The map and the territory: an ethnographic study of the low utilisation of a global eHealth network

摘要: Recent years were marked by the implementation of many eHealth projects using information and communication technologies to provide health services in developing countries. While generating great expectations, these remain poorly documented available data suggest high failure rates. This raises a practical question: How are such networks be effectively designed implemented? paper addresses this question. Specifically, it presents an ethnographic study Pan-African e-Network, project which connects hospitals all across India Africa, providing medical teleconsultations distance learning services. The investigates low utilisation network, issue undermining its potential efficiency. Factors contributing situation include barriers, presumed ego doctors, poor awareness project, lack flexibility work with specificities connected sites. Above all, factors point towards dichotomous approach project’s design implementation, taking two distinct yet related forms: (a) ontological divide between technical ‘non-technical’ domains; (b) political sorting out what is not aimed at neutralising accounting for heterogeneous processes practices. In both cases, reveals tensions closure control, openness life that will contained. Ultimately, intends destabilise binary modes thinking as they crystallise oppositions context, social worlds, efficacy improvisation, mastery unruliness, map territory.