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Strengthening EU policies in support of ICT for development: Results from a survey of ICT experts
Author’s Accepted Manuscript Improving EU policies for ICT for development: Results from a survey of ICT experts GianLuca Quaglio, Theodoros Karapiperis, Giovanni Putoto, Laura Delponte, Giorgio Micheletti, Helmut Brand, Luigi Bertinato, Göran Tomson, Laurent Bonnardot, Paolo Zanaboni www.elsevier.com/locate/hlpt
PII: DOI: Reference:
S2211-8837(16)30070-3 http://dx.doi.org/10.1016/j.hlpt.2016.09.001 HLPT205
To appear in: Health Policy and Technology Received date: 26 July 2016 Accepted date: 8 September 2016 Cite this article as: GianLuca Quaglio, Theodoros Karapiperis, Giovanni Putoto, Laura Delponte, Giorgio Micheletti, Helmut Brand, Luigi Bertinato, Göran Tomson, Laurent Bonnardot and Paolo Zanaboni, Improving EU policies for ICT for development: Results from a survey of ICT experts, Health Policy and Technology, http://dx.doi.org/10.1016/j.hlpt.2016.09.001 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
IMPROVING EU POLICIES FOR ICT FOR DEVELOPMENT: RESULTS FROM A SURVEY OF ICT EXPERTS Title Improving EU policies for ICT for development: Results from a survey of ICT experts
Affiliation GianLuca Quaglioa,*, Theodoros Karapiperisa, Giovanni Putotob, Laura Delpontec, Giorgio Michelettid, Helmut Brande, Luigi Bertinatof, Göran Tomsong, Laurent Bonnardoth, Paolo Zanabonii
Scientific Foresight Unit (Science and Technology Options Assessment [STOA], Directorate-General for Parliamentary Research Services (EPRS), Brussels, Belgium a
b Operational c Centre
Research Unit, Doctors with Africa CUAMM, Padua, Italy
for Industrial Studies (CSIL), Milan, Italy
d International e Department f
Data Corporation (IDC), Milan, Italy
of International Health/CAPHRI, Maastricht University, The Nederlands
Local Health Authority N. 20, Veneto Region, Italy
Departments of Learning, Informatics, Management, Ethics and Public Health Sciences, Karolinska Institutet, Sweden g
h Department i Norwegian
of Medical Ethics and Legal Medicine, Paris Descartes University, Paris, France
Centre for E-health Research, University Hospital of North Norway, Norway
Corresponding author GianLuca Quaglio, MD
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Scientific Foresight Unit (Science and Technology Options Assessment [STOA]) Directorate-General for Parliamentary Research Services (EPRS) European Parliament Rue Wiertz 60, B-1047 Brussels, Belgium E.mail: [email protected]
Background: There is scarce and fragmented evidence of the European Union’s policies and strategies being used in ICT for development in LMICs. Methods: An online survey was conducted to collect feedback from experts evaluating past EU initiatives in ICT for development, and the type of approach EU institutions should pursue in ICT in LMICs in the future. Structured interviews were also carried out with ten of the respondents. Results: One hundred and twenty-one experts responded to the survey. About 30% believe that the EU institutions’ support to ICT for development has improved in the last decade. However, a similar percentage indicated that the EU’s support has not improved or even has worsened. The evaluation of the EU’s cooperation with international organizations was considered good or sufficient by nearly 31% of respondents. Regarding priorities to be pursued by EU policies towards the use of ICT for development, the EU should focus on reducing health inequalities and the digital divide. Concerning the approaches to promote ICT within EU development cooperation, the EU should carry out a mix of top-down and bottom-up approaches. Almost 70% believe that it is better to support an approach that integrates ICT into different areas of action, rather than having ICT as a specific priority area. Health and education were indicated as priority sectors where the EU should increase the use of ICT. Conclusions: The results of this survey can support decision-makers and ICT managers to better plan and implement ICT in LMICs.
Keywords Communications technologies, European Union, developing world, development
Running title EU policies for ICT for development
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Abstract Background: There is scarce and fragmented evidence of the European Union’s policies and strategies being used in ICT for development in LMICs. Methods: An online survey was conducted to collect feedback from experts evaluating past EU initiatives in ICT for development, and the type of approach EU institutions should pursue in ICT in LMICs in the future. Structured interviews were also carried out with ten of the respondents. Results: One hundred and twenty-one experts responded to the survey. About 30% believe that the EU institutions’ support to ICT for development has improved in the last decade. However, a similar percentage indicated that the EU’s support has not improved or even has worsened. The evaluation of the EU’s cooperation with international organizations was considered good or sufficient by nearly 31% of respondents. Regarding priorities to be pursued by EU policies towards the use of ICT for development, the EU should focus on reducing health inequalities and the digital divide. Concerning the approaches to promote ICT within EU development cooperation, the EU should carry out a mix of top-down and bottom-up approaches. Almost 70% believe that it is better to support an approach that integrates ICT into different areas of action, rather than having ICT as a specific priority area. Health and education were indicated as priority sectors where the EU should increase the use of ICT. Conclusions: The results of this survey can support decision-makers and ICT managers to better plan and implement ICT in LMICs.
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Background In the second half of the 1990s, donors from Europe and worldwide acknowledged the potential of Information and Communication Technologies (ICT) to provide economic opportunities and services which could promote social and economic progress. The Millennium Development Goals (MDGs) were written around the peak of the global interest in ICT, in the early 2000s. This wave of hope around ICT found its place in a specific target, target 8F of the MDGs. This target sets out the need to make available, in cooperation with the private sector, the benefits of new technologies, especially ICT, towards a global partnership for development [1]. As a result, donors have been developing appropriate ICT strategic frameworks and implementing a diversified ICT project portfolio. In addition, some donors established ICT-dedicated units within their own organizations, to provide adequate support to low and middle-income countries (LMICs) [2]. That period was followed by a loss of momentum “with a rhetoric of mainstreaming ICT covering in reality a side-lining of ICT” [2]. The policy work conducted by key ICT bodies (World Summit of the Information Society, the Internet Governance Forum, etc.), although played a relevant agenda-setting role, did not translate into concrete actions on the ground. Consequently, several donors decided to shift their activities towards more programmatic ICT work [3]. However, during the past 5-6 years a reverse trend has appeared. The development of ICT worldwide, as well as the high penetration of mobile telephony, has created a new momentum bringing, though not reaching the earlier level, a renewed interest in ICT for development amongst the donor community [1, 3]. LMICs have serious shortages of health workers, especially in rural areas. ICT have great potential to assist in the achievement of Sustainable Development Goal 3, which includes universal health coverage as one of its targets.
