MOBILE TELEPHONY IN DEVELOPING COUNTRIES: A GLOBAL PERSPECTIVE by THINK! The Innovation Knowledge Foundation

MOBILE TELEPHONY IN DEVELOPING COUNTRIES: A GLOBAL PERSPECTIVE

I Quaderni di THINK! N°4

MOBILE TELEPHONY IN DEVELOPING COUNTRIES: A GLOBAL PERSPECTIVE

Authors: Alizé Aversano Sophie Evers Amir Latif Marta Vaca-Viana

ISBN: 978-88-907047-3-4

www.thinkinnovation.org

I Quaderni di THINK!

Edited by: Silvia Masiero

Price € 18,00

THINK! Report, October 10 - 2013

I Quaderni di THINK! N°4

MOBILE TELEPHONY IN DEVELOPING COUNTRIES: A GLOBAL PERSPECTIVE

Authors: Alizé Aversano Sophie Evers Amir Latif Marta Vaca-Viana

Edited by: Silvia Masiero

THINK! Report, October 10 - 2013

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MOBILE TELEPHONY IN DEVELOPING COUNTRIES: A GLOBAL PERSPECTIVE

Executive summary The main argument of this report is that, whereas developing economies may need complex technologies to solve complex problems, simple technological solutions (i.e. mobile telephones) can be of help in the struggle to solve issues as complex as economic and human development. The mere fact that ‘about three quarters of the planet’s population now has access to a mobile phone’, suggests that mobile telephones have the potential to be a substantial tool with which to achieve this (World Bank, 2012). This report shall therefore seek to demonstrate the mechanisms through which mobile telephony may be able to solve these problems and contribute to the field of development. In the light of the above-mentioned arguments, the report focuses on the specific fields of health, entrepreneurship and finance, since these areas have experienced substantial advances that have been both innovative and impactful. Ultimately these were chosen based on the rationale that ‘What people can positively achieve is influenced by… the enabling conditions of good health, and the encouragement and cultivation of initiatives’ (Sen, 1999: 5). We deliberately chose to focus on the above pillars because we feel that there is an element of interconnectedness; with health providing an enabling condition from which the other two can develop, whilst entrepreneurship and finance exist in a symbiotic relationship. With regards to health, we gave particular attention to three mechanisms: service and quality; administration and management; and prevention. From our case studies, we observed that mobile phones have contributed positively to the development sphere when local knowledge was integrated with these tools, and when governments are committed to the promotion of mobile phones in a drive to reduce costs and healthcare campaigns. The successful integration of M-health within national policies, as well as the attention it received from both NGOs and private businesses, assisted in the development of numerous mobile innovations in areas such as enhancing efficiency, awareness and prevention through health education. This has led to the improvement of both institutionalised and grass roots healthcare in rural areas, which often lacks connectivity with urban areas. Within the entrepreneurship area, we emphasised three mechanisms: market access; transaction costs; and job opportunities. As case studies in this section show, within the field of M-entrepreneurship mobile telephony has enabled micro-entrepreneurs to overcome information asymmetries and, in doing so, it has allowed them to access new markets. Mobile applications have facilitated this process, and along with the creation of social networks have enabled entrepreneurs to increase their productivity via the sharing of best practices, as well as providing them with new job opportunities. In doing so, mobile based innovations have been a source of employment and therefore income for entrepreneurs who rely on their businesses for their livelihoods. Furthermore, individual know-how and the access to technology usage, tailored to their needs are fundamental to make mobile phones sustainable tools to increase freedoms. In the finance realm, we highlighted the two mechanisms of financial inclusion and insurance. From this chapter, we concluded that financial literacy is essential for these mechanisms to take place, whilst insurance is crucial to ensure a poverty trap does not become self-fulfilling. The implementation of

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mobile-based innovation has enabled M-banking and insurance coverage to increase significantly within the most poorly covered regions of the world, such as SSA. It can, therefore, be concluded that the main benefits of M-banking solutions have served a fundamental role in encouraging development through lowering costs of insurance and financial transactions, which has subsequently increased their uptake. And the gap in the literature, filled by this report, consists in establishing a taxonomy linking the adoption and usage of mobile phones with development. We have based our findings on the mechanisms and their impacts that we have identified above, conceptualised using qualitative data and case studies from the literature.

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Table of Contents IntroduCTION

Chapter 1: Mobile Telephony and Development Capabilities Approach The Three Pillars Our Approach

3 3 5 6

Chapter 2: M-Health Health Services and Development M-Health Service and quality Administration and Management Prevention

7 7 8 9 10 11

Chapter 3: M-Entrepreneurship 15 MSEs and development 15 M-Entrepreneurship 17 Market access 17 Transaction costs 18 Job opportunities 19 Chapter 4: M-Banking 23 Finance and Development 23 M-Banking 26 Financial Inclusion 26 M-Insurance 27 Chapter 5: Policy Recommendations The role of the government Adaptation to the local context Reciprocal learning

29 29 30 31

Conclusion 33 Bibliography 35 Appendix 41 Appendix 1 41 Appendix 2 42 43 Appendix 3 Appendix 4 44 Appendix 5 44 Appendix 6 44 Appendix 7 51 Appendix 8 51 Biographies 52

III

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MOBILE TELEPHONY IN DEVELOPING COUNTRIES: A GLOBAL PERSPECTIVE

INTRODUCTION Since the 1980s, Information and Communication Technologies (ICTs) have become increasingly important in strategic development planning for developing countries. With the belief that access to technology and economic growth were positively correlated, emphasis has been placed on bridging the ‘digital divide’ and make new technologies available in developing countries, and forging alliances with non-governmental organisations and the private sector who traditionally play a key role in transferring new technologies1. Dependency theory has influenced the debate within Information and Communication Technologies For Development (ICT4D), with the view that knowledge should be transferred from the West to developing countries in order to encourage development (Heeks and Kenny, 2002). However, this view is becoming increasingly contested, especially with the rise of technologies such as mobile phones which show that developing countries have the capabilities to develop from within, adopting technology on their own without transferral from the West. This also reflects a shift in development theory away from development as economic gain and towards development as a process of expanding the ability to choose one’s own destiny. In that sense, mobile phones are personal devices that give individuals the ability to freely choose how to make use of their potential. ‘About three quarters of the planet’s population now has access to a mobile phone’, and as such they have become a vital tool with which to fashion development (World Bank, 2012). This report aims to provide a taxonomy of the existing mechanisms through which mobile telephony has contributed to the field of development (See Appendix 1). For the purpose of this report, we will examine two aspects of development: economic development and human development. Economic development is understood as the increase of GDP per capita, and human development as the concept encompassing quality-of-life factors targeted to expand the range of things that a person can be and do (Fukuda-Parr, 2003). This view is evidently related to Amartya Sen’s capabilities approach, which perceives human development as the process of expanding economic, political, and social freedoms (Sen, 1999). According to his capabilities approach, to foster an individuals’ ability to choose freely and reasonably what they want to be and do, public policies should encompass not only the increase of personal incomes or gross national product but also the pursuit of a higher quality of life. Mobile phones are devices able to make and receive telephone calls, without the need for fixed wiring. For the purpose of this research, we shall distinguish between feature phones, which provide basic services such as voice communication and Short Message Services (SMS); and more sophisticated phones providing advanced services such as internet access, radio and Multimedia Messaging Service (MMS). This report will focus on feature phones, as they are most widely available in developing countries and their widespread usage represents the choices people have already made, which is consistent with the capabilities approach. In the light of the above-mentioned arguments, the report focuses on the 1 This is reflected by the UN General Assembly’s decision to mandate the World Summit on Information Society (WSIS) to explore ICT opportunities to achieve the Millennium Development Goals (MDGs) in 2003.

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health, entrepreneurship and finance fields since these areas have had substantially innovative and impactful developments. Furthermore, these pillars were chosen based on the idea that ‘What people can positively achieve is influenced by… the enabling conditions of good health, and the encouragement and cultivation of initiatives’ (Sen, 1999: 5). We deliberately chose to focus on the above pillars because we think that there is an element of interconnectedness, with health providing an enabling condition from which the other two can develop, whilst entrepreneurship and finance exist in a symbiotic relationship. Moreover, each pillar independently and explicitly contributes to human and economic development. With these areas in mind, this paper will expand on how mobile telephony has contributed to the removal of obstacles such as ill health and limited access to resources. The paper shall conclude by helping to use these mechanisms, illustrating suitable and effective policy recommendations that can expand human freedoms. Below is an illustration of the nations from which we have selected our case studies. This was done whilst keeping in mind both the desire to identify substantial initiatives, and the need to geographically spread out our analysis. Figure 1: Selected Countries for Case Studies

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CHAPTER 1: MOBILE TELEPHONY AND DEVELOPMENT Figure 2

MSEs

Job opportunities

Service and quality M-Health

Administration and management

Individual well-being

Prevention

Insurance M-Banking Financial Inclusion

Mechanisms

Societal Impact

Transaction costs

Economic and Human Development

Mobile Telephony

MEn

tre

pre

urs h

Market access

Micro Level Households

Impacts

CAPABILITIES APPROACH Mobile telephony can be a positive contributor to development because it is no longer about the 1940s development discourse that focused purely on income or gross national product, but about finding the paths to increase ‘political freedoms, economic facilities, social opportunities, transparency guarantees and protective security’ (Prakash, 2007). Mobile telephony has gained unprecedented relevance because, in a remarkably short period of time, mobiles have become the platform from which to expand the range of things that a person can be and do, and has been identified as the ‘platform for a new level of connectedness both between individuals and between individuals and institutions’ (Smith et al, 2011). In line with Smith et al, we argue that the greatest contribution of mobile phones is their ability to

