Digital advances would ideally offer opportunities for improved and efficient service delivery, population participation in decision making and accountability, but pose a risk of exclusion of the poor and marginalized. These are population segments who will be left behind in consultations, service delivery and economic opportunities through use of digital innovations. Such gaps are recipe for abuse and exploitation of the poor by the powerful. Relevantly, a conducive environment for successful deployment and use of technology is important. This involves appreciation of the scope of technology revolution as a transition involving optimizing social, political and economic conditions for inclusive growth in the digital age as opposed to isolated digital policies
World Health Organization, Inter-Country Support Team for Eastern & Southern Africa; Health systems and services cluster; P.O Box CY 348; Causeway, Harare, Zimbabwe
Developing Countries Urged to Take Charge of Their Digital Future
We are in an era of digital technology which is advancing at a very fast pace in developing countries. In as much as this creates opportunities for growth and better service delivery, challenges and risks are real. It is against this backdrop that the Pathways for prosperity Commission (here in referred to as the Commission) set out to investigate how developing countries can embrace advances in technology effectively. Through a research and consultative process that started as far back as January 2018, the Commission proposes rational solutions developing countries can implement in embracing digital solutions for the benefit of everyone.
Embracing opportunities accorded by advances in technology whilst guarding against risks lies the interface for wide spread adoption. Indeed, opportunities do exist in developing countries that can be leveraged. For example, 43 countries in sub Saharan Africa are implementing a Health Information System Strategy based largely on the use of ICT (Information and Communications Technology). Eight percent of people in developing countries live under a cellular internet signal although only 30% have ever used the internet. The Commission further cautions that “do not connect people to the internet just for the sake of it, people must be able to make use of it to improve livelihoods”.
There are concerns to be addressed. The use of digital solutions in developing countries today is described as suboptimal at best or chaotic at the worst. Several countries in Sub Saharan Africa have witnessed an epidemic of pilots of digital solutions to improve service delivery and monitoring that are never scaled up, and in influx of APPs with varied relevance to developing countries’ health systems. In majority of African countries, capacity for health technology assessment to guide decision making is at infancy. The Pathways for prosperity Commission further highlights the low human capital, lack of digital readiness, ineffective institutions and a difficult business environment as major challenges.
Digital advances would ideally offer opportunities for improved and efficient service delivery, population participation in decision making and accountability, but pose a risk of exclusion of the poor and marginalized. Whether developing countries can ensure reach of digital solutions to the poor and vulnerable cannot be ascertained and the Commission likens “trickle-down digitalization” to failed attempts of “trickle-down growth” to deliver inclusive development. How can developing countries purposively plan for inclusiveness? A significant proportion of the population live below the poverty line as high as 28% in Colombia; 65% in Burundi. These are populations who will be left behind in consultations, service delivery and economic opportunities through use of digital innovations. Such gaps are recipe for abuse and exploitation of the poor by the powerful.
Loss of jobs due to advances in technology is a real fear that must be handled carefully to mobilize popular support for technology development. Taking an example of Africa, mobile money banking by mobile telephone providers impacted on use of banking services which concern was real to commercial banks. In some countries this happened in a regulatory vacuum and subsequent efforts to introduce a tax on such transactions resulted in tensions between the government and the population. On a positive note however, linkages with mobile money banking and commercial banks have been forged paving a way for a fruitful coexistence.
The Commission draws our attention to the importance of a conducive environment for successful deployment and use of technology and refers to this as “getting the analogues matters right in a digital age”. This involves appreciation of the scope of technology revolution as a transition involving optimizing social, political and economic conditions for inclusive growth in the digital age as opposed to isolated digital policies. In this regard, availability of essential physical infrastructure, foundational digital systems and investment capital are among the prerequisites for wide spread adoption.
Challenges notwithstanding, the Commission asserts that developing countries should not resign to being passive observers but should take charge of their digital future. In rising to the challenge, the following are proposals to embrace:
- Creation of a digital compact involving all stakeholders to guide coordination, deployment and use of technology and improve inclusiveness and adoption of consensual options. The effective use of such a compact will be premised on strong institutions and regulatory frameworks that are enforced. An important component of such effective partnership efforts that has not received much recognition in the past is institutionalization of mechanisms to manage conflict of interest. This is crucial given the important role of the private sector in technology development who have been labeled as “for profit”.
- Technology advances must put people at the center, be it to spur economic growth, improve service delivery, participatory processes the focus must be the people as major beneficiaries. In ensuring this, training in digital use should be mainstreamed in training curriculum for all learners. Relatedly, Governments must make information relating to their programs, including budgets, publicly available.
- The private sector and government must put in place foundational digital systems which are interoperable.
- Public and private actors must make deliberate efforts to leave no one behind through embracing business models that enable the poorest to access and use digital solutions; provide incentives or regulation to encourage pro-poor innovation. Private sector needs to work towards a balance between profitability, affordability and user experience.
- The role of governments in ensuring meaningful contribution of digital solution to economic development and efficient service delivery is paramount. Particularly is addressing technical disruptions and advancing digital transformation which the commission contends that should not be left technical agencies with a narrow mandate.
- Governments need to actively purpose to embrace digital solutions. While the private sector and donors need to explore regulatory solutions designed to meet the unique needs of developing countries, governments need to explore ways to ensure effective regulation.