“If we agree that people have a right to information, it is not our place to decide what that information can and cannot be used for.” This argument was raised for a second time in the semester this week, and I’m surprised that it doesn’t come up more often. It was raised in regard to the efficacy of two automated SMS health interventions: 1) Effect of a Text Messaging Intervention on Influenza Vaccination in an Urban, Low-Income Pediatric and Adolescent Population) 2) Mixed-Method Evaluation of a Passive mHealth Sexual Information Texting Service in Uganda.
For the first case, we as a class determined that the high cost project implementation didn’t outweigh the small change in flu vaccinations: $7,000 in programming costs produced a 3-4% rate of vaccination change in a low-income urban community in New York City. The rate of change wasn’t statistically significant because “Five text messages about the importance of flu vaccinations and where to get them are not going to change the misconceptions people have about getting the vaccine,” raised by a Public Health student in class. Similarly, for the second case, just because teens have information on healthy sexual behavior, doesn’t mean that they’re going to make better decisions. In fact, teens with this service actually increased their number of sexual partners with this information. As much as we in the ICT4D sector would like to reduce our margin of error through testing and evaluating our lessons learned, there are just some factors that we cannot account for that influence people’s behavior – such as power differentials, deeply rooted fears, and prejudices.
Does this mean that we should not provide people with information that could potentially benefit their lives? Upon reflection, I would say that information dissemination is still important for several reasons. 1) Just because an authority figure tell us something is right or wrong, doesn’t mean that we have to accept it at face value. Sometimes we need to have secondary information to make a decision that is right for us. 2) Just because a service does not work for some people, doesn’t mean it will not work for all, or even just one person! This individualism argument falls in line with human development approach, where the goal is to enhance individual freedoms and capabilities. 3) If we don’t provide this information at all because of it’s potential negative side effects or failures, then we risk kicking away the ladder, denying for developing countries the very paths to development that industrialized countries used (Heeks, Ha-Joon Chang). This, to me, is the most convincing argument because developing countries have debated the effects of information since its release – think Calvinism and the Catholic Church! Our political freedom allows citizens to research, accept, or reject this information depending if it is relevant for them. Denying access to information based on protectionist policies leads to social constructivism, which produces my first reason promoting dissemination of information: necessity to question the authority or culture in which you were raised. The reason that ICT projects fail, however, is because project initiatives tend to not understand the local context and demand for information where they implement their technologies. So the technology becomes obsolete because it is supply-led rather than demand-driven.
For us in the ICT4D sector, we have the opportunity to challenge the way information has been traditionally disseminated. We can ask questions about who or where are people now turning to for information, what is the new language that people are using to ask for information, and what can we do to facilitate access to this information. These theoretical debates, which challenge our assumptions about information and technologies, are to me the most exciting part of ICT4D.