EU policy documents on ICT for development There are few relevant European Union (EU) policy documents on ICT for development. In 2000 a resolution of the European Parliament (EP) identified the potential impacts of ICT in the development process of LMICs in three main areas: i) democratisation; ii) poverty reduction through an increasing use of ICT in health, education, rural development and environment; and iii) job creation in IT-related industries. The resolution also warned of the possible marginalizing 4
effect of ICT as a result of an increasing digital divide amongst and within countries, and urged the EU and Member States (MSs) to take action towards broadening access to ICT in LMICs. The resolution called for the European Commission (EC) to formulate a single and coherent policy for ICT within the EU development policy and to update it frequently. The resolution envisaged an increase in the quantity and quality of ICT programmes, and suggested to integrate ICT in country strategy papers [4]. Building on the EP's resolution, the role of ICT in the EU development policy was later established in a communication issued by the EC in 2001. The communication considered the relevance of ICT as enablers of socio-economic progress and laid out a number of actions to support the use of ICT in the priority sectors of EU development cooperation. A more systematic use of ICT to enhance development projects was also encouraged. However, while acknowledging the increasingly important role of ICT in economic development, the communication warned of the possible conflict between promoting ICT and addressing other more pressing priorities of LMICs that have a more direct impact on poverty reduction [5]. Since 2001, the EC has not released a revised approach for promoting ICT within EU development cooperation. The 2005 European Consensus on Development mentioned the potential power of an increased use of ICT in bridging the digital divide, but did not further elaborate on this subject and kept it limited to the infrastructural issue [6]. It is only in a EC communication from 2011 that ICT were clearly identified as powerful drivers of change with respect to job creation, economic growth, and poverty reduction. Therefore, ICT generally referred to as new technologies, acquired more prominence within the EU aid policy framework [7]. In 2012, the EP adopted a resolution on a digital freedom strategy within the EU’s foreign policy, that emphasised how ICT could be used both as an enabler of democracy and as repressive instruments under authoritarian regimes. Recognizing that human rights should also be protected through ICT, the resolution called for the increased use of ICT in all EU external programmes. It also called upon the EC to propose new regulatory frameworks in the areas of Internet governance and trade [8]. Within the communications released by the EC between 2013 and 2014, digitalisation was mentioned as an important driver of change to shape a new global partnership for development [9, 10]. A later communication released in 2015, also addressed the potential impact of ICT in LMICs and acknowledged that technical progress does not 5
automatically benefit the poor. To this end, donors are encouraged to use innovation as an instrument that meets the needs of the most vulnerable people [11].
The regional approach of the EU to ICT As for other EU development sectors, the EU’s support to ICT is built upon a regional approach. In particular, but not exclusively, in Africa, ICT interconnectivity is considered instrumental to achieve higher regional integration, trade and growth. High priority is given to regional ICT infrastructures, along with the harmonization of regulatory frameworks amongst countries of the same region. For instance, the Joint Africa-EU Strategy, which provides a framework for AfricaEU relations, aims, amongst other objectives, to bridge the digital divide [12]. In the roadmap of the Joint Africa-EU Strategy (2014-2017), the EU strategy framework in the area of ICT is further broadened by increasing the harmonisation of e-communication policies and regulatory frameworks, strengthening research and education networks through e-infrastructure, enhancing the general capacity of ICT [13]. While some regional strategies and policies of EU development cooperation include explicitly ICT, these often are not well integrated in sector strategies. For example, an EU communication adopted in 2014, laying out the role of the private sector in development, mentioned the use of ICT only in relation to achieving financial inclusion of the poor [14]. Another example is the EU policy framework for the agriculture sector adopted in 2010. This set out EU priorities for promoting sustainable agriculture and improving food availability, yet without integrating ICT [15].
EC support to ICT provided by DG DEVCO Within the EC, support to ICT in development cooperation is mainly delivered through the external aid provided under the supervision of Directorate-General for International Cooperation and Development (DG DEVCO), which also establishes the general and ICT-specific direction of EU development cooperation [16]. A unit within the infrastructure division of DG DEVCO is in charge of coordinating ICT for development issues, whereas programme design and implementation is carried out in the field offices of the EU Delegations. When capacity on specific ICT issues is not available internally, project development and implementation is
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outsourced to other organizations. The development and implementation of e-Infrastructure initiatives has been entrusted to DG Connect. DG Connect is in charge of managing the implementation of the EU Digital Agenda. It also provides advisory services to DG DEVCO on these issues. DG Connect does not have internal funds for engaging in ICT for development activities, but rather it provides expertise and taps into the financial resources of other EC directorates. Within the EC’s services dealing with ICT for development, the channels of communication are not structured and systematic but are based on programme specific needs and rely on personal networks. Other EC Directorates are involved in supporting the development of research partnerships and infrastructures in the ICT sector, namely DG Research & Innovation. The last Development Assistance Committee Peer Review of the EU external assistance reported that EU institutions could create better links with DG Research & Innovation to tap into its vast knowledge base, thus improving knowledge transfer to other DGs [17].
Study aim The Science and Technology Options Assessment (STOA) Panel is the European Parliament’s in-house source of analysis of public policy issues related to science and technology [18]. STOA recently published a study entitled ‘ICT in the developing world’ with the aim to provide EU decision-makers, policy options for future actions to support LMICs in benefiting from ICT [19]. In this study, evidence from a literature review was complemented by an online survey conducted to collect feedback from experts. The survey was divided into four sections which explored: A) the characteristics of the respondents; B) the role of ICT in economic development of LMICs; C) the benefits of e-health programmes in the developing world; and D) the EU institutions’ policies for ICT for development. The results of the first three sections are published elsewhere [20]. The present paper reports the results of section D, which focused on respondents’ opinions on past EU initiatives on ICT for development, and the type of approach EU institutions should pursue in ICT in LMICs.
Methods Data collection 7
On 12th March 2015, invitations to the online survey were sent out via e-mail through an electronic system. On 30th March 2015, a reminder was sent via e-mail to the experts invited to the survey. The survey was closed on 3rd April 2015. The survey’s questions were validated through a pilot test conducted in February 2015 on 10 selected experts. The survey mainly comprised of closed-ended questions where participants were asked to select and rank 3 or 5 answers from a larger set. The final online questionnaire was structured in the four sections mentioned above. Section D, the results of which are presented in this paper, was divided into different sections, as summarised in Table 1. A selection of different stakeholders were invited to the survey as experts. Target respondents were identified through online databases, as well as through formal requests sent to consortia, companies, donors and investors involved in ICT for development and ICT for health. The survey also relied upon the spontaneous circulation of the questionnaire through specific professional and social networks. The affiliation of the respondents ranged from researchers (e.g. academia, think tanks and research institutes), bilateral and multilateral donors (e.g. UN, WHO, and development agencies of several EU MSs), private non-profit organisations (e.g. NGOs), private for-profit organisations (e.g. ICT firms), public authorities (e.g. recipient countries’ institutions, Ministries of Health, national commissions, hospitals, etc.) and EU institutions. Structured interviews were also conducted with ten experts from the survey’s respondents, to deepen the discussion by raising relevant points that could contribute to the enrichment of the survey results. Interviewees were selected in such a way as to guarantee a balanced representation of different types of affiliations and areas of expertise. A structured form was used for the interviews, with a predefined list of questions. The interviews lasted between 45 to 60 minutes and were carried out by phone.
