A Critique of the Emancipatory Promise of Open-Source Software in Digital Health in LMICs
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University of Warwick
United Kingdom -
University of Warwick United Kingdom
Abstract
Digital health innovation through open-source software (OSS) is often presented as a critical response to the health system crises that low- and middle-income countries (LMICs) face due to inadequate public health infrastructure. Proponents of OSS argue that it offers a more sustainable, economical, and democratic approach to developing health solutions in underresourced contexts. Drawing on the experiences of software developers in East Africa working on digital health initiatives, this article argues that the potential of OSS to be transformative in LMICs is constrained by different infrastructural problems and its continued reliance on a middle-class elite who rely on technological fixes over health system solutions. This, we argue, is because OSS innovation is entangled in extractive legal regimes, digital ecosystems and persistent knowledge hierarchies. By foregrounding these epistemic and political dynamics, we call for renewed attention to the structural conditions that shape OSS innovation, particularly to the practices of software development in LMICs.
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Author Biographies
United KingdomTatenda Chatikobo is a Research Fellow at the University of Warwick’s Law School. He has published on digital inequalities, digital coloniality and media studies. Tatenda is currently leading analytical work exploring how critical social theory and decolonial thought can offer productive tools to reimagine digital health data regulation. His work draws on socio-legal critique of datafication and techno-solutionism to understand how claims to openness of digital infrastructures can conceal social vulnerabilities.
United KingdomSharifah Sekalala is a Professor of Global Health Law at the University of Warwick and serves as Director of the Centre for Global Health Law at Warwick School of Law. Sharifah is a socio-legal scholar whose scholarship is at the intersection of law, public policy, and global and digital health. She leads two funded projects on health data justice, focusing on experiences of marginalised communities in health data governance.
