Paper short abstract:

DS-I Africa is a multi-million dollar initiative of the US National Institutes of Health. Its large scale, emphasis on African-led research, and vision of transformative impact, make it important to interrogate the future(s) of healthcare envisioned by the DSI-Africa framework and actors within it.

Paper long abstract:

DS-I Africa (Data Science for Health Discovery and Innovation in Africa) is a multi-million dollar initiative funded by the US National Institutes of Health, with the stated aim to “advance data science, catalyze innovation and spur health discoveries across Africa.” Since 2021, it has emerged as one of the major examples of an imagined future of African healthcare systems transformed by data science and AI, based on Africa-generated data sets analyzed by newly trained Africa-based researchers and healthcare professionals. I propose to address the imagined futures embedded in the institutional framework of DSI-Africa as well as the varied, emergent understandings of those involved with the research, training, and ethics hubs.

My positionality is that of a Europe-born anthropologist and Africanist with a prior research focus on epistemology and linguistic ideologies, who now works with AI researchers and clinicians, including those in the DSI-Africa UZIMA-DS project. Drawing on the concept of “administrative activism” (Di Leo 2018, Lehrer forthcoming), I analyze DSI-Africa as a prime example of a “science-first” futuristic understanding of how “transformed” healthcare systems on the continent could/should look. I simultaneously explore the tensions, constraints, and possibilities emerging from the vision and structures put in place by initiatives such as DSI-Africa, and ask how (far) we can push the boundaries of these institutional imaginations.

I am very interested in joining this panel as much as to present my analysis as to learn about alternative imaginations for the future of healthcare systems from fellow panelists, the moderators, and audience.

Paper short abstract:

In this article, I argue that the sociotechnical imaginaries of AI-powered healthcare solutions in Ghana are embedded in a set of captivating attributes and promises mediated and supported by different social actors who are imagining and reshaping the hospital.

Paper long abstract:

In this article, I am employing the concept of 'sociotechnical imaginaries' by Sheila Jasanoff to explore how hospitals have been imagined and reshaped by the promises of deploying Artificial Intelligence in the healthcare system in Ghana. The article is based on carefully examining Ghana's National E-Health Strategy for 2010, which is -so far- the only national strategy available for healthcare digitalization in Ghana and it is the official policy framework that guides Ghana's implementation of digital healthcare. In addition to, interviews with developers and entrepreneurs from Ghana who are developing AI-powered solutions for healthcare are utilised to understand the trajectories from simply digitalizing hospitals and other healthcare facilities to employing the state-of-art technology and to disrupt healthcare spaces. This article will show how data-driven healthcare solutions are imagined and what are the current and foreseen obstacles of deployment and upscaling. Digitalizing healthcare hindrances are often documented as poor digital infrastructure, data availability and quality, and regulations, and trained healthcare givers and users. However, these obstacles didn’t discourage sociotechnical imaginaries of AI powered healthcare delivery evolvement. I argue that the sociotechnical imaginaries of AI powered healthcare solutions are embedded in a set of captivating attributes and promises mediated and supported by government healthcare policies, media, national and international healthcare organizations’ programmers, investors and donors, data scientists, tech engineers, and tech entrepreneurs.

Paper short abstract:

This paper reflects on the future of African hospitals from the perspective of a unique experiment in social medicine located in a rural and poor district of northern Rwanda, where the nexus between a new kind of medical university and its teaching hospital radically transforms healthcare.

Paper long abstract:

In this paper I approach the question of the future of African hospitals from the perspective of a unique experiment in social medicine that is currently taking place in a rural and poor district of northern Rwanda. In 2011, the ONG Partners in Health (PIH), following the vision of the medical anthropologist and physician Paul Farmer, opened a hospital in this district – then a medical desert – to provide the best available healthcare to its underprivileged communities. Eight years later, in 2019, PIH opened in the same district the modern campus of a medical university, called the University of Global Health Equity (UGHE), with the ambition to train a new generation of health professionals – not only for Rwanda but for the entire continent. Both institutions have strong community engagement programmes and are “rooted in a place” (Farmer), as much as they have a global outlook and partnerships with prestigious institutions. UGHE and the Butaro district hospital (now UGHE’s teaching hospital), built on the top of two hills separated only by marshes and maize and potato fields, have attracted much attention. They are seen by many as a particularly striking “exemplar” in global health, and by others as a utopian project that cannot easily be replicated. Based on my experience as faculty at UGHE, I will offer some reflections on what makes the nexus between the hospital and the university so unique, on the challenges it faces, and on its potential to radically transform the hospital in rural Africa.

Paper short abstract:

This paper presents a case study of the Panzi model of holistic care, and by incorporating diverse voices of care-professionals in the Democratic Republic of Congo, casts a vision for African care futures that integrate biomedical approaches while preserving African views and perspectives on care.

Paper long abstract:

Dominant epistemologies of medical care have been shaped by capitalist, colonial and gendered legacies. These legacies often manifest in negative power-dynamics between caregivers and patients; infrastructure that is unwieldy and unsustainable without foreign intervention; and a focus on cost-recovery, vs the provision of care to individuals. While biomedical advances have led to increased positive clinical outcomes, indigenous and pre-colonial African perspectives on care as a relational activity are steadily devalued. Future hospitals in Africa and other post-colonial contexts face the challenge of how to integrate technical bio-medical advances, without losing traditional, pre-colonial, perspectives on care.

This paper analyzes this dilemma, by focusing on Panzi Hospital in the Democratic Republic of Congo, which provides an important case study for the future of African care. The integration of community perspectives, the primacy of relationships among the caregiver and patients, and an emphasis on the social ethos of care are part of the approach now defined as the Panzi One Stop Centre model, which has inspired the development of a Regional Integrated Model of Care in the Great Lakes region of Africa. This framework suggests a new elan for the future of care in the continent.

By utilizing participatory action research methods, the paper incorporates the views of medical professionals primarily in the Democratic Republic of Congo, casting a vision of the future African hospital, which integrates biomedical and technological innovation, with a holistic, social ethos of care that refocuses indigenous and African perspectives and practices, within and outside the walls of institutions.