Data analysis Two indicators were extracted from each question. The first indicator was the percentage of respondents selecting a specific answer, independent of its ranking (this synthetized the opinion of respondents about the relevance of that answer). The second indicator was a synthetic score, measuring the average preference/ranking given to that answer. This was measured and constructed as follows: for each question, a score of 5 (or 3 for those questions where only 3 answers had to be selected) was assigned to each answer any time it was ranked in the first 8
position. A score of 4 (or 2 for those questions where only 2 answers had to be selected) was assigned any time it was ranked in the second position, and so on. Then a weighted average of all of the scores from the answers was computed. The resulting indicator measured the average preference assigned to each answer by those selecting it. In this way, answers could obtain relatively high values even if selected only by few individuals, as long as they were assigned a high ranking. At the end of section D there were open-ended questions giving the respondents the opportunity to leave any general comments that they had.
Results In total, 1275 experts were invited to participate in the survey, in the end 145 responded. Of those, 121 (83%) respondents replied to section D. The results are summarised as follows: i) main respondents’ characteristics; ii) results of questions; iii) results of interviews. Respondents’ characteristics The sample of survey respondents that replied to section D consisted primarily of experts working in academia/research centres (47, 39%). The second largest group of respondents were experts employed in NGOs (30, 25%). Affiliations also included bilateral/multilateral donors (14, 10%), private for-profit organizations (11, 9%), EU institutions (11, 8%) and public authorities (7, 9%). The sample provided a good balance between private and institutional actors: private profit and non-profit organizations accounted for 36% of respondents’ affiliations, whereas public authorities, public organizations and EU institutions accounted for 27% (Fig.1). Teachers, researchers, and project managers were the most represented job positions, accounting for 19%, 17% and 17%, respectively. In relation to geographical distribution, the vast majority of respondents (77, 64%) worked in one or more countries in Sub-Saharan Africa. More than 40% of participants were reported to work in high-income countries, 1/3 of which working exclusively in such nations. It was established that most participants (95, 78%) have worked in the field of ICT for development, development cooperation and/or health sectors in LMICs for more than 5 years. Twelve per cent of the respondents had more than 20 years of experience in the development sector.
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Results of questions
EU support to ICT in LMICs and cooperation with international organisations About 30% of respondents believe that the EU institutions’ support to ICT for development has improved over the last ten years. However, in contrast to this, a similar percentage of respondents indicated that the EU’s support has not improved or has even worsened (Fig. 2). The evaluation of the EU’s cooperation with international organizations on ICT for development was considered satisfactory (i.e. it was marked as either very good, good or sufficient) by nearly 31% of respondents. However, 35% of respondents evaluated the EU’s cooperation as insufficient (Fig. 3). Interestingly, in both questions, there was a high percentage of respondents without an opinion regarding the achievement of these EU actions.
Objectives to be pursued by EU policies and priority sectors of intervention In terms of priorities to be pursued by EU policies towards ICT for development, the respondents indicated that the EU should focus on reducing health inequalities and the digital divide, as well as provide support to achieve the MDGs (Fig.4). Health and education were indicated as priority sectors in which the EU should increase the use of ICT (Fig. 5).
EU policy approaches and ICT integration in EU development strategy Concerning the approaches to promote ICT within EU development cooperation, the prevalent opinion was that the EU should carry out a mix of top-down and bottom-up approaches in promoting ICT (Fig. 6). However, some differences were observed amongst different categories of experts. For example, among respondents from academia and non-profit organizations there were more people convinced of the importance of a bottom-up approach, whereas for-profit organizations (and to a minor extent public authorities) seemed to prefer a top-down approach. Regarding the question that explored the policy approach that should be taken by the EU for ICT for development, either an integrated or a priority area approach, 70% believe that the EU should take an integrated approach (Fig. 7).
Most effective actions to facilitate the dissemination of ICT in LMICs
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According to the respondents, the three most effective instruments in promoting ICT within EU development cooperation were technical assistance to specific e-projects, research partnerships, and infrastructure financing (Fig. 8). In the last question, respondents believed that allocating more financial resources and support to LMICs in developing their regulatory and legal frameworks are the actions that the EU institutions should take in order to remove the obstacles hampering the dissemination of ICT in LMICs (Fig. 9).
Results of interviews EU support to ICT in LMICs and cooperation with international organisations The majority of experts interviewed, gave the general impression that the visibility of EU initiatives in LMICs – at least in the ICT for development field – is quite low. Some comments made by the respondents on the initiatives carried out by the EU for ICT for development, highlighted the fact that the EU should seek a greater coordination with other donors and at the very least improve its federating role among EU MSs active in the field.
EU policy approaches and ICT integration in EU development strategy When asked to comment on the fact that EU development cooperation is not guided by a general policy document concerning ICT for development, interviewees gave mixed feedback. Several interviewees pointed out that the idea that ICT should constitute a distinct strategic area would favour the adoption of a narrow, “technology-driven” view. In this perspective, a lack of strategic focus could be seen as a sort of advantage. On the other hand, a poor strategic definition of ICT for development is expected by some experts to affect coherence, and affect the ability of other actors (such as donors and potential beneficiary countries) to understand the EU funding opportunities in this area. Concerning the type of approach that the EU should follow in ICT for development, the vast majority of interviewees agree that a mixed approach (bottom-up and top-down) is ideally the best one, as it would allow for the addressing of different problems in the most convenient way. The suitability of different approaches depends on country-specific issues, as well as the level of development, the strength of the government, and the strength of NGOs working in a specific country or context. However, some interviewees seem to maintain that concretely the EU institutions current comparative advantages concern top-down initiatives, and they may not have 11
sufficient capacity to engage with small organizations operating on the ground. In general, some of the advantages of top-down initiatives that emerged during interviews are that they are not affected by the endemic poor durability that undermines many local based projects, and they do not require a complex routine project management. On the other hand, the majority of interviewees stressed that top-down initiatives tend to exclude local communities from the decision-making process.
Discussion EU support to ICT in LMICs and cooperation with international organisations One third of respondents indicated that the EU’s support to ICT for development has improved over the last ten years. Yet a similar number of respondents indicated that the situation has not improved, and some even suggested that the situation had worsened. Moreover, the relative majority of respondents evaluated the EU’s cooperation with international organizations in the field of ICT diffusion as insufficient. Interviews with experts also confirmed the general impression that the visibility of EU initiatives in LMICs, at least in the ICT for development field, appear to be low. This is in line with the high percentage of survey respondents (34%) that did not have an opinion about the EU’s ICT policies over the last 10 years. Some comments suggested that the EU seeks a greater coordination with other donors to improve its federating role among EU MSs. This seems to be a widespread problem in the field of development, where duplication and fragmentation of European development aid is well recognised, and where competition amongst EU development agencies and NGOs is still evident. A resulting consequence, among others, is that the impact of the EU's development action is not acknowledged or cannot be identified among the populations in beneficiary LMICs [21]. Donor coordination is poorly studied. It is estimated that as much as 800 million euros (around 1.4% of EU development aid) could be saved annually by improving donor coordination [22], however these figures appear to underestimate the magnitude of the issue [23-25]. In 2013 the EP adopted a resolution with recommendations to the EC to avoid unnecessary parallel processes and fragmentation between EU MSs in the field of aid [26]. There is scope for EU institutions to do more to grasp the potential advantages of collaborating with international organizations, such as the ability to exchange good practices and 12
the combination of resources. Regarding this, a 2010 communication from the EC on the role of the EU in global health urged the EU to better streamline its work with other international bodies [27]. The high percentage of respondents without an opinion regarding the achievement of the EU in supporting ICT for development and cooperating with international organisations indicates that the evaluation of these EU actions remains a complicated task.
