A long and thoughtful article in MIT’s Technology Review with lessons for everyone planning a large, government-inspired project. It describes how the Kenyan health ministry “wanted to let community health workers put information into the database directly from mobile phones, which are ubiquitous in Kenya. The ministry initially sought a solution the usual way: it explored hiring a multinational contractor. It drafted a contract with the Netherlands office of Bharti Airtel, the Indian telecommunications giant that also operates a mobile network in Kenya. The company proposed spending tens of thousands of dollars on mobile phones and SIM cards for the data-gathering task, and it said it would need another $300,000 to develop the data application on the phones. The total package ran to $1.9 million.
“The contract was never signed; Kenya’s attorney general stopped the deal over questions about its reliance on one mobile carrier…Kenya’s director of public health made an urgent call to Gerald Macharia, the East Africa director for the Clinton Health Access Initiative (CHAI), a wing of the foundation started by former president Bill Clinton. Macharia then called an instructor at [Nairobi’s Strathmore University] who quickly rounded up four students. They spent the spring of 2011 at the CHAI offices, receiving internship pay of about $150 a month. They sat for days with the staff in the health ministry to understand the traditional way of gathering information. Then they pounded out the app and polished up the database software to allow disease reporting from any mobile Web interface. By last summer their ‘Integrated Disease Surveillance and Response’ system was up and running.”