As fair warning, this post is part rant, part confession, part promotion (see links below!), and part call to action for increased investment in local innovation in low- and middle-income countries.
I spend a good deal of my time raising money, working on budgets, and generally championing open source software designed to be used by health workers in low-income countries. Most of this ‘eHealth’ software ends up being developed by extremely talented and dedicated software developers from the United States and other wealthy countries. I spend a relatively small portion of my time trying support and strengthen local software development capacity.
For example, we’re working with a small, all Tanzanian innovation company called ITIDO. While equally talented and motivated, ITIDO’s staff has less training and, consequently, less expertise than those of the organizations I’m affiliated with. However, it’s hard to shake the feeling that in the long run, Tanzania needs successful ITIDOs more than it needs organizations I’ve helped create. It seems that a well-functioning ITIDO is more likely to build lasting, relevant, solutions that will actually be used in Tanzania.
A key challenge is time. We often feel the need to deliver results in a few months. And, indeed, there is no time to waste in developing and deploying technologies that have the potential to improve desperately needed healthcare. Given limited funds and the need to deliver quickly, the most efficient approach is almost always to go with highly experienced software developers. And this becomes more and more true once you start building software with one group of experts. The people who know the current software best are the ones who can most quickly extend it. Capacity building takes time.
One approach we advocate is establishing a “Coded in Country” (CIC) label for software, akin to a Fair Trade label for projects. There is ongoing discussion about the best definition of CIC, and if there should be an official certification process, but the original idea was that a software application or module is CIC if at least half of the money goes into local development. CIC nodes will provide capacity strengthening and opportunities for international exposure to talented local developers. The idea has generated a good deal of enthusiasm from many groups, especially those deploying eHealth software for use in Sub-Saharan countries in Africa.
CIC and other related topics will be discussed during an online panel hosted by GHDonline on the topic of local development of global eHealth software from July 19-30 (sign up now!)