Objectives to be pursued by EU policies and priority sectors of intervention According to the majority of experts surveyed, the primary aim of EU policies for ICT for development should be the reduction of health inequalities, followed by the achievement of the MDGs and the reduction of the digital divide. E-health promotion does not appear to be central to EU development cooperation policies. Currently, DG DEVCO does not have a specific document or guidelines presiding over the use of ICT within the priority sector of health. A relevant strategy is provided by the EU eHealth Action Plan 2012-2020, which is however directed towards EU MSs [28]. Amongst the operational objectives of the Action Plan, the EU promotes policy dialogue and international cooperation on e-health at a global level. The purpose of this action is to remove obstacles towards a wider use of e-health solutions, such as the lack of interoperability and international standards. It is however unclear as to what extent this action is going to engage LMICs [28]. As a result of this loose strategic framework, the EU tends to adopt an ad hoc project/programme approach when it comes to e-health actions within the broader picture of development and cooperation. E-health appears to be a relatively unexplored area for EU development cooperation. The new European strategy on Global Health recognises the potential use of ICT to improve health service provision, but this has not translated yet into a more systematic use of ICT in health development projects [27]. In 2004, STOA carried out a study on the subject of health and ICT in LMICs. The study emphasised that there was little use of ICT in the EU's aid for the health sector. The report’s recommendations suggested that donors, overcome traditional concepts of health cooperation towards a gradual use of ICT innovations, improve coordination of health programmes and support LMICs by introducing ICT into their health strategies [29]. ICT have created new opportunities for education. However, e-learning is still in its infancy in LMICs which experiences unique challenges compared to developed countries. Many LMICs are interested in implementing e-learning but face obstacles in infrastructure and resources. They 13
also have cultural, political, and economic concerns affecting the implementation of e-learning [30]. The EC pledged to spend at least 20% of its EU development aid on human development and social inclusion, including education. The EU funding for education in LMICs is expected to total some €4.5 billion between 2014 and 2020 [31]. The EU and its MSs are the biggest donor to the Global Partnership for Education Fund [32]. At present, e-learning does not appear to be a sector where the EC is investing in, neither has a strategy or specific policy documents in support of this.
EU policy approaches and ICT integration in EU development strategy As for the EU policy approach, surveyed experts believe that the EU should try to balance the top-down approach that has traditionally characterised its initiatives for ICT for development, with bottom-up interventions. In 2001, a STOA study on ICT in LMICs identified two major weaknesses in the EU's ICT for development approach, namely: the lack of a focused strategy and the excessive use of a top-down approach. The study suggested that a combination of topdown interventions (e.g. policy and regulatory support for ICT) and bottom-up activities (e.g. direct support to ICT projects) would make EU development cooperation more effective [33]. Combining top-down with bottom-up approaches, as well as involving different stakeholders (e.g. local communities, international organizations, private actors, public actors), would promote a better management of projects and more effective monitoring and evaluation processes. This would also make project results better recognized by the local governments, making sure that sustainability is embedded in the project design, thus building local capacity. The suitability of different approaches depends on country-specific issues, such as the level of development, the strength of the government, and the strength of NGOs working in the field. For example, in countries in which the governments are relatively less active in supporting poorer groups, a bottom-up approach is advisable. However, some interviewees argued that the EU institutions might not have sufficient capacity to engage with small organizations operating on the ground. From a strategic point of view, there is consensus on the fact that ICT are instrumental and should be integrated in other areas of development rather than being seen as a self-standing priority. When asked to comment on the fact that EU development cooperation is not guided by a general policy on ICT, the majority see this as a positive factor, because to have strict policies in 14
place could support the adoption of a technology-driven approach, which is not beneficial in a LMICs context. Examining the approaches taken by other multilateral and bilateral donors in promoting ICT in LMICs could provide some further insight into this topic. The World Bank for example, has had a strategy to guide its ICT activities in LMICs since 2001. The World Bank supported ICT broadly, engaging in both the ICT sector (including networks, infrastructure, policy and regulatory frameworks), and ICT applications (such as the use of ICT in other sectors, e.g. mbanking, m-health). Compared to its past strategy, their more recent approach marked a shift from supporting voice telecommunication to broadband and high-speed Internet services, while connectivity infrastructure remains the top priority [34]. The ICT operations strategy of the African Development Bank (a major contributor to promoting ICT in Africa), supports the development of regional and national broadband infrastructure, and the creation of an enabling regulatory environment. It also includes crosscutting areas related to capacity building, coordination, and knowledge management and sharing [35]. Looking to some EU MSs, the Swedish International Development Cooperation Agency (SIDA) , the government agency working
on implementing Swedish aid programmes, considers ICT as a major contributor towards economic growth and poverty reduction. It addresses the digital divide by granting broader possible access to open and free Internet, and by improving capacity and infrastructure at country level [36]. The German development cooperation has recently released a number of priorities for ICT in LMICs. These are to improve regulation of the telecommunication market; to support the local ICT sector (e.g. by providing long-term financing to telecommunication infrastructure and service providers, and capacity development for local IT firms); and to increase the use of ICT in sector programmes (e.g. governance, healthcare, education, financial system, etc.) [37].
Most effective actions to facilitate the dissemination of ICT in LMICs While rapid innovations in technology are making ICT both less expensive and easier to use, many bottlenecks remain in the dissemination of ICT in the LMICs. Lack of users’ capabilities to identify the right technology, insufficient infrastructure (from transportation to market facilities), lack of policies support, fragile legal systems (unsure property rights), and limited financial resources reduce the potential of ICT in the developing world [38, 39]. Respondents believed that technical and financial assistance (mostly for infrastructure) and support to LMICs in 15
developing their regulatory and legal frameworks are the main actions that the EU should take to facilitate the dissemination of ICT in the LMICs. From the survey however, it also emerged that research partnerships could be a useful tool in this regard. A number of strong collaborations and partnerships have been successfully carried out in other fields, such as health research [3942]. Similar effective, balanced, international partnerships between universities and research centres of LMICs and high-income countries can be essential in the tackling of ICT challenges in LMICs.
Study limitations This survey has some limitations common to those of other online surveys, including bias of predefined questions and number of respondents. It is possible that there was some selection bias and other conclusions would have been reached with a different group of respondents. Regarding the questions related to the EU's performance in the last 10 years and the collaboration with international organisation (Fig. 2 and 3) the percentage with no opinion was high. Despite the low response rate, the experts participating in the online survey represented all relevant stakeholders, thus increasing the generalisability of the results. The majority of survey participants (78%) have worked in the field of ICT for development, development cooperation and/or health sectors in LMICs for more than 5 years and 20% of them had more than 20 years of professional experience. This helped to ensure that the answers received were based upon an in-depth knowledge of the topic. In addition to the online survey, ten interviews were carried out in order to enrich the conclusion of the study.