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expand human capabilities, first by enabling individuals to have greater access to information and second by expanding connectedness between people. Furthermore, linking the capabilities approach with mobile phones distinguishes between two different types of development enhancing mechanisms: • Internal mechanisms: Those that result from greater access to information and facilitate internal activities for individuals or organisations. • External mechanisms: Those that result from greater interconnectedness and allow the creation of linkages between the individual and external actors. One should note, however, that the boundary between internal and external mechanisms is extremely blurred, and achieving a particular outcome often requires an interplay of both mechanisms. Figure 3: Different mechanisms linking mobile phones and development

Households Entrepreneurs

External mechanisms: create linkages with external actors

Health Centres

• • • •

Family and friends Service providers Market actors Patients/customers

Internal mechanisms: Facilitate internal activities

Source: Adapted from Donner and Escobari, 2010

Mobile phones, apart from facilitating communication between people, are ‘easy to access, and easy to master, and mobile innovations are easily transferred to other platforms’ (Smith et al, 2011: 83). Therefore, it is relevant to recall Richard Heeks (2008:26) who affirmed that ‘[E]conomic, social and political life in the 21st century [would] be increasingly digital’ because this has evolved in line with the increasing adoption of mobile phones, even in developing countries where most ‘have skipped fixed-line infrastructure and leapfrogged directly into mobile telephony’ (Rashid & Elder, 2009). For instance in countries like Mexico, for every 100 people, 84.3 have mobile subscriptions whereas only 21.5 have fixed-telephone subscriptions; in Kenya, 71.7 versus 6.0, and in Thailand 84.3 versus 21.5 (ITU, 2012). The scale of the phenomena is particularly substantial in Sub-Saharan Africa, where the mobile phone penetration rate is the highest in the world. In line with Rashid and Elder (2009), mobile phones not only offer basic connectivity, but they overcome problems such as the lack of infrastructure or the complicated wiring installations previously needed to complete simple tasks. Nowadays, even people with basic literacy levels can use a hand-sized device to advance in areas such as health, finance and entrepreneurship, therefore enabling these individuals to use their cell phones to increase their freedoms and in doing so the range of options available to them. A mobile phone is therefore a fundamental tool to allow individuals to increase their freedom to choose.

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THE THREE PILLARS The contribution of this report shall be in the form of a comprehensive analysis of the link between mobile phones and development. This is lacking in the literature, as there is still no broad consensus, or synthesis of the mechanisms connecting mobile adoption and usage, to development. This report therefore addresses a clear gap in the literature in terms of providing a succinct taxonomy that clearly identifies the mechanisms within the three aforementioned pillars: Health: This is an essential pillar because individuals need to be strong enough to carry on with the activities that sustain their lives. If individuals suffer from ill health, their potential to expand their options is diminished. Despite health being fundamental for development, around 4 billion people worldwide have insufficient access to health care systems (WHO, 2008). Hence, the use of mobile phones has been targeted as a tool to improve the service and quality of patient care and as a vital link between government, Non-Governmental Organisations (NGO) and the private sector. Entrepreneurship: Micro and Small Enterprises (MSEs) are fundamental to development as an important source of employment and, therefore, income. Seeing that individuals often decide to engage in entrepreneurial activities to sustain their lives, we have reason to link this topic to the development realm. Whilst there are different definitions of MSEs (See Appendix 2) this report will focus on Micro enterprises i.e. up to 10 employees (European Commission, 2003) as they represent the most dominant sources of employment in developing countries (Mead and Liedholm, 1998). Finance: The field of finance is hugely relevant in developing countries as individuals that have limited contact with financial products can use their mobile phones to increase access to them, and overcome the impediments of financial inclusion. Through financial inclusion they gain access to insurance and other financial products, thereby encouraging their entrepreneurial projects and invariably accelerating poverty reduction and increasing development. Within the health field, we have found that doctors in Nigeria have been responding to emergencies and communicating with each other via mobile phones with an automated innovation in Cape Town sending SMSâ&#x20AC;&#x2122;s to patients to remind them to take their tuberculosis treatment. Furthermore, SMS has been used in the Philippines to report child injuries and develop telemedicine systems in Indonesia that have helped book routine check-ups through mobile phones (Rashid & Elder, 2009). A Senegalese organisation, Manobi, implemented a program tailored for entrepreneurs that collected information from the market and uploaded it to a database for farmers to consult prices and then decide whether it is convenient for them to engage in business. As for the financial pillar, the widely known case of M-PESA is paramount. M-PESA is a remittance system in Kenya, where people have been using their mobile phones to make day-to-day transactions and subsequently increase productivity and accessibility to financial products such as insurance. While these mechanisms are promoting development in developing countries, there is also potential for the Western world to learn from developing countries when it comes to the use of mobile telephony in this area.

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OUR APPROACH The focus of this report shall be on the latter view on development, focusing on mobile telephony as an important pillar of ICT, supporting Akpan’s view (2003) that conditions such as inadequate infrastructure, low literacy levels and poverty could be eliminated with the use of ICT. The paper shall therefore extend the scope of the argument as we look to identify why ‘[W]here there is limited or no overlap between formal and informal rules, informal rules tend to take priority in shaping behaviour’ (Nicholson, 2009: 6). Formal rules are considered laws or formal codes, whereas informal rules are those traditions that are culturally reinforced. Under this umbrella, we conclude that local conditions might be relevant drivers of development and should be taken into account when discussing the way that mobile phones have enhanced development. Nonetheless, it is amiss to suggest that everyone who owns a mobile phone has enjoyed the benefits mentioned above. Therefore, our task is to ask why and determine which mechanisms and conditions enabled successes in the various cases. Selected authors explain successes and failures as consequences of the existing ‘gaps between the system[s] as designed/intended/imagined and the ‘actuality’ of the context[s] into which [they are] deployed’ (Donner, 2010). This view shall be expanded on and the mechanisms that determine whether mobile phones can strengthen development, and under what conditions, analysed. In this view there is no obvious suggestion that mobile phones directly contribute to development, which requires supplementary factors such as (a) knowing how to use them in their favour and (b) seeing them as tools to expand their own freedoms. Keeping the above in mind, the principal aim of this report is to create a clear taxonomy of the mechanisms through which mobile phones foster development, and in doing so has filled a gap in the existing literature. This taxonomy is a reflection of our conceptualisation of the literature, which will be illustrated through qualitative studies and specific case studies, including one of our own in the Sudan. Due to the ever-changing nature of technology the focus shall be predominantly on existing technologies, and ‘looking back’ to evaluate the existing innovations and provide policy recommendations.

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CHAPTER 2: M-HEALTH

Transaction costs

MSEs

Job opportunities

Service and quality M-Health

Administration and management

Individual well-being

Prevention

Insurance M-Banking Financial Inclusion

Mechanisms

Societal Impact

Market access

Economic and Human Development

Mobile Telephony

MEn

tre pre n

rsh

Figure 4

Micro Level Households

Impacts

HEALTH SERVICES AND DEVELOPMENT As highlighted in the previous chapter, the use of mobiles phones has increased dramatically over the past decade. This chapter reflects our conceptualisation of how people in developing countries have benefited from broad access to mobile phones in relation to health services, which fits with Sen’s capabilities approach and the perception of health as a basic good. Good health expands a person’s capabilities and freedoms by ‘Bringing many benefits, including enhanced access to education and the job market, an increase in productivity and wealth, reduced health care costs, good social relations, and of course longer life’ (OECD, 2012). There are substantial average life expectancy differences between developed and developing countries, with Japan leading the ranking with 82.73 years on average and the Central African Republic footing the table with 45.99 years (World Population Prospects, 2010). Sachs

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(2001) argues that the role of health in economic growth has been greatly undervalued, suggesting that each 10% improvement in life expectancy is associated with an increase in economic growth of about 0.3% to 0.4% per year.

M-HEALTH Although it is universally accepted that accessible health care is necessary for development (Van Gunniken, 2010), many countries lack sufficient health care services for average citizens, whilst health care is often only available for the ruling elite, the politically connected or those able to buy those services from the private sector. To improve this situation, an affordable and accessible health care system that takes into account local circumstances must be made available. This chapter shall demonstrate that mobile phones in the health sector allow customised solutions and the effective treatment of patients with the goal of reducing costs at the same time. These new health services are summarised under the headings of M-Health (mobile health) and E-Health (electronic health). Both areas are often interlinked as health services involve community workers and patients using their mobile phones, whilst hospitals and doctors use electronic devices such as computers in their work routine. Figure 5: The M-Health Ecosystem

Health Health system Health care workers Medical supply chains Patients

Government Legislators Regulators Legal system Ministries

mHealth applications

Technology Software developers Mobile operators Handset makers

mHealth Service delivery Mobile platforms

Health funding Finance Banks Insurance companies Private investors Philanthropists Donors Individual user/ households

Source: Qiang et al, 2012

Integrating mobile phones in the health sector has not been a hugely recent addition to the agenda of international institutions. In 2005, the World Health Organization (WHO) recommended its member states use ICTs in health care to improve institutional health care. As Miscione (2007) points out, the implementation of â&#x20AC;&#x2DC;ICT-based development efforts are usually based on an alliance between ICT-supported science, international organisations and national and regional governmentsâ&#x20AC;&#x2122;. However, these ICT based efforts have not necessarily demonstrated the results that were expected by policy actors, best exemplified by a nation-wide ICT-health-programme in Peru called RISS, which showed limited results. In addition to international organisations and governments, private companies have recognised the potential for ICTs to

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improve health care systems. The innovations around mobile telephony by businesses or NGOs lay emphasis on individual solutions that complement or even replace the often weak state institutions in developing countries. Jaspar Sandhu (2011) highlights that many M-Health innovations including administration, management, education, diagnosis and prevention, as well as the treatment of patients, have their origins in Sub-Saharan Africa (SSA) and South Asia. In these two regions, there are huge gaps in the health system and the innovations are a result of multiple factors, including targeted private and public funding and a flourishing mobile market. Both internal and external mechanisms, as defined by Donner and Escobari (2010) are in place in the growing M-Health sector. Within this sector, the highest priority is for a ‘close-to-client’ system as highlighted by Sachs (2001). In terms of the internal mechanisms, patients benefit from greater access to information that is newly accessible through their mobile phones. The external mechanisms, are those problems faced by doctors or health workers in terms of getting in touch with patients in rural areas, and can be solved by picking up a mobile phone and making a call or sending a text to the patient or fellow health worker.

