Can technology boost development? E-Governance in India

LSE’s Dr Shirin Madon discusses the shortcomings of India’s e-governance initiatives, which she argues privilege data collection over data analysis and cultural contextualisation

Can village committees improve primary healthcare accountability in India?

LSE’s Shirin Madon argues that healthcare accountability in India does not draw enough on health workers’ capabilities to respond to local conditions and needs, and asks whether new democratic spaces can address the problem

Socio-ecological dynamics and challenges to the governance of Neglected Tropical Disease control

The current global attempts to control the so-called “Neglected Tropical Diseases (NTDs)” have the potential to significantly reduce the morbidity suffered by some of the world’s poorest communities. However, the governance of these control programmes is driven by a managerial rationality that assumes predictability of proposed interventions, and which thus primarily seeks to improve the cost-effectiveness of implementation by measuring performance in terms of pre-determined outputs. Here, we argue that this approach has reinforced the narrow normal-science model for controlling parasitic diseases, and in doing so fails to address the complex dynamics, uncertainty and socio-ecological context-specificity that invariably underlie parasite transmission. We suggest that a new governance approach is required that draws on a combination of non-equilibrium thinking about the operation of complex, adaptive, systems from the natural sciences and constructivist social science perspectives that view the accumulation of scientific knowledge as contingent on historical interests and norms, if more effective control approaches sufficiently sensitive to local disease contexts are to be devised, applied and managed. At the core of this approach is an emphasis on the need for a process that assists with the inclusion of diverse perspectives, social learning and deliberation, and a reflexive approach to addressing system complexity and incertitude, while balancing this flexibility with stability-focused structures. We derive and discuss a possible governance framework and outline an organizational structure that could be used to effectively deal with the complexity of accomplishing global NTD control. We also point to examples of complexity-based management structures that have been used in parasite control previously, which could serve as practical templates for developing similar governance structures to better manage global NTD control. Our results hold important wider implications for global health policy aiming to effectively control and eradicate parasitic diseases across the world

Digital identity as a platform for improving refugee management

Digital platforms are restructuring how many companies and industries function, including humanitarian organisations that operate in complex environments and serve vulnerable populations. To date, however, there has been limited study of their use in humanitarian and particularly refugee contexts. This paper seeks to address this gap by drawing on the concept of platformisation to study the opportunities and challenges arising from UNHCR’s transition from a closed transactional system to an open innovation platform focusing on core processes of identification, value creation and platform governance that are relevant for refugee management and protection. Our empirical study captures the perspectives of the UNHCR, organisational stakeholders and refugees in the world’s largest refugee camp in Northern Uganda with regards to UNHCR’s strategy towards platform openness. We find that UNHCR’s data transformation strategy introduces the potential for increasing institutional value in the form of more effective service delivery to refugees. However, these technological opportunities do not necessarily translate to greater value if they do not mesh with current work practices, incentives and activities of service provider organisations and refugees. Our study helps identify opportunities to address these constraints, primarily through improving understanding of the emergent governance-related tensions that exist for digital platforms for development and surfacing existing issues of exclusion and vulnerability. We conclude with insights for the broader theorisation of identification platforms and with recommendations for policies and practices that together might help realise the potential value creation introduced through the platformisation of identification systems

Covid-19: how are new uses of technology transforming healthcare?

Research is desperately needed on what works and how to embed digital tools in existing systems and processes, write Ela Klecun and Shirin Mado

Theorizing community health governance for strengthening primary healthcare in LMICs

In recent years, community health governance structures have been established in many low and middle-income countries (LMICs) as part of decentralization policies aimed at strengthening primary healthcare systems. So far, most studies on these local structures either focus on measuring their impact on health outcome or on identifying the factors that affect their performance. In this paper we offer an alternative contribution that draws on a sociological interpretation of community health governance to improve understanding of how the government’s policy vision and instrumentation translate to interactions that take place within local spaces at field level. We study 13 Village Health Sanitation and Nutrition Committees (VHSNCs) in Karnataka, India, from 2016 to 2018 focusing on sanitation, nutrition and hygiene which remain impediments to improving primary healthcare amongst poor and marginalized communities. Three local governance mechanisms of horizontal coordination, demand for accountability and self-help help to explain improvements that have taken place at village level and contribute to the creation of a new theory of community health governance as evolving phenomenon that requires a constant process of learning from the field to strengthen policymaking

Challenges of accountability in resource-poor contexts: lessons about invited spaces from Karnataka’s village health committees

Invited spaces have been discussed by development scholars and policymakers as a new and important means of promoting accountability in primary healthcare. Although numerous experiments have been initiated to establish such spaces in resource-poor contexts, we still have little understanding of how these spaces are used and their effectiveness. Based on our longitudinal study of the Village Health Sanitation and Nutrition Committees (VHSNCs) in Karnataka, we trace changes that have occurred in the frequency and quality of interactions between state, political and civil society committee participants as they come to understand the possibilities afforded to them, work out tactics and develop a set of practices that make them accountable to each other for improving village health. Our findings suggest that strengthening accountability within invited spaces can form an important basis for improving the primary healthcare system with implications for research and policy

Impact sourcing in India: trends and implications

This paper focuses on impact sourcing which refers to a type of business process outsourcing activity whereby service providers elect to provide high quality, information-based services to clients by purposefully employing youth from low-income communities to carry out simple data handling tasks. Whilst this activity proliferated across countries in Africa, Asia and Latin America from 2010 providing jobs and skills to many individuals, its growth seems to have been constrained in recent years. In order to explain this phenomenon, we undertake a longitudinal study of impact sourcing based on the case of Karnataka which has been a prominent player in this sector since 2008. We commence by describing the operations of three impact sourcing enterprises in the state and locate this activity within the broader scope of state government policy focusing on two key aspects. First, we assess the adequacy of state support for rural entrepreneurs to sustain their operations for client companies, and second whether there has been sufficient policy focus on ameliorating the socio-economic context within which impact sourcing activity takes place. Finally, we reflect on important implications of our findings for further research on impact sourcing in the field of information systems and for policy prescriptions in order to create a conducive environment within which this socially-focused business activity can thrive