The effects of the Introduction of Information and Communication Technologies on interaction dynamics between citizens, service providers and rulers in precarious health care settings: insights from an mHealth pilot experiment in rural Guatemala

Abstract : Information and Communication Technologies (ICTs) have ubiquitous influence on health systems. From smartphone applications and web services to wearable devices and the Internet of Things, innovations are eagerly adopted by patients, clinicians, health centers and governments worldwide. Although their effects on health outcomes, quality and costs have been previously studied, little effort has been made to describe their implications on interactions between individuals. The assessment of their impact is particularly difficult in low-resource health settings, where fundamental dynamics have been disregarded by theoretical studies. This thesis was constructed as an attempt to reduce gaps in the literature about the effects of the introduction of ICTs in low-resource health settings. In the first part, it draws on empirical and theoretical insights from health economics, behavioral science and public administration to consolidate a unified framework. Its formulation allows to derive empirically testable hypotheses regarding health outcomes, co-production of services and actor interactions when mobile technology is introduced. In the second part, it presents the methodology used to generate unique data and to test some of the model's predictions. Principal discussions and conclusions focus on the impact evaluation of a mobile-health pilot experiment that was run in rural Guatemala in the context of newborn and maternal care. The novelty of the thesis lies in the proposed theoretical framework and in the adopted experimental strategy. Results from the pilot experiment highlight the interest of a peculiar organizational setup —virtual communities of indigenous mothers exposed to social support, expert advice and timely medical response via text-message— for precarious health care contexts. Discussions, albeit limited in scope by the exploratory nature of the intervention, shed new light on the impact of ICT-based heath programs in poor contexts. Collaborative governance between citizens, service providers, governments and research entities seems appropriate when sustainable changes in health systems are needed. Analyses are of timely relevance for countries looking to scale-up interventions with potential to induce healthy attitudes in underserved areas.
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Contributor : José Tomás Prieto <>
Submitted on : Thursday, August 6, 2015 - 4:07:48 PM
Last modification on : Wednesday, January 23, 2019 - 10:29:31 AM

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  • HAL Id : tel-01182544, version 2

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José Tomás Prieto. The effects of the Introduction of Information and Communication Technologies on interaction dynamics between citizens, service providers and rulers in precarious health care settings: insights from an mHealth pilot experiment in rural Guatemala. Humanities and Social Sciences. Ecole polytechnique, 2015. English. ⟨tel-01182544⟩

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