M-Health

Administration and management

Prevention

Mechanisms

Individual well-being

Societal Impact

Service and quality

Economic and Human Development

Mobile Telephony

Figure 6

Impacts

The above diagram represents the three distinct mechanisms through which mobile phones contribute to the health sector and subsequently to development. It illustrates how mobile telephony can improve the health service in three areas, (a) service and quality, (b) administration and management and (c) prevention. In addition, the diagram highlights that the usage of mobile phones improves individual well being as well as leading to collective benefits. Being in good health allows individuals to use the full potential of their body and brain to take part in everyday life activities or for example to start an enterprise or engage in financial activities. As Smith argues, ‘mobiles help to generate collective benefit uses and services in health’ (2011): the following sections will elaborate on the above-mentioned mechanisms, and the ways they can impact on development.

Service and quality Mobiles have potential as an alternative health service delivery channel for governments because the technical infrastructure in rural areas is scarce

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and in many cases so is the linkage to hospitals in nearby cities. Moreover, community health workers are often badly equipped, and lack the diagnostic equipment that they would need to work properly. In addition to thi, the price of health care depends on the education level of the staff, with doctors based in the city being more expensive compared to rural community health workers. Therefore health workers in remote areas often receive little training and education as well as receiving limited feedback from laboratories and specialists. The usage of mobile phones is however able to help overcome these issues, as illustrated by the case of MOTECH below.

Case 1: MOTECH MOTECH (Mobile Technology for Community Health) is a mobile health information technology system, which aims to increase the quality and availability of maternal health care. The initiative is a collaboration between different actors; the Grameen foundation, Columbia University and the Ghanaian health ministry. It offers two different applications: the ‘mobile midwife’ app and the ‘nurse’ app. The mobile midwife app sends text or vocal messages in the local languages (English, Kasem, Nakam, Senya and Fante) to pregnant women and their families, which sends specific information about doctor appointments or nutrition related to the week of the pregnancy. The nurse app is connected to a specific mobile phone that offers the option to save data on the phone if the community worker can not get in contact with the hospital because of bad connection. Evidently, mobile phone based innovations around maternity care and customer service have proved hugely successful by lowering costs and improving the education of local health staff. MOTECH has shown that evaluations are important for the success of a project, with evaluations of the pilot project in 2011 finding that only 1% of users have chosen SMS as their preferred method of message delivery due to prevalent literacy levels of about 50% (Grameen Foundation, 2011) – which was included in the design. In July 2012, 19,528 people were registered to MOTECH’s services with constantly growing rates (see Appendix 4). The programme expansion was led by the Ghanaian health ministry, which is implementing the service in the rural areas of the country.

Administration and Management A World Bank study (2012) has estimated the potential of M-Health and found that the cost of data collection dropped by almost a quarter as a result of mobile phones. For example, VidaNet uses SMS to remind a patient of their appointments or when to take prescribed medicines. This has significantly improved the health conditions of HIV patients in Mexico and helped to reduce costs for the health ministry. Secondly, health data and diagnostic information, which are predominantly collected on paper, can be easily lost. Usually, community health workers collect the data and transfer it to a hospital or doctor, where a diagnosis is made. It is now possible for diagnoses to be made directly using a mobile phone, which therefore makes it cost and time efficient.

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Therefore instead of using expensive technology there are innovations that can be used in connection with the mobile phone, as can be observed in the SIMpill case below. Case 2: SIMpill SIMpill is a medication adherence management system using cellular networks to provide real-time information about, and support to, patients on long-term medication (see Appendix 5). This application allows patients to self medicate either at their homes or at their places of work, supported by the SIMpill system. Such applications have been used in various developing-world and developed-world contexts, as a cost-effective alternative to directly observed treatment for tuberculosis patients. The project’s pilot found that the drug adherence of the 155 patients tested for 10 months stabilised between 86-92% and achieved a treatment success rate of 94% (Barclay, 2009). The SIMPill device fits over commonly used prescription bottles, and it flashes and sounds when the time comes to take a pill. If the patient forgets, the product then uses an embedded wireless chip to offer a phone or text reminder. Shackleton (2007) found that ‘by using the SIMpill solution a community health worker is able to manage around 50 patients instead of 15’. SIMpill is currently undergoing a large scale evaluation in line with the International Clinical Trails guidelines of the WHO. SIMpill has even been able to enter international markets and their solutions are being offered and actively marketed in the United States, The Netherlands, and United Kingdom as well as undergoing a pilot study in Botswana.

Prevention Ivantury et al (2009) have analysed the potential of health hotlines in developing countries and found that people are willing to use services that will lead to earlier diagnoses and faster treatments. The South-East Asia region reported the highest percentage of health telephone services at around 88% (WHO, 2011). A successful example is mDhil in India, which broadcasts health messages on a subscription basis (see Case 3). In 2010, over 150 000 people had registered as paid SMS subscribers. Numerous other operators have recognized that providing value-added services is one of the most effective ways of retaining customers in a hypercompetitive business with limited service contracts. Examples of such services include mobile money and life insurance services attached to SIM card purchases from Grameenphone, Bangladesh’s largest mobile network operator, as well as the free HealthLine service. Any Grameenphone subscriber can call the medical consultation and services 24 hours a day, 7 days a week. In a similar being, European citizens recently used health line services during the H1N1 influenza pandemic of 2009. Aside from M-Health services that provide general health information, mobile innovations have been used to monitor or alter the spread of infectious diseases and epidemics. In many cases, healthcare workers or the health ministry only learn from a crisis when it is too late. Waidyanatha et al (2011) analysed the potential of pilot projects in India and Sri Lanka and found

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mobile devices were helpful in monitoring outbreaks of Dengue Fever. In the world before mobile communications, it generally took the provinces 15 to 30 days to report data on disease outbreaks to central authorities, which meant slower treatment responses and aggravation of the spread of infectious diseases. However, with the onset of mobile communications, the wait time on infectious diseases has dropped considerably. The following two cases highlight how individuals and government both stand to benefit from mobile prevention services. Despite the successful implementation of the M-Health services above (see Appendix 2), it is crucial to point to the danger of settling for solutions that only address part of the problem in developing countries. This is rife in healthcare, with decisions on the adoption of new healthcare technologies often made in the absence of information on the implications of its use (Kazanjian and Green, 2002). ‘Healthcare ICT innovation can only succeed if design is deeply informed by practice’ says Sanderson (2007). Figure 7: Number of Countries with at least one M-Health deployment by region (ICT4D 2012)

90 3 6 7

80 70

Countries

50 40

30 20 10

Europe and Central Asia East Asia and Pacific Latin America and Carribbean

South Asia Middle East and North Africa Sub-Saharan Africa

Developed countries Source: Adapted from GSMA mHealth Tracker, 2012

Furthermore, only specific M-Health innovations receive funding, and in these cases their popularity leads to other funding opportunities for M-Health innovations in developing countries. Qiang et al state that ‘The M-health industry is at a pivotal moment in its rapid evolution’ (2012). Many of the innovations have received international donor funding in order to be widely distributed into the countryside. In short, mobile health has clearly expanded in the number and type of initiatives and is expected to become a multibillion dollar field by 2017, with PwC (2011) projecting that annual revenues will reach $23 billion worldwide. The question is how many of these health

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innovations undergo evaluations. It is clear based on this review that more research is required to link mobile technology to health outcomes, with the WHO (2012) stating that only 12% of countries have evaluated their M-Health initiatives. Nevertheless, successful M-Health innovations travel across countries and regions without the help of external donors, for example in the case of maternal health care. The US messaging service Text4Baby for pregnant women and new mothers was modelled after VidaNet in Mexico and started as a community initiative to fight high infant mortality rates. The cases presented in the prevention section should be highlighted; the health information is often sent out for free or the call services are complementary in connection to other services. Users seem to enjoy a voluntary participation and like to inform themselves about various health issues that they find interesting or of concern to themselves. The next chapter, M-entrepreneurship will highlight how people can independently discover the potential of their mobile phone to increase their business activity and improve their livelihoods.

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CHAPTER 3: M-ENTREPRENEURSHIP Figure 8

MSEs

Job opportunities

Service and quality M-Health

Administration and management

Individual well-being

Prevention

Insurance M-Banking Financial Inclusion

Mechanisms

Societal Impact

Transaction costs

Economic and Human Development

Mobile Telephony

MEn

tre pre n

rsh

Market access

Micro Level Households

Impacts

MSEs AND DEVELOPMENT It is today widely recognised that MSEs are key contributors to development and poverty reduction in developing countries, noticeably because they represent a major source of employment and innovation in developing countries. For instance, the World Bank (2013) reports that agriculture is the main source of income and employment for the 70% of the worldâ&#x20AC;&#x2122;s poor who live in rural areas.

