Duchesne Véronique / Université Paris Descartes

Cell phone and medical assisted reproduction in African transnational families

A partir d’une enquête de terrain, menée entre 2011 et 2013, par observation participante et entretiens, auprès d’un réseau de professionnels de l’assistance médicale à la procréation (AMP) en Île-de-France et de leurs patientes et de leurs patients nés en Afrique, je présenterai comment de nouveaux modes de surveillance et de contrôle sont apparus avec le téléphone portable. Parce qu’elle s’immisce dans les relations sociales quotidiennes, la téléphonie mobile permet tout à la fois l’extension du pouvoir biomédical sur les corps reproducteurs féminins et l’extension de la contrainte sociale et familiale normative en matière de vie procréative. Là où l’auteur de “Surveiller et punir” insistait sur une certaine atténuation de la surveillance, on constate au contraire un développement de techniques plus précises et plus invasives avec des pouvoirs qui gouvernent à la fois des corps et des conduites. Je montrerai comment la téléphonie mobile participe à la biomédicalisation des corps reproducteurs féminins et comment, dans le même temps, cette (nouvelle) technologie de la communication agit sur la façon d’exercer la médecine de la reproduction. Sera ensuite développé le pouvoir exercé via le téléphone portable par la famille transnationale à l’encontre de ses membres ayant recours à l’AMP.

Schräpel Norman / Department for Anthropology and Philosophy, University of Halle

Counting bodies. Digital data infrastructures and the standardization of medical practice in Rwanda

Medical care in Africa is characterized by massive lacks in infrastructures, including the insufficient quantity of health personnel or the unreliable supply of drugs and equipment. This often leads to poor outcomes of care and consequently health issues become major burdens for whole societies. Biomedicine in turn has become a complex apparatus, depending on sophisticated technologies and expert knowledge. During the last years the government of Rwanda invested enormously in the instalment of new medical data infrastructures to address these challenges. New (and older) technologies are supposed to promote efficiency, accuracy and accountability within Rwanda’s health system and improve the quality of care. A continuing global emphasis on medical information systems for the ‘rationalization’ of health care is commencing to shift the institutional arrangements of global health. In the paper I trace these changes, by introducing an ethnographic case study on community health workers in Rwanda. I show how digital technologies translate the therapeutic and diagnostic work of these ‘lay experts’ into simple data collection activities and investiagte the various contradictions that emerge when the medical gaze becomes a numerical gaze.

Al Dahdah Marine / CEPED, Université Paris Descartes, IRD-Ined

Health in Africa : mobile phone is the cure

In 2014, seven billion people were mobile phone users, thus propelling mobile phone ahead of all ICTs. Whether it be Mobile Health Record or SMS reminders, those devices are increasingly used to provide “better” health services in a context of reduced health expenditure. Yet, very little research has been conducted on “mHealth”, and especially in the global South. However, the impact of mobile technologies on health care in such contexts raises critical questions, especially when millions of dollars are being invested in mHealth in Africa where poor health systems are failing to meet the needs of the population and where the lack of legal framework may leave the door open to experiments. It calls for anthropological questioning on the implementation in developing countries of projects that are sometimes entirely designed and funded by developed countries. It raises important issues in terms of data safety in the context of “globalized” collection of data. It also highlights the dynamics of how foreign practices adapt to local economic, sanitary and political contexts. This communication offers an overview of this new field and the various ways it contributes to new global healthcare trends. It also aims to explore how mobile connectivity gives rise to new forms of power and friction through the study of a particular mHealth project, we’ve conducted in Ghana. Finally, we propose to focus on the perceptions of the end-users of this technology as an expression of its effects.

Dale Penfold Erica / South African Institute of International Affairs, Stellenbosch University

Regional Health Governance: A Suggested Agenda for Southern African Health Diplomacy and Social Protection

The rise of regional organisations in global health diplomacy marks a significant shift in health governance, highlighting the importance of including regional policy makers to address health challenges. Digital health technology is also on the global increase. However, there is limited evidence to suggest that there is regional support for information and communication technologies for health in Southern Africa. Adopting digital technology to support healthcare systems in developing countries will create greater access to healthcare and medicines, particularly in poor communities.
This paper identifies the role of SADC in South-South health diplomacy and argues that SADC has the potential to play more of a role in facilitating health policy and access to healthcare and medicines in the region. It further argues that SADC needs to play an active role in ensuring support for digital technology to support access to healthcare and medicines. The paper first explains the concepts and identifies the role of global health diplomacy and niche diplomacy in determining health governance. The role of SADC as a regional organisation and how it functions is then explained, focusing on how SADC engages with health. Recommendations are made to further our argument as to how SADC can step up as a regional organisation to implement South-South management of the regional health diplomacy agenda and how SADC can work to ensure a digital health agenda for the region in the future.

Nyakinye Tobias / Jaramogi Oginga Odinga University of Science and Technology

Technology and status of telemedicine and ehealth strategies in the global south: emerging trends.

The 58th World Assembly adopted, in the month of May 2005, Resolution WHA58.28 which established and eHealth strategy for the WHO. This recognition of ICTs as a positive contributor to the wellbeing of people’s health has been determined as an integral step in meeting the UN Millennium Development Goals (MDGs) by the international community. The ICTs like mobile phones and computers have contributed and continue to contribute to the development of both clinical and public health systems in the global South and especially Sub-Saharan Africa. Mobile phones and Internet technologies are the fastest spreading phenomena in Africa today. These ICT tools, in their remarkable simplicity of use, have dramatically changed how societies and hospitals in particular interact with their clientele and the global community at large and their promise to the health care needs of local communities are even more remarkable. Lack of interoperable health systems and consensus on data standards is one of the major barriers to the use of health information. Mobile phone use has seen tremendous growth across the developing world offering opportunities to engage e-Health applications. This paper looks at the status of e-Health in the global South (and especially in Kenya ) then further explores the efforts the Kenyan governments have put in place to create a conducive environment for e-Health.