ICTs and the changing health knowledge economy: how people find health information in Bangladesh

This proposal is responding to the theme of "Information and Communication Technology and Development".
Global access to Information and Communication Technology (ICT) is changing rapidly with the potential to impact on development in both positive and negative ways.
One way of analysing the health sector is as a knowledge economy - how to access expert advice on how to manage a particular health problem and how to access specific commodities, such as drugs, which embody a large amount of research and development. Yet where does this access start? It starts with the individual or household making a decision to seek information - to seek the advice or find the commodities. In a resource poor household, how are such decisions made? In common with many of us, and the general human experience, 'Everyday Life Information-Seeking', is a mixture of sources: mediators - friends, family: finding information grounds (the local market) , and technology - going online, phoning a helpline, listening to the radio, accessing a library, etc. But for resource poor households what does that mix look like, and is it changing with the growth of ICTs? We know that poor households often have access to mobile phones and increasingly to the internet. Is this changing access changing the core behaviour of health information seeking?
In this research we see three changing landscapes that could be affecting households choices. The health landscape is changing. New opportunities are opening up. In Bangladesh there are telephone helplines, local providers of health are sometimes networked in professional support, there are new private providers of healthcare. How does a household navigate these new opportunities?
The ICT landscape is changing. Households have access to mobile phones. In many cases they have access to the internet. How much do they use these for seeking health information? Have they begun to use Google to self diagnose? Do they phone their distant cousins for advice, or are they still prioritising face-to-face contact?
'Information-seeking' itself is a changing (global) landscape. The world over we are creating new patterns of information-seeking. For instance, in developed countries the role of online social networks is a dominant channel. Are resource poor Bangladeshi households beginning to explore alternative information channels? Do they have a basic information literacy? Do the trust what they read in the newspapers, what they hear on the radio? Is the radio still a key channel for information or has it been replaced by the television?
Our research will consider how these three changing landscapes interact with each other and while there are emerging bodies of work on each, there is very little that attempts to bring them together into a single conceptual framework supported by empirical research. This project, although focused on a single country, will explore different households in different resource settings to identify common approaches and decision-making patterns, to contribute to our understanding of how resource poor households are seeking health information in a changing world.

National stakeholders in Bangladesh: Early in the project the research team will identify key stakeholders, who will probably include policy makers concerned with health and with government strategies to encourage the spread of ICTs, the professional regulatory agencies, heads of health departments of large national NGOs, donor agencies, and private (for profit and not-for-profit) organisations providing ICT-based health information and advice services. We will organise a workshop to review the study objectives and agree a process for providing access of all stakeholders to the study findings. We will produce a policy influence strategy based on the conclusions of the workshop. We anticipate that it will include publicising study findings on the ICDDR,B website and presenting them to the annual ICDDR,B conference on health and health systems, producing one or more policy briefs and presenting findings to a learning platform that the Future Health Systems Consortium is establishing to bring together policy-makers, researchers, and health system innovators in Bangladesh and West Bengal, in India to facilitate learning from experiences with innovative approaches to health system development.
International stakeholders in ICTs and health: We will formulate our strategy for reaching international stakeholders in close collaboration with the Future Health Systems Consortium, the STEPS Centre and the many development information networks based at the IDS. This will enable us to disseminate our findings through websites aimed at different policy networks. We will build on existing cooperation with the Development Section of the Guardian online. We will also use discussion forums such as Eldis Communities as knowledge intermediaries for the research. We will link to international initiatives, such those on e- and m-health of the Rockefeller Foundation and the World Health Organisation. We will build on strong links between members of the research team and the Bangkok Office of the Rockefeller Foundation to ensure that study findings are disseminated to their programme partners. We will establish links with the ongoing research programme supported by the Global Alliance for Health Systems and Policy Research at the WHO. We will disseminate findings through the website of the Future Health Systems Consortium and through the website of the Centre for Health Market Innovations, organised by Results for Development, a Washington-based NGO. The PI is on the advisory group of that Center. We also intend to target potentially important global players such as the large mobile telephone companies and large internet based knowledge intermediaries, in our international policy influence and research uptake strategy.
Academic Community: Our strategy for reaching the academic research community will take advantage of links that the research team have with the Future Health Systems Consortium and the STEPS Centre so we can disseminate our findings through websites aimed at specific academic communities. We will work with these partners to organise panels at conferences such as the biennial conferences of the International Health Economics Association and the Global Symposium on Health Systems Research and the annual meeting of the Development Studies Association. We will produce at least six scientific papers for journals such as Health Policy and Planning, Social Science and Medicine and World Development. We will submit at least one summary article to The Lancet or the British Medical Journal to reach the broader health systems research community. We will aim to bring together some of these papers in an edited volume at the end of the project. The working papers and edited volume will be of particular interest to other researchers in the field, but will also be made available to practitioners and decision-makers. The ultimate beneficiaries will be to poor households in terms of access and a better enabling/regulatory environment.