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Share in total employment / including agriculture

Figure 9: Employment in the informal economy as percentage of total employment 100 80 60

Total Men Women

40 20 0

* Urban areas only

Source: ILO, 2009

Mead and Liedholm (1998) have undertaken one of the most comprehensive studies on the dynamics between MSEs and development and distinguish between new or existing MSEs in determining their contribution to poverty alleviation and growth: • New MSEs are often ‘survival-type enterprises’, and consist of one-person establishments that are inefficient and face a high risk of closure. People engage in these activities in order to survive, because they have no other option. Their creation and growth is therefore closely related to poverty alleviation, and mechanisms that could increase the likelihood of these businesses survival would directly address poverty by helping owners earn a more reliable income. • In contrast, MSEs who expand do so because they have become more efficient, their expansion translating into high levels of growth and the creation of more productive jobs that yield higher income for new and existing workers. They have a more direct impact on economic growth and mechanisms that could help increase their efficiency would have the power to provide people with higher levels of income and eventually lift themselves out of poverty. The adoption of mobile phones has significant positive impacts on economic activity. Perry (2011) reported that ‘every 10 additional mobiles per 100 Africans, increased GDP by 0.6% to 1.2%. In this chapter, we will look at the mechanisms at play; that is, the particular use of mobile phones to these ends, that we have labelled ‘M-Entrepreneurship’. The understanding of these mechanisms is crucial in an attempt to undertake adequate development policies.

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M-ENTREPRENEURSHIP As discussed in chapter one, mobile phones can enhance development via both internal and external mechanisms. In terms of MSEs, internal mechanisms are those that facilitate their internal business activities. As explained by Jagun et al. (2007), the main obstacle to MSEs growth is information failure, which makes the trading processes slow, costly and risky for micro-entrepreneurs, and often forces the adoption of inefficient business structures. Businesses are often localised to avoid travel expenses, however this restricts them from reaching new markets in other areas. Moreover, they depend on intermediaries to access information, creating huge information asymmetries. Mobile phones improve access and the quality of information, therefore directly addressing these inefficiencies and providing opportunities for MSEs to improve their productivity and competitiveness. As for external mechanisms, they relate the creation of social networks. Mobile phones, by increasing interconnectedness between different actors, can therefore either help create new networks or reinforce existing ones. This has different impacts on entrepreneurs, by both helping them to find new job opportunities and increasing productivity through the sharing of best practices. Drawing from this, we will now describe these mechanisms in detail and show how they improve MSEs activities in terms of (a) Greater market access (b) Lower transaction costs and (c) Job opportunities.

Mechanisms

Societal Impact

Job opportunities

MSEs

Economic and Human Development

Transaction costs

tre

pre

ne urs

hip

Market access

M-

Mobile Telephony

Figure 10

Impacts

Market access Access to information is crucial for price and goods allocation mechanisms to apply- market information allows micro-entrepreneurs to react to price differences and sell their goods where there is demand. A study by Jensen (2007), looking at the fishing industry in Kerala, India, shows how better access to information has improved market performance. Fishermen used to sell exclusively in the market closest to their catch, regardless of the price and demand, therefore creating market inefficiencies. Supply was not determined by demand but by the number of fish caught in the area, resulting in either over-supply and waste, or supply shortage and unsatisfied consumers. This

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is because fishermen were unable to observe prices in other markets while at sea and high transportation costs limited their incentives to move to these markets. Mobile phones, by improving access to information, allowed fishermen to better respond to price and demand information, therefore reducing price dispersion and waste, and increasing both fishermen profits and consumer welfare. A large number of country and sector-specific studies have been undergone to illustrate those mechanisms; the main ones are presented below: Study Muti (2009)

Country Industry Mechanisms Uganda

Banana and maize

Mobile phones have increased market participation by reducing marketing costs. This is true for banana producers, but not maize producers, which suggests the effect is greater for producers of perishable crop.

Niger

Grain

Reduced price dispersion across markets by 10% due to reduced search costs and access to new markets. Rreduction in price dispersion is higher in remote areas.

Kerala, India

Fishing

Improved market efficiency by lowering price dispersion and volatility, access to new markets. Other benefits emphasised are reduced wastage of time and resources and reduced risk and uncertainty.

“Impacts of mobile phone coverage expansion on market participation: panel data evidence from Uganda”

Aker (2010) “Information from markets near and far: mobile phones and agricultural markets in Niger”

Abraham (2007) “Mobile phones and economic development: evidence from the fishing industry in India”

When looking at these mechanisms, as recognised by Muto (2009), one should note that improved market efficiency is likely to work better for perishable goods such as fish, fruits and vegetables, as waste cannot be reduced by storage and directly relies on the efficient allocation of goods. One should also be careful in not over-stating the benefits of mobile phones. For example, Abraham (2007) has shown that mobile phones did not eliminate intermediaries for banana, maize producers and fishermen. Jagun et al. (2007) also arrives at the same conclusion in their study of cloth-weaving entrepreneurs in Nigeria. This implies that outcomes are endogenous to the context and the type of industry surrounding mobile phone users, and therefore existing relationships and power structures might hinder some of the benefits offered by mobile phones.

Transaction costs As well as improving access to markets, mobile phones can also increase business efficiency and profitability through cost savings. Indeed, better access to information allows micro-entrepreneurs to directly communicate with suppliers and customers, which makes business relations quicker and has the potential to eliminate intermediaries. It also reduces the cost of transportation, as entrepreneurs with better information can choose to travel only when it is unavoidable (Essegbey and Frempong, 2011). In a study of micro-entrepreneurs in Ghana, 91% emphasised the cost-effectiveness of

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making transactions via mobile phones (Frempong, 2009). We will further illustrate this with the results of our own survey of retailers in Sudan: Case 5: Retailers in Sudan As part of our investigation into the impact of mobile phones on the efficiency of MSEs in developing countries, we undertook a survey of mobile phone usage by commercial retailers in Khartoum, Sudan. The survey was done in partnership with DAL Food Industries, using the Coca-Cola distribution network to facilitate face-to-face interviews supported by pretested structured questionnaires that were designed by our team. The interviews were undertaken by trained retail audit staff, who regularly carried out similar questionnaires on a monthly basis. The survey was undertaken in February 2013 and covered 250 outlets. The first significant finding that ties in to our interpretation of the literature, is that mobile phone coverage is extremely high, with 80% of retailers owning one phone, and 18% owning two. This ties in with the general trend in the developing world, and further illustrates the potential for mobile telephony to contribute to development, which touches the health and finance fields. Most importantly, the results highlight the direct positive impact of mobiles on business efficiency in Sudan. Retailers emphasised the use of mobiles to place orders (66.1%), calling wholesalers (17.3%) and receiving orders (10.1%), which shows they have replaced traditional means of doing business. Moreover, the final survey question indicated that that 42.6% of retailers used mobiles for better coordination with suppliers and 28.9% indicated that their impact directly led to faster communication and subsequent time saving as a result of not having to travel long distances to do business. This clearly correlates with the mechanisms described above, showing the potential for mobile to reduce transaction costs and increase efficiency.

A further example of this is Manobiâ&#x20AC;&#x2122;s free-access SMS market information service Xam MarsĂŠ in Senegal, mentioned in chapter one. This illustrated that fruits and vegetable farmers in Senegal were able to increase their sale prices on the market by over 50% (2013). There is also scope for mobile phones to help micro-entrepreneurs improve their efficiency by interacting with other entrepreneurs and share best practices. This can be done via network participation. As there is little emphasis on this particular mechanism in the literature on mobile phones and entrepreneurship, we will try to address this gap using a case study (see Case 6):

Job opportunities A report from the World Bank (2012) acknowledges the role of mobile phones as an employment opportunity for people in the developing world. For instance, it reports Safaricomâ&#x20AC;&#x2122;s M-PESA has generated 23,000 jobs for agents in Kenya. Mobile phones can also greatly enhance job opportunities for microentrepreneurs, most notably as they facilitate contact between entrepreneurs and their consumers. In their ethnographic study of urban micro-entrepreneurs in Morocco, Ilahiane and Sherry (2012) illustrate this by introducing the

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term “Bricolage”: ‘The active and strategic assembling of diverse economic opportunities through the use of mobile technology’. They show how mobiles phones lower the cost of finding work for micro-entrepreneurs by putting them in direct contact with customers, such as a plumber receiving a call for an emergency. They also emphasise how the creation of communication networks reinforce the process by binding individuals from different networks together, who then recommend their relatives or acquaintances for a particular job. Mobile phones therefore, by lowering the time and cost of interaction, play a key role in building social networks, and acts as a leveraging tool in searching for job opportunities.

