Intervention Breakdowns as Occasions for Articulating Mobile Health Information Infrastructures

Abstract

AbstractThis study investigates a mobile health project launched in Malawi and considers its sustainability in light of activities that occur in the pilot stage. It has been said that most projects of this nature fail during piloting hence it is pertinent to review the activities in this early stage. The study follows a grounded theory inspired research approach and is focused on the day to day breakdowns that occur in the pilot, what they reveal, and how the resolutions relate to the project's goals. It is found that when breakdowns occur, an articulation process to sustain the intervention becomes visible. Breakdowns can reveal tensions in the technical design and organisational context thereby offering opportunities for action in order that an intervention is sustained. The ensuing activity, for analytical purposes, is termed articulation work, and its variety and limitations are explained. In this study we discover two categories of articulation work, technological and human. Further to this, we argue that these two categories of articulation work can be further analysed into different dimensions, based on the levels of organizational involvement required to resolve them: (i) localised; (ii) multiple levels within a single organization; (iii) and multiple levels inter‐organizational.