Conclusions Some key aspects have distinctly emerged from the survey. The visibility of the EU's initiatives in ICT for development seems to be quite low. The current EU approach does not appear to be guided by a strategic framework able to identify priority areas for action. So far, the EU seems to have chosen to integrate ICT across sector programmes, instead of having a technology-driven approach. The EU's cooperation in ICT for development is not perceived to have improved 16
significantly over the last ten years. The top-down approach still appears to be prevalent in the EU’s support of ICT for development. In contrast, bottom-up initiatives appear to be scarce, and the EU is not perceived to have enough experience, or the appropriate instruments, to deliver these types of interventions. Evidence from the study suggests that there is room for EU institutions to enhance the effectiveness of their ICT for development interventions by having a more balanced approach combining bottom-up and top-down interventions in different contexts (such as the level of development of the recipient country, the strength of the government, the development of the private sector, etc.). Many EU MSs are also actively supporting ICT with their national cooperation systems. However, there appears to be little coordination of the approaches and interventions that could be achieved with the federating capacity of the EU. The EU has always been a world-leading innovator in many areas, including health and well-being [43]. We hope that the results of this survey may support decision-makers to better plan and implement ICT projects in LMICs, to make improved use of European resources, and make the case for a renewed commitment by the EU to innovative actions in ICT for development.
Acknowledgements We are grateful to Sarah McCormack, STOA trainee, for her comments and suggestions in the revision of the manuscript.
Disclaimer The views expressed in this publication are the sole responsibility of the authors and do not necessarily reflect the views of the affiliated organizations.
Funding The fieldwork for the present survey was carried out by CSIL-IDC and funded by the Directorate-General for Parliament Research Services (DG EPRS) of the European Parliament (grant number 04-0-03200-04).
Competing interests None declared. 17
Ethical approval Not required.
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http://ec.europa.eu/epsc/pdf/publications/strategic_note_issue_15.pdf Respondents’ information
22
at:
Figure 1
Breakdown of experts invited to the survey and survey participants by type of affiliation.
23
EU support to ICT in LMICs and cooperation with international organisations
40% 35% 30%
25% 20%
15% 10%
5% 0% Significantly improved
Improved
Neither improved nor weakened
Worsened
No opinion
Figure 2 In the last 10 years, to what extent have the EU institutions improved their support to ICT for development as compared to the past? (% of respondents).
40% 35% 30%
25% 20% 15% 10% 5% 0% Very good
Good
Sufficient
Insufficient
No opinion
Figure 3 How do you judge the EU cooperation with international organizations in the field of ICTs diffusion in LMICs? (% of respondents).
24
Objectives to be pursued by EU policies and priority sectors of intervention
45% 40% 35%
30% 25% 20% 15% 10% 5% 0% Reduce health inequalities
Reduce the digital divide
Support the Increase economic achievement of growth the MDGs
No opinion
Other
Figure 4 Please select the objective that in your opinion should be the key priority of the EU policies in ICT for development (% of respondent).
25
% on total respondents
Score
90%
5.0
80%
4.5
70%
4.0
60% 3.5 50% 3.0 40% 2.5 30% 2.0
20%
1.5
10% 0%
1.0 Health
Education
Economic growth
Human development
Food and Agriculture
Infrastructure Human rights Energy and Migration and and Environment Asylum governance
Other
Figure 5 In which priority sector should the EU increase the use of ICTs in LMICs? (% of respondents and score).
EU policy approaches and ICT integration in EU development strategy
60%
50%
40%
30%
20%
10%
00% Top-down/bottom-up combination
Bottom-up approach
No opinion
Top-down approach
Minor/No support to the development of ICTs in LMICs
Other potential policy options
Figure 6 Which instruments are more effective in promoting ICTs within the EU development 26
cooperation? (% of respondents).
40% 35% 30% 25% 20% 15% 10%
05% 00% Focus on applying ICTs to two/three key sectors
Integrating ICTs in Establishing ICTs as all priority areas of a priority area of the the EU Development EU Development Cooperation Cooperation
No opinion
Strengthening the PPPs in ICTs in LMICs between EU and industry
Other
Figure 7 Please select the policy approach that, in your opinion, should be followed by the EU institutions in ICT for development (% of respondents).
27
Most effective actions to facilitate the dissemination of ICT in the developing world % on total respondents
Weighed average of preferences
60%
5.0 4.5
50%
4.0 40%
3.5
30%
3.0 2.5
20%
2.0 10%
1.5
0%
1.0 Technical assistance to specific eprojects
Research partnerships
Infrastructure financing
Rising LMICs policy makers’ awareness on ICTs benefits
Policy/regulatory Rising EU policy dialogue on ICTs makers’ at central level awareness on ICTs
Other
Figure 8 Which instruments are more effective in promoting ICTs within the EU development cooperation? (% of respondents and score).
% on total respondents
Weighed average of preferences
50%
5.0
45%
4.5
40% 4.0 35% 3.5
30% 25%
3.0
20%
2.5
15% 2.0 10% 1.5
5% 0%
1.0 Allocate more Support LMICs in Rise LMICs policy financial resources developing ICTs makers’ awareness to ICT development regulatory and on ICTs benefits programmes legal frameworks
Contribute to telephone and internet cost reduction
Build ICTs capacity Stimulate local Rise donors’ at international ICTs Public-Private awareness on ICTs level, enhancing Partnerships benefits co-ordination among actors
28
Other
Figure 9 In order to remove the obstacles hampering the dissemination of ICTs in LMICs, which action should EU take? (% of respondents and score).
Table 1 Questions of section D.
Section 1. EU support to ICT in LMICs and cooperation with international organisations
Section 1 assessed the EU’s support of ICT for development in the last 10 years (Q1) and evaluated the EU’s cooperation with international organisations on ICT for development (Q2).
Section 2. Objectives to be pursued by EU policies and priority sectors of intervention
Section 2 analysed the objectives that should be pursued by the EU’s policies for ICT for development (Q3) and the priority sectors where the EU should increase the use of ICT in LMICs (e.g. health, education, agriculture, etc.) (Q4).
Section 3. EU policy approaches and ICT integration in EU development strategy
Section 3 explored the approach that should be followed to promote ICT for development (e.g. top down, bottom up, a combination of the two, or other approaches) (Q5), and the choice that should be taken between an integrated approach or a priority area approach (i.e. to support ICT for development that is integrated into different areas of development, or to have ICT as a specific priority area) (Q6).
Section 4. Most effective actions to facilitate the dissemination of ICT in LMICs
The final section explored the most effective instruments in promoting ICT (e.g. technical assistance, research partnerships, regulatory dialogue, etc.) (Q7) and the major obstacles hampering the dissemination of ICT in LMICs (Q8).