7,0% 6,0% 5,0% 4,0% 3,0% 2,0%

Malaysia

Serbia

Thailand

Pakistan

0,0%

Ukraine

1,0%

Bangladesh

Economic impact (% of GDP)

Figure 11: Economic impact of the mobile communications industry in 2007 as a percentage of total GDP

Source: Deloitte, 2008

Moreover, mobile phones can themselves be a source of employment, offering opportunities for individuals to innovate and start a business (see Case 7): Case 7: Grameen Village Phone Ladies Women buy mobile phones and earn their living by offering telecommunication services to their villages in Bangladesh, selling calls. Grameen Bank (2013) reported that there were about 364,000 village phone ladies by the end of 2009. For example, in the rural village of Kalimajani (Bangladesh) that was cut-off from the world, with no fixed line telephone service provided by the government, people now can rely on telephone ladies to connect to the world. The Phone ladies have changed the lives of the villagers, but their business also improved their own lives. One of them reported that she makes a good living since she became a phone lady, earning $60 to $70 a month. She also highlighted how owning a phone and engaging in the business has helped her gaining respect from other villagers, even members of the local council, suggesting there is also an empowerment dimension benefiting entrepreneurs (BBC, 2005).

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A critical point to make here is that even though mobile phones can significantly improve the economic lives of micro-entrepreneurs through all the mechanisms described above, there is an important individual dimension that is non-negligible. As implied by the capabilities approach, people are free to choose how to use their mobile phones, and it is not guaranteed that they do so in an economic manner. On the contrary, a number of studies have found that people in the developing world tend to use their mobile phone for predominantly social rather than business interactions, for example to keep in touch with their family while they are doing business away for home (Donner, 2004; Souter et al., 2005). This shows that mobile phones provide social benefits to micro-entrepreneurs in addition to economic benefits. In their survey on mobile use in South Africa, Tanzania and Egypt, Samuel et al. (2005) reported that 91% people in Tanzania and 77% in South Africa called their friends and relatives rather than travelling to see them. As Murphy and Prime (2011) put it, technology is â&#x20AC;&#x2DC;embeddedâ&#x20AC;&#x2122; within its social context, which determines its acceptability and usage. Understanding this context is therefore crucial in order to understand the true impact of mobile phones on development, a factor that is also relevant to the finance pillar which shall now be discussed.

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CHAPTER 4: M-BANKING

Transaction costs

MSEs

Job opportunities

Service and quality M-Health

Administration and management

Individual well-being

Prevention

Insurance M-Banking Financial Inclusion

Mechanisms

Societal Impact

Market access

Economic and Human Development

Mobile Telephony

MEn

tre pre n

rsh

Figure 12

Micro Level Households

Impacts

FINANCE AND DEVELOPMENT The final pillar through which mobile telephony is able to generate development is that of mobile finance. This is hugely relevant in developing countries as individuals that often have scarce access to financial products are able to use their mobile phones to increase access to them and overcome the impediments of financial inclusion. As it will be elaborated on in this chapter, their inclusion can help them transfer money, and particularly remittances, whilst also providing access to previously unaffordable insurance products that help accelerate poverty reduction and increase development. The purpose of this chapter is therefore to identify the means by which mobile telephony has led to development through increasing financial inclusion and insurance subscription. The role of mobile telephony is indirect in so much that it â&#x20AC;&#x2DC;Resolves an idiosyncratic market failure that farmers face; access to

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financial services’ (Kirui et al 2012). This market failure is most prevalent in SSA where deposit institution penetration rates stand at 16.6% compared to the 63.4% in other developing countries (Ondiege, 2012). Consequently this chapter’s focus shall be on SSA, where it is clear that the impact of financial exclusion is most strongly felt. This is evidently clear from the attached graph (see Appendix 7), which illustrates the substantially lower rates of inclusion in developing countries, at around 10%, when compared to developing regions of the world such as Australia or Europe where the rates are over 80%. Below is a diagrammatic representation of the mechanisms that this chapter shall focus on, which illustrate how mobile innovation overcomes (a) Limited financial inclusion and (b) Insurance in developing countries and ultimately contributes to development:

M-Banking Financial Inclusion

Mechanisms

Micro Level Households

Societal Impact

Insurance

Economic and Human Development

Mobile Telephony

Figure 13

Impacts

The World Bank has defined financial inclusion as the ‘absence of price or non-price barriers in the access to financial services’ (2012). The decision to steer clear of savings as a developmental mechanism was driven by the lack of clarity as to the causal link between provision of savings mechanisms and increases in savings ‘even when given access to free savings accounts, few people made use of them’, derived from a lack of self-control (Dupas and Robinson, 2012). Thus, regardless of individual perspectives on the spending and saving patterns of the extreme poor the area is still debated in terms of the direct impact of providing a means by which to save. It is for this reason that the focus of financial inclusion in this chapter is solely on inclusion as a means by which to transfer and transact. The reason that financial inclusion is inherently low throughout SSA is the lack of competition between banks, which limits the quality and increases the cost of financial services. Sanyan and Gaertner (2012) highlight this and find the rate of competition within the African banking industry is extremely low, making it weak, expensive and inefficient, thereby forcing the use of expensive intermediaries as remittance vehicles (see Appendix 8). These remittances are of extreme importance and totalled $40 billion in 2010, despite being significantly underestimated as a result of many African countries not collecting data regularly (Ratha et al, 2010).

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The dispersion of Africa’s population also serves to contribute to financial exclusion, since, with the exception of the metropoles, the vast majority of the continent has less than 10 inhabitants per km2 (see Appendix 9). This, as well as the weak infrastructure, limits the ability of banks to set up a viable branch network able to reach a wider audience, and therefore begets low financial inclusion (Linard et al, 2010). Largely because the general weakness of infrastructure in Africa compounded the geographical dispersion by making these already long distances more difficult and expensive to traverse. In addition to this a prerequisite for increased financial inclusion is wide financial literacy, which was found to be lacking by a FinScope study; with 40% of Tanzanians having never heard of a savings account, and 56% of Rwandans having never heard of insurance. Gleason reiterates that without a clear understanding adoption will be restricted, since ‘Pushing clients into committing to something they don’t know enough about reinforces the idea that financial institutions cannot be trusted’ (Gardeva and Rhyne, 2011). Kimenyi and Songwe (2012) emphasise that ‘G-20 summits have acknowledged that a key driver for economic growth is access to financial services such as money transferral’. Therefore, the unique suitability of M-banking to the developing world context facilitates increased financial inclusion, and therefore development. A study by Perry (2011) confirms this, suggesting that mobile telephony induced financial inclusion has a significant impact on economic performance in an urban setting (see Case 8)1: Case 8: Arusha Flowers Arusha Flowers in Dar es Salaam, Tanzania is a small micro-enterprise where M-banking has recently been introduced. The principal benefit of not relying on bank deposits and payments through the banking infrastructure is in this case that ‘Banks are very slow’, a problem that is exacerbated by the weakness of the road infrastructure getting to the bank, meaning that ‘one to three hours spent in traffic jams’ (Bangens and Soderberg, 2011). The impact of using M-banking to make payments has led to a 50% reduction in delivery times (Four days to two days), which has in turn contributed to increased order handling per week as a result of improving logistics. Whilst the economic impacts of this case is clearly substantial it is worth noting that the impact at a personal level is extensive, with increased ‘free time’ to engage with family and manage the business (Bangens and Soderberg, 2011).

The reasons for limited financial inclusion discussed above has undoubtedly had a knock on effect that has contributed to low insurance take up in the developing world, and particularly in SSA. As it stands less than 80,000, or 0.1% of, Africa’s farmers2 have insurance, made more shocking when we consider that half of SSA countries suffer a drought every 7.5 years and flooding roughly every 3 years. This lack of a safety net makes farmer 1 Increasing financial inclusion will indirectly increase savings, with Aggarwa et al (2006) finding that having an M-banking account increases the amount that is ‘likely to be saved’. Therefore M-banking has the potential to positively impact on micro and macro-economic indicators by increasing savings. 2 Data from Micro Insurance Innovation Facility study (2009) suggests that over the past 30 years has seen 1,000 natural disasters affecting 328 million people and causing $24 trillion of damage.

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entirely reliant on the weather, with 89% of Andhra Pradesh households saying rainfall variability, is the most important source of risk (Cole et al, 2009). Barnett and Barrett (2008) examined insurance scarcity in developing countries, and suggest that without insurance a poverty trap can become selffulfilling. The idea being that a ‘Plunge in income due to death, disability, and adverse agricultural outcomes translates into substantial decreases in consumption and investment that can permanently set back a poor family’s livelihoods and prospects’ (Brainard, 2006). This shifts a household to a new equilibrium, transforming their spending and investment decisions into ‘low risk, low return’ tactics3. This approach makes them less likely to go hungry; but simultaneously limits their ability to invest in productive assets. Moreover, the negative consequences of limited insurance coverage are predicted to increase for rain fed agriculture as the impacts of climate change on weather patterns begets ‘more frequent and more extreme weather’ that will further strain their productivity and livelihoods (Oxfam, 2011).

M-BANKING Mobile telephony has gone a long way towards overcoming the aforementioned problems of limited financial inclusion and insurance through mobile-based innovations. The remainder of this chapter shall therefore be a discussion of the mechanisms through which mobile telephony is best able to provide developing countries with banking and insurance services. These mechanisms are infact further categorisable in terms of external and internal mechanisms; with financial inclusion leading to external benefits such as the ability to interact and trade with new agents, the ability to send money and therefore assist family members and through the creation of improved external linkages thereby increasing efficiency at an individual and a business level. The insurance mechanism is largely an internal mechanism in so much that it serves to smooth the output of an individual farmer by ensuring they do not descend into a poverty trap or resort to growing low return goods. It is however worth noting that the external/internal categorisation above is often less than clear, and in some instances insurance and increasing financial inclusion may play alternative functions.

