea inform the future design of a virtual care system for their contexts through translation. Chapter 4 investigates how translation facilitates the local embedding of a digitally enabled health initiative in Sub-Saharan Africa. How actors translate IS artifacts and associated knowledge to enhance their relevance within local practices, norms, and cultures is examined. This thesis makes five key contributions: it offers a reimagined approach for digital development research; broadens the understanding of what translation entails in digital development; contextualises and extends the lens of the IS artifact; makes a methodological contribution through a translation-focused research design; and identifies interrelated outcomes of virtual care in remote settings.