29
IMPROVING EU POLICIES FOR ICT FOR DEVELOPMENT: RESULTS FROM A SURVEY OF ICT EXPERTS
Highlight
The visibility of the EU's initiatives in ICT for development seems to be quite low. So far, the EU seems to have chosen to integrate ICT across sector programmes, instead of having a technology-driven approach. The EU's cooperation in ICT for development is not perceived to have improved significantly over the last ten years. The top-down approach still appears to be prevalent in the EU’s support of ICT for development. There is room for EU institutions to enhance the effectiveness of their ICT for development interventions by having a more balanced approach combining bottom-up and top-down interventions. Many EU MSs are also supporting ICT with their national cooperation systems. However, there appears to be little coordination of the approaches and interventions that could be achieved with the federating capacity of the EU.
30
PII: DOI: Reference:
S2211-8837(16)30070-3 http://dx.doi.org/10.1016/j.hlpt.2016.09.001 HLPT205
To appear in: Health Policy and Technology Received date: 26 July 2016 Accepted date: 8 September 2016 Cite this article as: GianLuca Quaglio, Theodoros Karapiperis, Giovanni Putoto, Laura Delponte, Giorgio Micheletti, Helmut Brand, Luigi Bertinato, Göran Tomson, Laurent Bonnardot and Paolo Zanaboni, Improving EU policies for ICT for development: Results from a survey of ICT experts, Health Policy and Technology, http://dx.doi.org/10.1016/j.hlpt.2016.09.001 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
IMPROVING EU POLICIES FOR ICT FOR DEVELOPMENT: RESULTS FROM A SURVEY OF ICT EXPERTS Title Improving EU policies for ICT for development: Results from a survey of ICT experts
Affiliation GianLuca Quaglioa,*, Theodoros Karapiperisa, Giovanni Putotob, Laura Delpontec, Giorgio Michelettid, Helmut Brande, Luigi Bertinatof, Göran Tomsong, Laurent Bonnardoth, Paolo Zanabonii
Scientific Foresight Unit (Science and Technology Options Assessment [STOA], Directorate-General for Parliamentary Research Services (EPRS), Brussels, Belgium a
b Operational c Centre
Research Unit, Doctors with Africa CUAMM, Padua, Italy
for Industrial Studies (CSIL), Milan, Italy
d International e Department f
Data Corporation (IDC), Milan, Italy
of International Health/CAPHRI, Maastricht University, The Nederlands
Local Health Authority N. 20, Veneto Region, Italy
Departments of Learning, Informatics, Management, Ethics and Public Health Sciences, Karolinska Institutet, Sweden g
h Department i Norwegian
of Medical Ethics and Legal Medicine, Paris Descartes University, Paris, France
Centre for E-health Research, University Hospital of North Norway, Norway
Corresponding author GianLuca Quaglio, MD
1
Scientific Foresight Unit (Science and Technology Options Assessment [STOA]) Directorate-General for Parliamentary Research Services (EPRS) European Parliament Rue Wiertz 60, B-1047 Brussels, Belgium E.mail: [email protected]
Background: There is scarce and fragmented evidence of the European Union’s policies and strategies being used in ICT for development in LMICs. Methods: An online survey was conducted to collect feedback from experts evaluating past EU initiatives in ICT for development, and the type of approach EU institutions should pursue in ICT in LMICs in the future. Structured interviews were also carried out with ten of the respondents. Results: One hundred and twenty-one experts responded to the survey. About 30% believe that the EU institutions’ support to ICT for development has improved in the last decade. However, a similar percentage indicated that the EU’s support has not improved or even has worsened. The evaluation of the EU’s cooperation with international organizations was considered good or sufficient by nearly 31% of respondents. Regarding priorities to be pursued by EU policies towards the use of ICT for development, the EU should focus on reducing health inequalities and the digital divide. Concerning the approaches to promote ICT within EU development cooperation, the EU should carry out a mix of top-down and bottom-up approaches. Almost 70% believe that it is better to support an approach that integrates ICT into different areas of action, rather than having ICT as a specific priority area. Health and education were indicated as priority sectors where the EU should increase the use of ICT. Conclusions: The results of this survey can support decision-makers and ICT managers to better plan and implement ICT in LMICs.
Keywords Communications technologies, European Union, developing world, development
Running title EU policies for ICT for development
2
Abstract Background: There is scarce and fragmented evidence of the European Union’s policies and strategies being used in ICT for development in LMICs. Methods: An online survey was conducted to collect feedback from experts evaluating past EU initiatives in ICT for development, and the type of approach EU institutions should pursue in ICT in LMICs in the future. Structured interviews were also carried out with ten of the respondents. Results: One hundred and twenty-one experts responded to the survey. About 30% believe that the EU institutions’ support to ICT for development has improved in the last decade. However, a similar percentage indicated that the EU’s support has not improved or even has worsened. The evaluation of the EU’s cooperation with international organizations was considered good or sufficient by nearly 31% of respondents. Regarding priorities to be pursued by EU policies towards the use of ICT for development, the EU should focus on reducing health inequalities and the digital divide. Concerning the approaches to promote ICT within EU development cooperation, the EU should carry out a mix of top-down and bottom-up approaches. Almost 70% believe that it is better to support an approach that integrates ICT into different areas of action, rather than having ICT as a specific priority area. Health and education were indicated as priority sectors where the EU should increase the use of ICT. Conclusions: The results of this survey can support decision-makers and ICT managers to better plan and implement ICT in LMICs.
3
Background In the second half of the 1990s, donors from Europe and worldwide acknowledged the potential of Information and Communication Technologies (ICT) to provide economic opportunities and services which could promote social and economic progress. The Millennium Development Goals (MDGs) were written around the peak of the global interest in ICT, in the early 2000s. This wave of hope around ICT found its place in a specific target, target 8F of the MDGs. This target sets out the need to make available, in cooperation with the private sector, the benefits of new technologies, especially ICT, towards a global partnership for development [1]. As a result, donors have been developing appropriate ICT strategic frameworks and implementing a diversified ICT project portfolio. In addition, some donors established ICT-dedicated units within their own organizations, to provide adequate support to low and middle-income countries (LMICs) [2]. That period was followed by a loss of momentum “with a rhetoric of mainstreaming ICT covering in reality a side-lining of ICT” [2]. The policy work conducted by key ICT bodies (World Summit of the Information Society, the Internet Governance Forum, etc.), although played a relevant agenda-setting role, did not translate into concrete actions on the ground. Consequently, several donors decided to shift their activities towards more programmatic ICT work [3]. However, during the past 5-6 years a reverse trend has appeared. The development of ICT worldwide, as well as the high penetration of mobile telephony, has created a new momentum bringing, though not reaching the earlier level, a renewed interest in ICT for development amongst the donor community [1, 3]. LMICs have serious shortages of health workers, especially in rural areas. ICT have great potential to assist in the achievement of Sustainable Development Goal 3, which includes universal health coverage as one of its targets.