Financial Inclusion In 2007, in response to the low rates of financial inclusion reported above, M-PESA was introduced by Safaricom to provide a platform from which customers could access transfer and receive ‘money’. The use of a mobile platform was common sense given that the low rates of financial inclusion were starkly contrasted by substantial mobile phone subscriptions, with Gabon leading the way with near 100% subscription rates (see Case 9): The principal reason for the growth of M-Banking is the gulf in cost between informal financial services such as sending remittances on buses and the mobile equivalent. To this end, a study by the Bill and Melinda Gates foundation found that mobile transfers are six times cheaper than alternative informal structures (Valenti, 2007). Kabbucho et al (2003) quantify this difference, finding that transferring $100 through Moneygram costs $12, and through a bus company costs $3. These sums may seem relatively small, yet in the context of SSA they amount to 20% to 30% of the sum being sent (Sander, 3 This can be seen to be similar to the ‘Survival Type’ enterprises discussed in chapter 3.

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2011). This is much higher than the <$2 it costs to send a payment through M-PESA to a non-user (Safaricom, 2008). Evidently then the introduction of M-banking has led to a reduction in the cost of transferring money which has disrupted the traditional money transfer industry and changed the way it is perceived, coined by Schumpeter in 1942 as ‘creative destruction’ (Aghion and Howitt, 1992). The reduction in cost is one of many reasons that mobile banking has been able to increase financial inclusion in SSA. This closely ties into the capabilities discussion within chapter one, as a result of the lower costs giving users increased freedom and the ability to transact as they desire. This is particularly relevant given the aforementioned geographical dispersion and infrastructural weaknesses. These obstacles contribute to a further advantage of M-banking in terms of the extensive time and potential for delay. This is inherent within informal services such as bus transfers and even in more formal services such as the post . This is compounded by many instances of ‘loss, theft or the use of funds to pay for repairs en route’ (Morawczynski and Pickens, 2009). It is therefore evident that numerous benefits accrue as a result of mobiles requiring little investment in costly infrastructure. This therefore allows services like M-PESA to substitute for banking and remittance transferral services, and in doing so increase financial access from 0.6 bank branches per 100,000 in Uganda and Tanzania (Beck et al, 2008).

M-Insurance The role of M-banking as a platform upon which services such as insurance can be added is evidently where the true value of mobile phones lies. In so much that it acts as a platform from which insurance and other services can be provided. This ability to increase insurance take up is therefore important when we consider it with respect to the impact of insurance on development. Fundamentally, the introduction of M-banking based insurance policies has alleviated the significant issues highlighted above by providing financial products for farmers in rural areas, (see Case 10). Whilst the impact of M-banking is clearly substantial, it is the evolution of the service that possesses the true economic impact, turning it from ‘[A] pure money transfer system into a payment platform for formal financial services’ (Aker and Mbiti, 2010). Brainard (2006) identifies ‘A positive S-curve relationship between per capita income and insurance penetration’. Providing insurance through mobile telephony contributes substantially to the smoothing of household consumption curves, therefore helping farmers avoid and overcome poverty. This reduced vulnerability to income shocks affords them increased freedom, which in line with the Amartya Sen view, directly contributes to increased development. In the case of farmers, this allows them to cope with extreme events, a necessity to improve their welfare in the short term and create opportunities for income growth such as investment in healthcare (Hill, 2010).

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CHAPTER 5: POLICY RECOMMENDATIONS Figure 14: Mobile subscriptions worldwide

Source: World Bank, 2012a

As we have seen throughout this report, the mobile telephony industry has become a fast-growing global industry, and presents a very relevant opportunity for developing countries to be part of the trend and â&#x20AC;&#x2DC;bridge the digital divideâ&#x20AC;&#x2122;.

THE ROLE OF THE GOVERNMENT Mobile telephony has had the potential to generate development in developing countries throughout the last decade. However, the mechanisms enabling mobile phone adoption to translate into successful and long-term developmental outcomes depend on government participation and buy-in. For example, mobile-facilitated health services can only be provided if the basic health infrastructure, such as hospitals and medicine, are in place. Boosted by mobile phones usage, micro-enterprises need a level playing field in order to grow and leave the informal sector. And finally, in order to benefit from financial services, M-banking innovations such as ZAP must exist in an enabling regulatory environment, allowing them to operate in the first place. As enablers of these mechanisms, governments also have a role to play in promoting mobile phone usage amongst citizens. On the demand side, this means creating a facilitative environment for the adoption of mobile phones, by for example insuring owners against loss or theft. At the same time, on the supply side, this may mean investing in telecommunications infrastructure in order to keep communication costs low, and guarantee access to mobile phone services. The role of private companies in creating these enabling conditions should not be overlooked. In India, for instance, Vodafone is the second largest telecom operator. In addition, the market research firm

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iSuppli Corp (2010) predicts that wireless subscriptions will cover 97% of the country’s population of 1.26 billion by 2014. In line with these trends and the growing interest of private companies in mobile technology, the role of the government becomes encouraging such firms to invest in their country, by for example attracting Foreign Direct Investments (FDI), which are important for national productivity and human capital formation. Indeed, the positive role of FDI in enhancing a country’s competitiveness has been recognised by many (for example Dicken, 2007). Multinationals increase local competition and create a ‘productivity spillover effect’ that upgrades human capital through technology transfer (Guggler and Brumer, 2007). A risk when dealing with mobile phones for development is that the ‘increasing of mobile phones penetration rate’ is taken as the ultimate goal. As we have emphasised in this report, owning a mobile phone does not necessarily lead to development, and there are alternative uses/benefits of mobile phones. In Chapter 2, for example, mobile innovations can easily be implemented in rural areas of developing countries, and yet it needed to be cheap and easily replicable to benefit the greatest number of people. Furthermore, chapter 3 illustrated that many entrepreneurs use mobile phones to keep in touch with their relatives while working away from home instead of exploiting their real potential for improving economic activities. Finally, in chapter 4 it is clear that the use of M-Banking is widespread, but evidently not all that have a mobile phone use the services. Social drivers are therefore a determinant of the success of mobile phone use for development goals, and as stated by Wade (2002) it is not just about promoting the uptake of mobile phones, but about how individuals learn to combine its uses to meet their local needs.

ADAPTATION TO THE LOCAL CONTEXT The above analysis suggests that governments should strive to increase the usage of mobile phones within a developmental perspective instead of simply focusing on mobile penetration rates. This means that governments should design training programs that teach individuals how to use their mobile phones in the health, entrepreneurial and financial areas as a means of increasing their personal freedoms. A clear illustration of this is the Wireless Reach Initiative, which helps educators, health care workers and entrepreneurs take advantage of mobile technology. This will occur mostly by mobile phones allowing MSEs to grow and not remain stuck as ‘survival type’ enterprises, which is a key element of economic growth in developing countries. According to this objective, mobile phones can play an important role, however, they cannot replace investments in other infrastructures necessary for sustainable development. In health, for example, you cannot replace hospitals by mobile phones. Training programs would also have to be tailored to the local necessities to make sure individuals understand the importance of using mobiles as tools to increase their capabilities. In Chapter 2, the case study of Motech demonstrates this, as 50% of Ghanaian users are illiterate, and therefore tailors itself to the local context by being voice message based.

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RECIPROCAL LEARNING The usage of mobile phones in the health, entrepreneurship and finance sectors are boosting development in developing countries, which is what we have analysed in this report. This gives these countries a competitive edge in comparison with the Western World, as mobile applications increase efficiency and the simplicity of delivering complex information, as highlighted by our internal and external mechanisms framework. In this sense, developing countries have leapfrogged these mobile technologies and showed how a simple tool like a feature phone has more potential than the Western countries expected (Steinmuller, 2001). The Western focus on legacy technologies (such as wired phone lines), means that in some ways they have been left behind in comparison with developing countries. For example, no western country has a service as good as M-PESA. This suggests that the Western world could also learn from developing countriesâ&#x20AC;&#x2122; successes and use these innovations to complement their processes in the health, entrepreneurship and finance sectors. An example in line with this argument can be observed in the United Statesâ&#x20AC;&#x2122; implementation of Text4Baby, where mobile phone applications in the health sector were implemented based on the Mexican model of VidaNet. This program consists of SMS services informing about 800,000 pregnant women about relevant issues. Moreover, in line with the financial crisis and rising unemployment, mobile phones, as we have seen with the Grameen Phone Ladies, have the potential to provide opportunities for many people to develop innovative applications and start a business, which is crucial given that small businesses are already the major source of employment in the USA (SBA, 2010). Finally, in finance, applications like M-PESA could reduce the cost of financial services for many people in developed countries, who are currently utilising inferior and expensive products. However, we should note that many countries have different cultures of mobile phone use. In the developing world, prepaid models dominate; users commonly maintain active accounts with multiple providers; people often share phones; and users do not pay to receive phone calls or text messages. This vastly different context between developed and developing countries therefore matters significantly in terms of technology adoption and usage when mobile phones applications are transferred from the developing world to the developed world.

