Paper short abstract:

In the context of an increasing push in healthcare towards technologically-mediated self-management of chronic conditions, we discuss the potential complications arising from the introduction of self-monitoring technologies into non-western environments by describing a study undertaken in Blantyre, Malawi.

Paper long abstract:

This study, with fieldwork to be completed in June 2015, is a preliminary investigation of self-monitoring health technologies in urban Blantyre, Malawi, and their impact on lay people's perceptions of illness, wellbeing and their engagement with health services.

Currently, several biomedical technologies are available for purchase for use at home without the supervision of a healthcare professional. These include technologies for self-diagnosis such as pregnancy tests and rapid diagnostic tests for malaria, and devices aiding self-management of chronic conditions such as diabetes.

However, little is currently known about the extent to which these technologies are available and used in resource poor settings, or of the ways these 'self-monitoring' devices affect their users' perceptions of health and wellbeing, their ownership of health agendas and their health-seeking behaviours.

This study aims to identify self-monitoring technologies currently available in Blantyre and to investigate their roles and meanings in the community through semi-structured interviews with users. We will explore concepts of bio-sociality, new types of 'patient-hood', the 'fluidity' of objects, and the often under-acknowledged degree to which technologies are appropriated by users to make them better fit their lives. In particular, we will consider how technology can empower people in situations where they experience inadequate healthcare, or highlight possible conflicts between self-testing and people's engagement with healthcare services.

The results will be used to generate hypotheses on the impact of self-monitoring technologies on the health and agency of users in resource-poor settings, particularly in Sub-Saharan Africa, laying the foundations for further research.