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Social and technical issues of IP-based multi-modal semi-synchronous communication: rural telehealth communication in South Africa

Most rural areas of developing countries are faced with problems like shortage of doctors in hospitals, illiteracy and poor power supply. Because of these issues, Information and Communication Technology (ICT) is often seen as a useful solution for these areas. Unfortunately, the social environment is often ignored. This leads to inappropriate systems being developed for these areas. The aims of this thesis are firstly, to learn how a communication system can be built for a rural telehealth environment in a developing country like South Africa, secondly to learn how users can be supported to use such a system. The thesis argues that the social environment, in which the users work, is important in understanding how the technical system can be built. The thesis adopts an Action Research approach in which prototypes are introduced in each cycle based on an understanding of the social space of the users, and the use of the technical system from the previous cycles. The thesis takes into consideration data collected from the ethnographic observations, semi-structured interviews and automated system usage to develop and enhance the prototypes in each cycle. Data triangulation is performed on this data to understand how a prototype can be changed and enhanced for the next cycle to better fit into the social space of the users. The thesis also uses the Outcome Mapping methodology to evaluate the progress made in terms of the required outcomes from the users and other stakeholders. The thesis reports on research activity that extends similar work done in the rural Eastern Cape of South Africa. Videoconferencing, video messaging and Instant Messaging have been added to the MuTI system to produce a new system called MuTI Version 2. The thesis discovers that an understanding of the social environment of the users is helpful when developing a technical system. The thesis also finds that the social space of the users is affected due to the way the technical system is built. The thesis posits that the social environment in which the users live and work should be taken into consideration when developing ICT applications for rural areas of developing countries. The thesis suggests that an understanding of the social space of the users, when developing a technical system for them, is likely to lead to an appropriate technical system for the users. Lastly the thesis contributes guidelines and recommendations concerning how to develop communication systems for rural areas …