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Did you say cell phones for development? "Yes, technology can do anything, really, but people have to drive it"
Association for Progressive Communications (APC)
April 26, 2007

http://www.apc.org/english/news/index.shtml?x=5059953

MAPUTO, Mozambique -- Considering the rapidly growing presence of cell phones in the developing world, interest in their role for advancing development goals is only natural. And, considering the demographic overlap between those most affected by HIV/AIDS and cell phone users, it only makes sense that a major focus be put on how this low-cost technology can fight this deadly pandemic.

APC-member Women'sNet recently engaged in a UNICEF-driven speed assessment of fifteen projects that apply cell phones towards development objectives in Africa, with a particular focus on HIV/AIDS prevention, treatment and care.

Gender in the HIV/AIDS crisis and the digital divide

Women'sNet was asked to join the study because of the gendered nature of development issues in general, and of HIV/AIDS in particular. For biological, economic, and social reasons, women and girls are at the greatest risk of contracting the virus and consequently make up a mounting proportion of the global HIV/AIDS-infected population. Sally-Jean Shackleton of Women'sNet told APCNews that, among eighteen to twenty-four year olds in certain areas of South Africa, "one in four females among eighteen to twenty-four year olds is HIV+, compared to one in twelve males."

What is more, women face significant barriers to accessing and benefiting from information communication technologies (ICTs), and many ICT for development (ICT4D) projects and programmes fail to effectively consider the gendered nature of development issues and/or the digital divide. Women'sNet has incorporated gender concerns into its research for the rapid assessment, looking at how women and men use cell phones differently, women's levels of access, and whether gender is adequately incorporated into projects' design, implementation, and monitoring.

South Africa's use of low-cost technology

Women'sNet's research for the five-month study, which culminated at the end of April 2007, is focused on three projects in South Africa. These are:

• Fahamu's Umn Yango (meaning 'doorway' in isiZulu) project, which promotes the use of cell phones to access and report information related to violence against women, women's access to land, and HIV/AIDS in five rural villages in the province of KwaZulu Natal;
• Cell-Life's AfterCare project in Cape Town, which enables home-based care workers to use their cell phones to collect and transmit data on HIV/AIDS patients' well-being and adherence to anti-retroviral drug treatment (low levels of which contribute to mutations of the virus and drug-resistant strains);
• And, SimPill's award-winning Adherence System project, also in Cape Town, which uses a real-time management system to increase adherence to medications prescribed to treat chronic illnesses - particularly tuberculosis, which is a significant cause of death of people living with HIV.

While the projects are experiencing success in the collection and transmission of medical data and, to a lesser degree, health information management and drug adherence, most of the projects studied are having little to no impact on HIV/AIDS prevalence rates just yet. The pandemic "is complex, deep, and overwhelming, and it would take a lot more than these projects to make a dent," said Shackleton. This is especially true considering that "many projects seem to skid to a halt after being piloted."

Challenges

Shackleton identifies mismanagement as the factor that most constrains the potential of these projects. Those expected to benefit from the projects are not always consulted or otherwise engaged, funds are not always spent wisely, and there is often disconnect between beneficiaries, health professionals, technologists, and managers. For example, Shackleton explains, "health care workers who transmit data from their cell phones may not get feedback as to whether their input was useful - or received, and police officers who receive messages reporting violence against women may not be prepared to respond."

Another major constraint is crime. Although cell phones are a relatively low-cost technology, they still hold considerable value in poverty-stricken areas, and are commonly stolen. And, such theft is likely to rise as these devices adopt increasingly sophisticated functions. At the same time, however, the theft of a cell phone involves much less financial loss than that of a more costly device.

Despite the challenges that exist in using cellular technology in development projects, Shackleton maintains that it holds great potential, saying, "I think cell phones are the way to go. They are useful, relatively inexpensive tools for networking, decreasing travel time and cost - especially for rural residents, maintaining relationships, pursuing opportunities, making money, banking, reporting crime, accessing services, and managing patient care. The technology can do anything, really, but people have to drive it."

Copies of the rapid assessment report can be obtained by contacting Sally-Jean Shackleton at sallys@womensnet.org.za.

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