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CONCLUSION The fact that 75% of the world’s population have now got access to mobile phones is undeniably significant (World Bank, 2012). For this reason, within the development field, mobile phones have gained upmost importance and have been identified – as other technological improvements once were – as the tools that can help developing countries emerge from their poverty traps. Nonetheless, the existence and access to mobile phones does not automatically translate into developmental objectives. Therefore, in this report, we aimed to highlight (a) how mobile telephony has contributed to both economic and human development realms in the light of Sen’s capabilities approach; and (b) why has this taken place in the presence of certain mechanisms and conditions. In doing so, this report has filled a gap in the literature and established a detailed taxonomy linking mobile phones and development. We have based our findings on the developmental impacts that we have conceptualised using qualitative data and case studies from the literature. As observed in our report, we explicitly focused on the health, entrepreneurship and finance realms given their interrelation, and given ‘[w]hat people can positively achieve is influenced by… the enabling conditions of good health... and the encouragement and cultivation of initiatives’ (Sen, 1999: 5). These pillars were also chosen because health is an essential good that individuals need to sustain their lives; entrepreneurship is an important source of employment and, therefore, income; and finance provides opportunities to access financial products that help individuals reduce costs, and thus, increase their freedoms and abilities to transact. Mobile phone adoption and usage have demonstrated that in some developing countries, and under certain circumstances local capabilities have been able to use ICTs to develop from within, using technologies to achieve their own goals without any kind of imposition. For this purpose, this paper has distinguished between internal mechanisms, as those that increase internal efficiency of the activities of households, entrepreneurs and health centres; and external mechanisms as those that increase the connectivity with external actors such as patients, trading partners, clients and personal relationships. In terms of health, we gave particular attention to three mechanisms: service and quality; administration and management; and prevention. From our case studies, we observed that mobile phones have contributed positively to the development sphere when local knowledge was integrated with the innovation and when governments committed to the promotion of mobile phone usage to reduce its own costs and healthcare campaigns. The successful integration of M-health within national policies as well as the attention it received from both NGO’s and private businesses assisted in the development of numerous mobile innovations in areas such as enhancing efficiency, awareness and prevention through health education. This has led to the improvement of both institutionalised and grass roots healthcare in rural areas, which previously lacked connectivity with urban areas. Within entrepreneurship, we emphasised three mechanisms: market access; transaction costs; and job opportunities. As case studies in this section show, within the field of M-entrepreneurship mobile telephony has enabled microentrepreneurs to overcome information asymmetries and in doing so allowed

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them to access new markets. Mobile applications have facilitated this process, and along with the creation of social networks have enabled entrepreneurs to increase their productivity via the sharing of best practices as well as providing them with new job opportunities. In doing so, mobile based innovations have been a source of employment and therefore income for entrepreneurs who rely on their businesses for their livelihoods. Furthermore, individual know-how and the access to technology usage, tailored to their needs are fundamental to make mobile phones sustainable tools to increase freedoms. In the finance realm, we highlighted the two mechanisms of financial inclusion, and insurance. From this chapter, we concluded that government driven financial literacy is vital for these mechanisms to be successful. However, there is huge potential for mobile-based insurance and financial inclusion in developing countries, and through mobile devices this coverage has increased significantly within the most poorly covered regions of the world, such as SSA. It therefore goes without saying that the principle benefit of mobile-based M-banking solutions has been to encourage development through lowering the costs of insurance and financial transactions, which have subsequently increased their uptake and driven development. As mentioned throughout, not everyone who uses a mobile phone has expanded his/her capabilities and freedoms. As we observed, social drivers are crucial for technological uptake and mobile phone usage towards a developmental goal. If laws are enacted or phones are just being delivered, increases in development indicators will hardly be observed. This means that governments should be aware of the local conditions and necessities of a particular region in order to integrate coherent and sustainable policies that incorporate the use of mobile phones in a dynamic market that is characterized by fast-moving technology. As emphasised in the policy recommendations section, we should remember that governments are enablers of mobile phone usage; adaptation to the local context is crucial to yield developmental benefits; and both developed and developing countries can benefit from the use of mobile telephony with reciprocal learning. The rapidly changing nature of the mobile telephony industry makes it difficult to accurately isolate a certain technology that is continually changing and discuss its future impacts. To this end it is clear that the rise of smart phones has the potential to substantially alter the ability of mobile telephones to generate development through the wide variety of services available through them. Whilst beyond the scope of this report, the growing importance of smart phones suggests that this is a potentially important area for future research. To conclude, the potential of mobile telephony in developing countries takes us away from dependency theory and assumes they have the capabilities to use the technology to expand their freedoms and be the architects of their own development paths. As put by Sen: ‘A telephone—and particularly one that is readily usable by the owner and others—is generally freedom- enhancing’ (Sen, 2010). The mainstream argument is that developing economies need complex technologies to solve complex problems, however this report has evidenced that simple technological solutions (i.e. feature phones) can solve an issue as complex as economic and human development.

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poverty reduction’ Reading, UK: Gamos. Steinmueller, W. 2001. ‘ICTs and the possibilities for leapfrogging by developing countries’. International Labour Review, 140 (2), pp. 193-210. Valenti, K. 2007. ‘Reach out and Enrich Someone’ Journal of Policy Innovation. 4(5) pp. 1-5 Vodafone. 2005. ‘Africa: the impact of mobile phones’, Vodafone Policy Paper Series, Number 2. Waidyanatha, N., Dubrawski, A., Gansana, M. and Gow, G. 2011. ‘Affordable System for Rapid Detection and Mitigation of Emerging Diseases’, International Journal of E-Health and Medical Communications, 2 (January-March), pp. 7390. Wang, H. and Liu, J. 2009. ‘Mobile Phone Based Health Care Technology’, Recent Patents in Biomedical Engineering, 2: pp. 15-21. Weil. D, & Mbiti, I. 2011. ‘Mobile Banking: The impact of M-Pesa in Kenya’ NBER Working Paper No. 17129 Wootton, R., Patil, N., Scott, R., and Ho, K. 2009. Telehealth in the Developing World. Royal Society of Medicine Press: London. World Bank, WB. 2004. World Development Report: Making Service Delivery of the Market Economy Work for Poor People. Washington, DC: World Bank. World Bank. 2012a. Information and Communications for Development 2012: Maximizing Mobile’ Washington, DC: World Bank. World Bank. 2012b. ‘Access to Finance and Development: Theory and Measurement. World Bank Working Paper. DC: World Bank Available at: http://siteresources.worldbank.org/INTFINFORALL/ Resources/4099583-1194373512632/FFA_ch01.pdf World Bank. 2013. ‘Agriculture and Rural development’, World Bank (online). Available at: http://data.worldbank.org/topic/agriculture-and-ruraldevelopment (Accessed 24th March 2013) World Health Organization, WHO. 2005. Health and the Millenium Development Goals. Geneva: World Health Organisation. World Health Organization, WHO. 2006. Building foundations for eHealth. Progress of Member States. Geneva: World Health Organization. Available at www.who.int/GOe (Accessed 20 March 2013). World Health Organization, WHO. 2011. mHealth New horizons for health through mobile technologies. Geneva: World Health Organisation.

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APPENDIX APPENDIX 1 Appendix 1: Mobile phones and Millennium Development Goals

Source: World Bank, 2012

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APPENDIX 2 Appendix 2: The M-Health Ecosystem and its outcomes

Health Health system Health care workers Medical supply chains Patients

Government Legislators Regulators Legal system Ministries

mHealth applications

Technology Software developers Mobile operators Handset makers

mHealth Service delivery Mobile platforms

Health funding Finance Banks Insurance companies Private investors Philanthropists Donors Individual user/ households

Source: Qiang, Yamamichi, Hausman, Miller and Altman, 2012 Appendix 2: How can mHealth improve outcomes? How can mHealth improve healthhealth outcomes?

Better health through reach, affordability, quality assurance, matching resources, behavioral norms

Outcomes

Multipliers

ICT literacy Health literacy Health training M&E

mHealth service delivery

Outputs Health system needs Health care best practices Procurement & Supply Chains Cultural attitudes Inputs

Policies & Strategies

Complementary mServices Complementary capital investments ICT maintenance and repair capacity

Financing Network installations Distribuition channels Research & Development

Related Infrastructure

Regulation & Standards

Leadership & Governance

Communication & Education

Source: Dalberg Research and Analysis

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APPENDIX 3: FIGURES MOTECH Appendix 3: Pregnant Women in MOTECH

Number of Pregnant Women

2951

3177

3646

3381

3924

4063

Jan '12

Feb '12

Mar '12

Apr '12

May '12

Jun '12

Source: Grameen Bank 2012 Appendix 30 3: Have you ever listened to a message?

number of clients

yes no

20 15 10 5 0 personal phone

household phone

public phone

phone ownership type Source: Grameen Bank 2012

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APPENDIX 4 Appendix 4: How the SIMpill system works

Source: Shackleton 2007: 46

APPENDIX 5 Appendix 5: Taxonomy of micro, small and medium-sized enterprises Micro-enterprise

Small-enterprise

Medium-sized enterprise

• Less than 10 employees • Maximum €2 millions annual turnover

• Less than 50 employees • Maximum €10 millions annual turnover

• Less than 250 employees • Maximum €50 millions annual turnover

Source: European Commission, 2003

APPENDIX 6: ECONOMIC IMPACT OF MOBILE COMMUNICATION ON RETAIL BUSINESS IN SUDAN (FEBRUARY 2013) Mobile telephony in Sudan has gone through a period of substantial development and change. The growth of mobile telephony in Sudan is a microcosm of what is happening globally with mobile handsets set to reach 5 billion in coming years. The business case points away from developed countries and towards more marginalized countries, and in particular SubSaharan Africa, which is now the fastest-growing mobile market in the world. In Sudan today there are three licensed operators facilitating large advances in population coverage, penetration and service offering. Increased completion has led to persistent reductions in the retail price charged by ‘Mobile Network Operators (MNOs) for mobile calls, text messaging and data transfers.

