Added on 01 Sep 2010
Last updated on 14 Jun 2011
Authors: Joaquin Blaya, PhD; Reviewed by Anat Rosenthal, PhD; Sophie Beauvais
Building and supporting local capacity and expertise is seen by many as critical to the successful development and roll-out of eHealth solutions in countries, programs, and communities. What are the benefits and challenges of having local organizations create and maintain health software and what are the lessons learned from various projects? These are addressed in depth by 26 members, moderators, and panelists with experience in for- and non-profit organizations across the globe.
Benefits of local software development:
Local programmers are better versed with the environment: Who is the user? Where will the software be used? This also makes the development, testing, and implementation of systems easier.
As much as possible programmers and intended users – here health personnel – should be located in the same office space in order to improve communication and avoid misunderstandings that sometime lead to the deployment of inappropriate solutions. A member suggested organizing a “Play Session” with blocks, markers and some paper for a creative way to exchange ideas.
In country development supports the local economy and, most importantly, increases institutional capacity to build and maintain systems. Many recount bad experiences with eHealth development by third party consultants from other countries that can’t be maintained locally.
Local authorities may accept and trust eHealth systems more if they are able to meet the developers.
Challenges of local software development:
It seems harder to find local programmers for open source languages than for proprietary languages like Microsoft .NET.
Financing of local software development and workforce is often time not competitive. A member cites the case of Nicaragua where there are very few projects that budget for or take into account software development itself. Some members also noted that there is a tendency to discount rates for local developers and that short contracts are common. While differences in cost of living should be accounted for, this double standard of payment hinders local startups’ ability to be sustainable.
Some members cite the lack of experienced leadership to guide a project as a challenge.
Other lessons learned:
Open source is becoming more popular among programmers in developing countries, and open source communities can provide mentorship to local programmers. For example, a member commented that OpenMRS has a mentorship program.
Planning helps identify what issues can be addressed with eHealth solutions and how the new software can be integrated within existing systems.
More collaboration and coordination is needed among eHealth actors, from non-governmental organizations to universities. Whenever possible, eHealth developers should work with local and national regulatory bodies to ensure interoperability, and partner with universities to allow on-the-ground training for IT students.
There are misrepresentations around “open source” projects, such as that they are done by volunteers, that they are unproven, or that there is no technical support. Some organizations stop using the words “open source” internally for this reason.
Organizing a training session at your organization as a launching pad for recruiting new programmers has proven valuable for some members – one mentioned an intensive 10-day Java training program taught by a professor from the University of Bergen in Norway.
The issue of gender imbalance in software development was discussed by several members.
Coded In Country (CIC), an effort to increase the contribution of local software developers in software applications intended for use in low- and middle- income countries by promoting a brand for software, similar to Fair Trade for merchandise.
The Apps4Africa competition where developers can post ideas for new applications and win a price.
Nyaruka (Kigali, Rwanda)
InSTEDD iLab (Cambodia)
eHealth Systems (Chile)
Anthill Partners (Kenya)
The California Healthcare Foundation’s Open Source Primer for Healthcare Leaders
Chilean government’s Report of Use of Open Source within the Government (Spanish)
Please consider replying to this discussion with the following information
Do you work in an organization that develops or maintains health software? If so, please share your project and thoughts in this discussion.
Do you have suggestions to better promote local software development?
Download: 08_23_10_Local_Development.pdf (52.5 KB)