Grafting: Balancing Control and Cultivation in Information Infrastructure Innovation

This paper proposes grafting as a new perspective on information infrastructure (II) innovation. We introduce the organic notion of grafting to help explore innovation processes in settings where control is distributed and episodic. Our case study follows the implementation of mobile phone-based reporting of routine data from sub-district health facilities in Malawi. Initial grafting work entails the careful alignment of available resources, capacities, and interests through the proposition of an information system (IS) innovation (e.g., mobile phone-based reporting). The nurturing of the implementation involves collaborative efforts spanning technological, professional, geographical, and organizational boundaries. This work is taken forward by the identification of opportunities for merging an innovation with existing socio-technical arrangements (e.g., health management information systems in Malawi) in such a way that the parts continue to grow

A Post-development Perspective on mHealth -- An Implementation Initiative in Malawi

While the sheer number of mHealth implementations around the world have been increasing dramatically, authoritative voices on global health have tried to put the focus on quantifiable evaluations and comparisons of these projects (e.g. health outcomes, cost savings, efficiency) in order to channel donor funds and investments into proven and scalable solutions. Drawing on empirical data from an mHealth implementation in Malawi we argue that quantitative evaluation of health interventions often assumes a top-down and limited view on the developmental impact of mHealth. Through our action-research involvement with facility-based reporting of routine health data through mobile phones, we conclude that developmental impacts of mHealth are local and each locale experience a different developmental impact depending on the context of use and available resources. The paper contrasts global concerns for quantifiable development with local priorities with respect to mHealth projects and information system (IS) interventions in health more broadly

A Post-development Perspective on mHealth -- An Implementation Initiative in Malawi

While the sheer number of mHealth implementations around the world have been increasing dramatically, authoritative voices on global health have tried to put the focus on quantifiable evaluations and comparisons of these projects (e.g. health outcomes, cost savings, efficiency) in order to channel donor funds and investments into proven and scalable solutions. Drawing on empirical data from an mHealth implementation in Malawi we argue that quantitative evaluation of health interventions often assumes a top-down and limited view on the developmental impact of mHealth. Through our action-research involvement with facility-based reporting of routine health data through mobile phones, we conclude that developmental impacts of mHealth are local and each locale experience a different developmental impact depending on the context of use and available resources. The paper contrasts global concerns for quantifiable development with local priorities with respect to mHealth projects and information system (IS) interventions in health more broadly