EU policy documents on ICT for development There are few relevant European Union (EU) policy documents on ICT for development. In 2000 a resolution of the European Parliament (EP) identified the potential impacts of ICT in the development process of LMICs in three main areas: i) democratisation; ii) poverty reduction through an increasing use of ICT in health, education, rural development and environment; and iii) job creation in IT-related industries. The resolution also warned of the possible marginalizing 4
effect of ICT as a result of an increasing digital divide amongst and within countries, and urged the EU and Member States (MSs) to take action towards broadening access to ICT in LMICs. The resolution called for the European Commission (EC) to formulate a single and coherent policy for ICT within the EU development policy and to update it frequently. The resolution envisaged an increase in the quantity and quality of ICT programmes, and suggested to integrate ICT in country strategy papers [4]. Building on the EP's resolution, the role of ICT in the EU development policy was later established in a communication issued by the EC in 2001. The communication considered the relevance of ICT as enablers of socio-economic progress and laid out a number of actions to support the use of ICT in the priority sectors of EU development cooperation. A more systematic use of ICT to enhance development projects was also encouraged. However, while acknowledging the increasingly important role of ICT in economic development, the communication warned of the possible conflict between promoting ICT and addressing other more pressing priorities of LMICs that have a more direct impact on poverty reduction [5]. Since 2001, the EC has not released a revised approach for promoting ICT within EU development cooperation. The 2005 European Consensus on Development mentioned the potential power of an increased use of ICT in bridging the digital divide, but did not further elaborate on this subject and kept it limited to the infrastructural issue [6]. It is only in a EC communication from 2011 that ICT were clearly identified as powerful drivers of change with respect to job creation, economic growth, and poverty reduction. Therefore, ICT generally referred to as new technologies, acquired more prominence within the EU aid policy framework [7]. In 2012, the EP adopted a resolution on a digital freedom strategy within the EU’s foreign policy, that emphasised how ICT could be used both as an enabler of democracy and as repressive instruments under authoritarian regimes. Recognizing that human rights should also be protected through ICT, the resolution called for the increased use of ICT in all EU external programmes. It also called upon the EC to propose new regulatory frameworks in the areas of Internet governance and trade [8]. Within the communications released by the EC between 2013 and 2014, digitalisation was mentioned as an important driver of change to shape a new global partnership for development [9, 10]. A later communication released in 2015, also addressed the potential impact of ICT in LMICs and acknowledged that technical progress does not 5
automatically benefit the poor. To this end, donors are encouraged to use innovation as an instrument that meets the needs of the most vulnerable people [11].
The regional approach of the EU to ICT As for other EU development sectors, the EU’s support to ICT is built upon a regional approach. In particular, but not exclusively, in Africa, ICT interconnectivity is considered instrumental to achieve higher regional integration, trade and growth. High priority is given to regional ICT infrastructures, along with the harmonization of regulatory frameworks amongst countries of the same region. For instance, the Joint Africa-EU Strategy, which provides a framework for AfricaEU relations, aims, amongst other objectives, to bridge the digital divide [12]. In the roadmap of the Joint Africa-EU Strategy (2014-2017), the EU strategy framework in the area of ICT is further broadened by increasing the harmonisation of e-communication policies and regulatory frameworks, strengthening research and education networks through e-infrastructure, enhancing the general capacity of ICT [13]. While some regional strategies and policies of EU development cooperation include explicitly ICT, these often are not well integrated in sector strategies. For example, an EU communication adopted in 2014, laying out the role of the private sector in development, mentioned the use of ICT only in relation to achieving financial inclusion of the poor [14]. Another example is the EU policy framework for the agriculture sector adopted in 2010. This set out EU priorities for promoting sustainable agriculture and improving food availability, yet without integrating ICT [15].
EC support to ICT provided by DG DEVCO Within the EC, support to ICT in development cooperation is mainly delivered through the external aid provided under the supervision of Directorate-General for International Cooperation and Development (DG DEVCO), which also establishes the general and ICT-specific direction of EU development cooperation [16]. A unit within the infrastructure division of DG DEVCO is in charge of coordinating ICT for development issues, whereas programme design and implementation is carried out in the field offices of the EU Delegations. When capacity on specific ICT issues is not available internally, project development and implementation is
6
outsourced to other organizations. The development and implementation of e-Infrastructure initiatives has been entrusted to DG Connect. DG Connect is in charge of managing the implementation of the EU Digital Agenda. It also provides advisory services to DG DEVCO on these issues. DG Connect does not have internal funds for engaging in ICT for development activities, but rather it provides expertise and taps into the financial resources of other EC directorates. Within the EC’s services dealing with ICT for development, the channels of communication are not structured and systematic but are based on programme specific needs and rely on personal networks. Other EC Directorates are involved in supporting the development of research partnerships and infrastructures in the ICT sector, namely DG Research & Innovation. The last Development Assistance Committee Peer Review of the EU external assistance reported that EU institutions could create better links with DG Research & Innovation to tap into its vast knowledge base, thus improving knowledge transfer to other DGs [17].
Study aim The Science and Technology Options Assessment (STOA) Panel is the European Parliament’s in-house source of analysis of public policy issues related to science and technology [18]. STOA recently published a study entitled ‘ICT in the developing world’ with the aim to provide EU decision-makers, policy options for future actions to support LMICs in benefiting from ICT [19]. In this study, evidence from a literature review was complemented by an online survey conducted to collect feedback from experts. The survey was divided into four sections which explored: A) the characteristics of the respondents; B) the role of ICT in economic development of LMICs; C) the benefits of e-health programmes in the developing world; and D) the EU institutions’ policies for ICT for development. The results of the first three sections are published elsewhere [20]. The present paper reports the results of section D, which focused on respondents’ opinions on past EU initiatives on ICT for development, and the type of approach EU institutions should pursue in ICT in LMICs.
Methods Data collection 7
On 12th March 2015, invitations to the online survey were sent out via e-mail through an electronic system. On 30th March 2015, a reminder was sent via e-mail to the experts invited to the survey. The survey was closed on 3rd April 2015. The survey’s questions were validated through a pilot test conducted in February 2015 on 10 selected experts. The survey mainly comprised of closed-ended questions where participants were asked to select and rank 3 or 5 answers from a larger set. The final online questionnaire was structured in the four sections mentioned above. Section D, the results of which are presented in this paper, was divided into different sections, as summarised in Table 1. A selection of different stakeholders were invited to the survey as experts. Target respondents were identified through online databases, as well as through formal requests sent to consortia, companies, donors and investors involved in ICT for development and ICT for health. The survey also relied upon the spontaneous circulation of the questionnaire through specific professional and social networks. The affiliation of the respondents ranged from researchers (e.g. academia, think tanks and research institutes), bilateral and multilateral donors (e.g. UN, WHO, and development agencies of several EU MSs), private non-profit organisations (e.g. NGOs), private for-profit organisations (e.g. ICT firms), public authorities (e.g. recipient countries’ institutions, Ministries of Health, national commissions, hospitals, etc.) and EU institutions. Structured interviews were also conducted with ten experts from the survey’s respondents, to deepen the discussion by raising relevant points that could contribute to the enrichment of the survey results. Interviewees were selected in such a way as to guarantee a balanced representation of different types of affiliations and areas of expertise. A structured form was used for the interviews, with a predefined list of questions. The interviews lasted between 45 to 60 minutes and were carried out by phone.
