Adapting to a World of Digital Health: Trust, Reliability & Accessibility in Developing and Developed Countries

How far would you go to track your health online? As far as dispelling personal information to ‘authorised’ bodies?

There is a stark contrast between developed countries like America, Britain and Australia to the likes of developing countries like rural China, India and Libya. What we need to analyse is the digital divide and the socio-economic divide that exists between these global boundaries.

One of the key factors that determine how people from developing countries learn to accept information and communication technology (ICT) is the issue of adaptation.

Digital health, on the other hand, has quantified the self in a more intimate way while social contexts continue to rely on the development of ICT.

So what is considered to be appropriate for developing and developed countries?

Let’s start by examining how we’ve come to view these two categories.

  • Developed countries have always been deconstructed into one individual entity- ‘The Self’
  • Developing countries, on the other hand, have been viewed by developed nations as an entire population- ‘The Collective’

I find this juxtaposition fascinating, since the media has shaped the way we have discussed these categories and perceptions. With digital health and digital literacy coming into the picture, the issue of compliance and the right to guard one’s identity is raised.

Why should we trust these new forms of technology? To what extent do we venture out to divulging personal information to these forms of health tracking benefits?

App Developers, Health & Fitness bloggers (even Instagram accounts), and devices like FitBit (which tracks your physical activity) have all played a part in forming this ideology of ‘the fitter, the better’.

What’s interesting though, is the fact that this notion cannot be applied to such a great extent in developing countries like India or rural China.

Some areas in these countries still lack basic facilities like housing and nutrition — introducing them to something so alien is only going to make them wonder why they need it.

In terms of examining adaptation in this context, we need to realise that developing countries are after more immediate solutions — with developed nations labelling this situation as a ‘public health crisis’.

David Heckerman (2009) from the Robertson Research Institute, in his research states that, there are key challenges in providing health care facilities to areas where it is most needed. Basic cell phones are a natural choice for delivering important information across a wide range of India’s cellular network (2008).

It is interesting to note that rural areas in India prefer to have access to cell phones rather than clean water. I’ve personally noticed this myself — having lived in India all my life.

Vegetable vendors, manual labourers and rag-pickers in India have one thing in common — access to a basic cell phone model. This had raised questions in my head regarding what they term to be beneficial and what they consider to be a basic necessity.

The Indian government has also introduced ICT systems in rural areas, where people require immediate medical attention and basic health care facilities.

This has been done in the form of providing local amenities to gain access to a computer (central PC solution) and the provision of cell phones. Notable organisations such as School Health Annual Programme (SHARP), has screened over 10 million Indian school children to create a unique virtual health record of the child — which is accessible online. Introducing these programmes has not only improved the health and well-being situation in India, but has also helped individuals (in rural areas, not urban areas) gain access to their personal health records.

I feel that in this way, trust and rapport can be established in a prevailing situation — through support and sufficient funding.

Another area that we can examine in this context would be the idea of the Quantified Self — prevalent in developed countries and even in the urban areas of developing countries where digital literacy and digital health is on par with developed nations.

Gary Wolf, in one of his TED Talks, highlights some of the ways in which we track our bodily functions and moods through mobile technology.

“ Some people will say it’s for biometric security. Some people will say it’s for public health research.Some people will say it’s for avant-garde marketing research. I’d like to tell you that it’s also for self-knowledge. And the self isn’t the only thing; it’s not even most things.”

The need to ‘feel better and look good’ has always been the underlying cause for people purchasing booming health products, Skinny Mint Tea and people breaking a sweat at the gym. The notion of demystifying the boundaries that exist socially, digitally and globally has been blurred — thanks to digital literacy and public health concerns.

Self-tracking users and people who regularly engage with health blogs are increasingly on the pursuit of something bigger — and it is safe to say that this pursuit is determined by existing cultural and socioeconomic boundaries.

It is not so much a narcissistic attempt at looking better than the person next to you, but it is more of a sense of belonging.

To me, this sense of belonging is the end result that is prevalent in developing and developed countries — which is why we get excited every time a new health care device or app is launched.


2. Joel Robertson Del Hart, Kristin Tolle ,David Heckermen - Healthcare Delivery in Developing Countries: Challenges and Potential Solutions
3. Gary Wolf- The Quantified Self (TED Talks)
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