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Akros in India: Perspectives on ICT4D

`Brian O'Donnell June 20, 2017
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What do you feel when the Star Wars end credits roll? If you’re like me, it’s an abrupt mental shift from awestruck fantasy back to real life, a reminder the movie only got made when thousands of real people collaborated towards a singular vision. If you’re nerdy enough to dive into “behind the scenes” extras, all the grunt work needed to make a blockbuster franchise looks… well… less exciting. Of course, once you discover how a film was made, you begin to appreciate its artistry on a whole other level.

I had the same feeling as I absorbed two weeks of conferencing in India with digital development and global health practitioners from around the world on behalf of Akros. At the Information and Communication Technology for Development (ICT4D) conference in Hyderabad, we joined global experts to share our practical experiences in applying new technologies across a wide spectrum of development and humanitarian programs. Akros also participated in the Health Data Collaborative’s community health experts’ consultation in Goa, The workshop convened academics, government officials, and implementers from eight countries to craft technical guidelines on digitizing mobile health data from community health workers, the volunteers who deliver critical services in the most remote regions of Africa and Asia.

From theorizing on the broad meaning of the “Data Revolution” down to nitty-gritty tech requirements of community information systems, the overarching theme of both events was mainstreaming technology into day-to-day operations of development programs. That means moving past the futuristic “gee wiz” stage of exploring what’s possible with ICT4D, towards setting practical expectations and realistic national strategies. This is very familiar territory for us at Akros, where we have a developed for applying practical informatics systems for a variety of complex development challenges, ranging from malaria prevention to education management.

Some of the tips shared at the ICT4D Conference might seem obvious in theory, but can be surprisingly rare in practice, especially in public health. For example, before you start an new system to collect community level health data, you ought to know what kind of data already exist, and ask real people how these data are used. This tactic was exemplified by Cooper/Smith, which presented a robust landscape analysis of HIV data in Malawi under the Kuunika – Data for Action! project. Their focus groups with stakeholders found over 3,527 unique data elements across five systems, informing 335 unique decisions. Detailed assessments like these will not only increase the use of routine health data for decision-making, but might catalyze new innovations to send data where its most needed. Ona presented on the tablet-based mSpray tool, deployed by Akros in Zambia, which gives managers of Indoor Residual Spray teams the localized geographic information they need to manage local spray operations. Mangologic and e-Registries also presented on two adaptive tools for health professionals to bridge individual-level patient records with population-level health management systems— two solutions which only arose from assessing what tools already exist, and finding their design inappropriate for the complex user needs.

Since the data requirements are often so complex and locally-specific, numerous actors have emerged to meet these needs at a local level, and the conference was a great outlet to share their diverse technical implementation experiences. For example, I did not know that public charging stations lead to lower battery life and phone theft, but WorldVision in Uganda highlighted this as a challenge for their mHealth programs. JSI offered reasons for the successes of the logistics management information systems in Zambia, as well as the more mixed results of a mobile app to support community health nurses in Ghana.

Such competition is healthy for the sector, but can often lead to system fragmentation, and unsustainable pilots that cannot achieve meaningful scale. Luckily, groups are already meeting the technical challenge of learning to evaluate different scaling strategies. Digital Impact Alliance is teaming up with technology and research partners to develop evidence-based guidelines for scaling “digital development” interventions. Meanwhile, multiple plenary panels discussed the minutiae of data security and privacy policies required to scale large data collection systems in developing country contexts.

The larger challenge is getting all these competing actors to cooperate through partnerships and policies that make the marketplace for ICT4D more sustainable in the long term. Consider the consultancy firm Dalberg, which has led numerous “big data” research projects to transform cell phone data into insights for urban planners in Africa. But for developing economies, data science research is often too expensive to maintain. Now these consultants are seeking to strengthen regulation, policies, and above all, partnerships that promote a global marketplace of “big data for development” services. Some of the most successful partnerships in ICT4D link surprisingly dissimilar groups, as when the Kenyan tech NGO Ushahidi collaborated with Indonesian government officials and a local street art group to ignite community participation in mapping over 50,000 buildings across the city of Semang, Indonesia.

In health information systems, and in the Millennium Falcon, “dynamic dashboards” transform real time data to show a path forward.

Cross-cutting partnerships, appropriate technology, and technical implementation at scale: my presentations at ICT4D and the Health Data Collaborative workshop explored each idea through the lens of Akros’s unique method for scaling a Community Led Total Sanitation monitoring system in Zambia. Through partnership with the Ministry of Local Government and Housing as well as UNICEF, SNV and Plan, Akros is transitioning a massive database, covering over of 40,000 villages and 3,000 users, to full government ownership. This has required working closely with our partners to provide technical assistance on database maintenance, and to train data gatherers from the community. We are now working with a global network of partners to translate our collective experiences into practical guidelines on establishing sustainable routine information systems for community health.

ICT4D is a big tent, enveloping many perspectives from health, agriculture, finance, education, and other sectors. But considered together, these personal experiences compose a community of practice which is drastically transforming the concept of “development” as we know it. While this community matures, appropriate use of digital technology will become a standard expectation—not a flashy novelty—in all development programs. We can only hope that in the future, ICT4D will be much more boring than it is today.


About Brian O’Donnell

Brian O’Donnell is an Informatics Project Manager for Akros, where he was a 2015/2016 Global Health Corps fellow. Prior to joining Akros, Brian was a project lead at AidData. He holds a Master of Public Affairs from The University of Texas at Austin, and a BA in Government from the College of William & Mary.


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