There is growing enthusiasm amongst analysts of global health for the possibilities opened up by the rapid spread of mobile phone coverage. This includes substantially increasing access to health-related information and advice and to expert medical consultations.
Some argue we are reaching a tipping point in the organisation of health systems in which new technology will drive new organisational arrangements (Christensen, Grossman and Hwang 2009; Bloom and Standing 2008). This is encouraging investment by foundations and bilateral aid agencies in the development of e-health and m-health as a way to improve access to health services in low- and middle-income countries. As with the introduction and spread of any new technology, there are a number of possible outcomes – or pathways – with different implications for the types of service provided and the distribution of benefits in the short and longer term.
A recent STEPS Centre publication (2010) proposes the following characteristics of the way a technological innovation is spread: the direction of development and the way organisations incorporate the new technology into their operations; the distribution of benefits from the technology and the diversity of ways the technology is applied. It argues that the actual pathway of development is strongly influenced by political processes, involving a number of stakeholders with differing interests and understandings.
A number of analysts argue that health systems are particularly path-dependent because of the importance that people give to arrangements they believe protect them from serious health problems (Bloom and Standing 2008). Lee and Lansky (2008), for example, suggest that resistance by stakeholders and complex regulatory barriers are substantially diminishing the impact of new technologies on the organisation of the American health system. Because of the path-dependent nature of the health sector, decisions made early in the emergence of a new technology are likely to have a strong and lasting influence (Bloom and Wolcott 2013).
This report presents a snapshot of how information and communication technologies (ICTs) are influencing health system development in Bangladesh.
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