An actor-network approach to understanding the Implementation of mobile phone-based innovations in less developed countries

This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University LondonThis thesis aims to assess the usefulness of actor-network theory (Latour, 2005) in understanding the process of implementing mobile phone-based innovations within the broader government–led public sector in less developed countries. An examination of the literature on implementations of innovations involving mobile-phones suggests that previous studies have either focused on the social elements or the physical elements in isolation and have failed to consider how one influences the other. It is proposed that actor-network theory may be able to provide an alternative ontological perspective that bridges this social physical divide and allows the influence of the relationships between the human and the non-human elements to be taken into consideration. In order to assess this, the thesis utilises a single case study from its inception, through development, to its eventual end. The case in question, is the implementation of a mobile phone- based information system known as MADEX. This effort, is a nation-wide project made by the federal government of Nigeria to deploy this innovation within the government-led public health sector. MADEX was designed to support a nation-wide scheme known as the Midwives Service Scheme (MSS); a public sector initiative that was set up to address the United Nations Millennium Development Goals (MDG) relating to mother and child health. The main objective of MADEX in its initial stages was to enable the routine reporting of maternal health information from primary health facilities across the country up to the national level (NPHCDA) where this information is required by public health administrators for action - that is regular and timely monitoring of key maternal and child health indicators as well as strategic planning and the setting of priorities. The expectation was that, MADEX will bring about increased information accessibility for monitoring and planning, ensure global transparency and accountability in the area of maternal and child health statistics and promote m-health activities. An interpretive approach using qualitative methods was adopted in this research to obtain and analyse the data acquired through interviews. These interview, were conducted with a total of about 75 participant from across the various levels of the public health system. Whilst initially these events are narrated using a traditional chronological format, the use of such a format hides the complex nature of the relationships that enable the case under study. Actor-network theory therefore provides a means of exposing some of this complexity and as a result can be regarded as a useful methodology for understanding mobile phone innovations deployed in the public sector of LDCs. In addition, the thesis shows that the actor-network perspective allows the process of implementing mobile-phone innovations, to be considered in a manner that demonstrates the complex interdependent relationships between the physical and the social dimensions as well as the impact of non-humans in shaping this process