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Appendix 6: Customers and Mobile Penetration

Customers ('000) Penetra on %

2002 500 1,0

2003 1.000 3,0

2004 2.000 4,0

2005 2.500 5,0

2006 4.000 10,0

2007 2008 2009 8.000 10.000 12.000 20,0 27,0 30,0

Source: Wireless intelligence and Deloitte estimates 2009

ECONOMIC IMPACT Various studies have been undertaken in Sudan to examine the ‘Economic Impact of Mobile’ on business enterprises. A review of these research reports indicates that apart from the impact on workers’ productivity, mobile phones have facilitated an improvement in information flows between the buyers and sellers, reductions in travelling time and accessibility to isolated areas of the country. Appendix 6: Economic Value from increases in productivity, 2004-2009 100

60 40

20 400

45 600

1800

2000

1400

2500 2000 1500 1000

800

500

0 Produc vity increase (Milion SDG) Popula on coverage (%)

2004

2005

2006

2007

2008

2009 Proj

400

600

800

1400

1800

2000

Source: Deloitte estimates 2008

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OBJECTIVE The objective of the study was to assess the impact of ‘Mobile phone’ on retail businesses in Sudan.

METHODOLOGY The means by which this was to be achieved was utilizing the extensive CocaCola distribution network to facilitate face-to-face interviews supported by pretested structured questionnaires. These were to be undertaken by trained retail audit staff who regularly undergo similar questionnaires on a monthly basis. The surveys scope was due to time limitations restricted to 250 outlets, focused on Khartoum city and the surrounding areas.

SAMPLE In all 250 interviews were conducted by trained research investigators in Greater Khartoum among retailers of different categories Category Split: Super Markets

Cafeteria/Restaurants Total

Groceries

250 80 90 80 While selecting the study sample, due weight was applied to each of the three geographical regions of Greater Khartoum.

FINDINGS Age Split of Respondents (%)

Appendix 6: Age Split of Respondents

45 + Yrs; 12% Up to 35 Yrs; 58% 36 - 45 Yrs; 30%

Number Of Phones Owned All Channels Super Markets Grocieries Cafeteria/Restaurants One Phone Two Phone More than two

80.0 18.0 2.0

79.9 16.5 3.6

72.5 27.5 0.0

84.0 14.0 2.0

The majority of respondents (80%) owned one mobile phone at the total sample level, with no remarkable variation across the outlet categories.

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Brand Share (%)

Appendix 6: Brand of Mobile Phone owned

Chinese make; 7,0; 7% Sony Ericsson; 2,5; 3%

Others; 2,5; 3%

Samsung; 12,5; 12%

Nokia; 75,5; 75%

Nokia

Samsung

Sony Ericsson

Chinese make

Others

Nokia was by far the most utilized mobile brand among the retailers in Greater Khartoum. As high as 75% of the retailers reportedly owned Nokia branded phones, followed by Samsung (12%) and Sony Ericsson (3%). Appendix 6: Subscription Length (% respondents)

10 + Yrs 6 - 10 Yrs 1 - 5 Yrs

All Channels 36,0 50,0 14,0

Super Markets 44,0 40,0 16,0

Groceries 13,0 72,0 15,0

Caf/Rest 40,0 49,0 11,0

The use of mobile phones in Super Markets and Cafeterias /Restaurants has been for longer in comparison to Groceries. As is evident from the graph, 44 % of the Supermarkets have had mobile subscription for over 10 years compared to 13% of Groceries.

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Appendix 6: Subscription Type (% respondents)

Post Paid Pre Paid

All Channels 3,5 96,5

Super Markets 3,8 96,2

Groceries 2,5 97,5

Caf/Rest 3,7 96,3

Findings illustrated that post-paid subscription were uncommon among the retailers and traders in Greater Khartoum. At the total sample level, 96.5 % retailers reportedly had ‘Pre Paid’ subscription or scratch cards. Appendix 6: Average Spend/Month (% respondents)

All Channels SDG / Month US$ / Month

187,6 35,4

Super Markets 213,0 40,2

Groceries

Caf/Rest

125,8 23,7

224,0 42,3

Super markets & Cafeterias spent relatively more in comparison to Groceries, with the average spend per month for a Super Market standing at around US$40 compared to a Cafeteria’s US$42.

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Appendix 6: Internet Accessibility & Usage (% respondents)

Does not have Access Have Access

All Channels 53,5 46,5

Super Markets 46,9 53,1

Groceries 72,5 27,5

Caf/Rest 50,6 49,4

Internet accessibility through mobile phone was not high at this point in time. However, there was some variability between channels, Groceries having the lowest internet accessibility (27.5%) , followed by Cafeterias (49.4%) and Super Markets (53.1%) with the highest. Appendix 6: Purpose of Internet Use (% respondents)

Accessing E Mails Web Surfing Commercial Usage

All Channels 73,1 49,5 16,1

Super Markets 76,2 54,8 14,3

Groceries 72,7 36,4 0

Caf/Rest 70,0 47,5 22,5

The principle Internet use amongst retailers was ‘Accessing E Mails’ (73.1%) at the total sample level. However it’s usage for ‘commercial purposes’ was extremely low at 16%.

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THINK! REPORT N° 4

Appendix 6: Awareness of Internet Services (% respondents)

All Channels

Super Markets

Groceries

Caf/Rest

Tele Banking

Tele Reserva on of Journey Tickets

Payment of Bills

The payment of bills using mobile phone internet facility, reservation of journey tickets and tele banking services are known to the respondents. The awareness about ‘Bill payments’ was highest at 83%, followed by ‘Tele banking’ (54%) and ‘Journey ticket booking’ (45%), all at the total sample level. Usage of Mobile Phones for Commercial Purposes (% respondents) All Channels Super Markets Grocieries Cafeteria/Restaurants Placement of orders Calling Whole Sellers Receiving Orders Trasfering Credits

66.1 17.3 10.1 6.5

78.1 14.6 0.0 7.3

65.7 17.9 0.0 16.4

56.1 19.3 24.6 0.0

As reported by the retailers, mobile telephone has provided a boom for their businesses. Its usage by retailers is mostly for placement of product orders with suppliers (66.1%)and Calling Whole sellers (17%). Cafeterias use it for receiving orders for home delivery, whilst Transferring Credits is also emerging as a business opportunity in Groceries. Impact of Mobile Phones on Retailers business (% respondents) All Channels Super Markets Grocieries Cafeteria/Restaurants Better Co ordination with Suppliers Better tracking of employees Faster Social communication Faster Communication/ Time saving

42.6

37.0

56.5

41.3

9.5

8.7

6.5

11.5

19.0

19.6

15.2

20.2

28.9

34.8

21.7

26.9

The principle impact of mobile phones identified by retailers was the increased coordination with suppliers and the ability to track workers/employees.

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MOBILE TELEPHONY IN DEVELOPING COUNTRIES: A GLOBAL PERSPECTIVE

APPENDIX 7 Appendix 7: Map of Global Financial Inclusion Percentages

APPENDIX 8 Appendix 8: Map to show Population Concentrations in Africa

Source: Cartes Thematiques, 2012

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BIOGRAPHIES Alizé Aversano completed a bachelor of science in Management at the Warwick Business School. In 2011, she was the head of internal marketing at the Warwick Emerging Markets Forum, a student-led organisation with the goal to discuss the changing global landscape and the rise of emerging nations. During her studies, Alizé undertook internships at Chopard SA (a luxury watches and jewellery business), a private bank in Geneva, and Firmenich SA (an international producer of perfumery and flavour chemicals). Her research interests revolve primarily around market-based solutions to poverty, in terms of corporate social responsibility and ICTs for development. Sophie Evers gained a MA (Honours) in International Relations and Social Anthropology from the University of St. Andrews. She studied various topics with a regional focus on Europe and Sub-Saharan Africa, and completed a primary research based dissertation related to the usage of ICTs by nongovernmental organisations. Using theoretical learning in her professional experiences, Sophie has worked in Burundi, France, Austria and Germany in development-related fields. Next to ICTs, her personal interest lies in social entrepreneurship and innovation, which she further explored in her MSc thesis on social innovation in the health sector. Amir Latif has a BSc in Economics, obtained in 2012 from the University of Nottingham. His professional experience includes an internship in the marketing strategy team at the Coca Cola Company in Sudan, and a position with the supply chain team at Saga Flour Mills. Also, Amir has been the Africa Desk Intern at Czarnikow, where he assisted in ensuring cost effective vessel routing by monitoring shipping times and costs. His interests include research on emerging markets, and on the usage of computing and mobile technologies for development. Marta Vaca-Viana studied Economics in Mexico, where she is the Corporate Social Responsibility Director of the Center for Excellence in Corporate Governance. In light of the centre’s objectives, Marta built a rating tool and consolidated a methodology in order to evaluate public companies on environmental, social and corporate governance issues. Also, Marta cofounded the Network of Corporate Governance Institutes in Latin America, and has been highly active in the promotion of governance in the region. In 2012, Marta was a panelist in Yale’s Corporate Governance Forum, and she has represented the Center for Excellence in Corporate Governance (CEGC) in the OECD’s Corporate Governance Latin American Roundtables since 2008. Editor Silvia Masiero is a PhD Candidate in Information Systems at the London School of Economics and Political Science (LSE), and a Bagri Fellow at the LSE Asia Research Centre. Her doctoral work is on the impact of computerization on the Indian Public Distribution System, the biggest anti-poverty net in the Indian subcontinent. An experienced researcher in ICT4D, Silvia is now exploring, with increasing interest, the field of mobile technologies for development, on which she has recently carried out a review for the Economic and Private Sector (EPS-PEAKS) division at Coffey International. Her research interests, within ICT4D, focus primarily on the role of e-governance in transforming the vision of the state, held by technology users in developing nations.

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