Data analysis Two indicators were extracted from each question. The first indicator was the percentage of respondents selecting a specific answer, independent of its ranking (this synthetized the opinion of respondents about the relevance of that answer). The second indicator was a synthetic score, measuring the average preference/ranking given to that answer. This was measured and constructed as follows: for each question, a score of 5 (or 3 for those questions where only 3 answers had to be selected) was assigned to each answer any time it was ranked in the first 8
position. A score of 4 (or 2 for those questions where only 2 answers had to be selected) was assigned any time it was ranked in the second position, and so on. Then a weighted average of all of the scores from the answers was computed. The resulting indicator measured the average preference assigned to each answer by those selecting it. In this way, answers could obtain relatively high values even if selected only by few individuals, as long as they were assigned a high ranking. At the end of section D there were open-ended questions giving the respondents the opportunity to leave any general comments that they had.
Results In total, 1275 experts were invited to participate in the survey, in the end 145 responded. Of those, 121 (83%) respondents replied to section D. The results are summarised as follows: i) main respondents’ characteristics; ii) results of questions; iii) results of interviews. Respondents’ characteristics The sample of survey respondents that replied to section D consisted primarily of experts working in academia/research centres (47, 39%). The second largest group of respondents were experts employed in NGOs (30, 25%). Affiliations also included bilateral/multilateral donors (14, 10%), private for-profit organizations (11, 9%), EU institutions (11, 8%) and public authorities (7, 9%). The sample provided a good balance between private and institutional actors: private profit and non-profit organizations accounted for 36% of respondents’ affiliations, whereas public authorities, public organizations and EU institutions accounted for 27% (Fig.1). Teachers, researchers, and project managers were the most represented job positions, accounting for 19%, 17% and 17%, respectively. In relation to geographical distribution, the vast majority of respondents (77, 64%) worked in one or more countries in Sub-Saharan Africa. More than 40% of participants were reported to work in high-income countries, 1/3 of which working exclusively in such nations. It was established that most participants (95, 78%) have worked in the field of ICT for development, development cooperation and/or health sectors in LMICs for more than 5 years. Twelve per cent of the respondents had more than 20 years of experience in the development sector.
9
Results of questions
EU support to ICT in LMICs and cooperation with international organisations About 30% of respondents believe that the EU institutions’ support to ICT for development has improved over the last ten years. However, in contrast to this, a similar percentage of respondents indicated that the EU’s support has not improved or has even worsened (Fig. 2). The evaluation of the EU’s cooperation with international organizations on ICT for development was considered satisfactory (i.e. it was marked as either very good, good or sufficient) by nearly 31% of respondents. However, 35% of respondents evaluated the EU’s cooperation as insufficient (Fig. 3). Interestingly, in both questions, there was a high percentage of respondents without an opinion regarding the achievement of these EU actions.
Objectives to be pursued by EU policies and priority sectors of intervention In terms of priorities to be pursued by EU policies towards ICT for development, the respondents indicated that the EU should focus on reducing health inequalities and the digital divide, as well as provide support to achieve the MDGs (Fig.4). Health and education were indicated as priority sectors in which the EU should increase the use of ICT (Fig. 5).
EU policy approaches and ICT integration in EU development strategy Concerning the approaches to promote ICT within EU development cooperation, the prevalent opinion was that the EU should carry out a mix of top-down and bottom-up approaches in promoting ICT (Fig. 6). However, some differences were observed amongst different categories of experts. For example, among respondents from academia and non-profit organizations there were more people convinced of the importance of a bottom-up approach, whereas for-profit organizations (and to a minor extent public authorities) seemed to prefer a top-down approach. Regarding the question that explored the policy approach that should be taken by the EU for ICT for development, either an integrated or a priority area approach, 70% believe that the EU should take an integrated approach (Fig. 7).
Most effective actions to facilitate the dissemination of ICT in LMICs
10
According to the respondents, the three most effective instruments in promoting ICT within EU development cooperation were technical assistance to specific e-projects, research partnerships, and infrastructure financing (Fig. 8). In the last question, respondents believed that allocating more financial resources and support to LMICs in developing their regulatory and legal frameworks are the actions that the EU institutions should take in order to remove the obstacles hampering the dissemination of ICT in LMICs (Fig. 9).
Results of interviews EU support to ICT in LMICs and cooperation with international organisations The majority of experts interviewed, gave the general impression that the visibility of EU initiatives in LMICs – at least in the ICT for development field – is quite low. Some comments made by the respondents on the initiatives carried out by the EU for ICT for development, highlighted the fact that the EU should seek a greater coordination with other donors and at the very least improve its federating role among EU MSs active in the field.
EU policy approaches and ICT integration in EU development strategy When asked to comment on the fact that EU development cooperation is not guided by a general policy document concerning ICT for development, interviewees gave mixed feedback. Several interviewees pointed out that the idea that ICT should constitute a distinct strategic area would favour the adoption of a narrow, “technology-driven” view. In this perspective, a lack of strategic focus could be seen as a sort of advantage. On the other hand, a poor strategic definition of ICT for development is expected by some experts to affect coherence, and affect the ability of other actors (such as donors and potential beneficiary countries) to understand the EU funding opportunities in this area. Concerning the type of approach that the EU should follow in ICT for development, the vast majority of interviewees agree that a mixed approach (bottom-up and top-down) is ideally the best one, as it would allow for the addressing of different problems in the most convenient way. The suitability of different approaches depends on country-specific issues, as well as the level of development, the strength of the government, and the strength of NGOs working in a specific country or context. However, some interviewees seem to maintain that concretely the EU institutions current comparative advantages concern top-down initiatives, and they may not have 11
sufficient capacity to engage with small organizations operating on the ground. In general, some of the advantages of top-down initiatives that emerged during interviews are that they are not affected by the endemic poor durability that undermines many local based projects, and they do not require a complex routine project management. On the other hand, the majority of interviewees stressed that top-down initiatives tend to exclude local communities from the decision-making process.
Discussion EU support to ICT in LMICs and cooperation with international organisations One third of respondents indicated that the EU’s support to ICT for development has improved over the last ten years. Yet a similar number of respondents indicated that the situation has not improved, and some even suggested that the situation had worsened. Moreover, the relative majority of respondents evaluated the EU’s cooperation with international organizations in the field of ICT diffusion as insufficient. Interviews with experts also confirmed the general impression that the visibility of EU initiatives in LMICs, at least in the ICT for development field, appear to be low. This is in line with the high percentage of survey respondents (34%) that did not have an opinion about the EU’s ICT policies over the last 10 years. Some comments suggested that the EU seeks a greater coordination with other donors to improve its federating role among EU MSs. This seems to be a widespread problem in the field of development, where duplication and fragmentation of European development aid is well recognised, and where competition amongst EU development agencies and NGOs is still evident. A resulting consequence, among others, is that the impact of the EU's development action is not acknowledged or cannot be identified among the populations in beneficiary LMICs [21]. Donor coordination is poorly studied. It is estimated that as much as 800 million euros (around 1.4% of EU development aid) could be saved annually by improving donor coordination [22], however these figures appear to underestimate the magnitude of the issue [23-25]. In 2013 the EP adopted a resolution with recommendations to the EC to avoid unnecessary parallel processes and fragmentation between EU MSs in the field of aid [26]. There is scope for EU institutions to do more to grasp the potential advantages of collaborating with international organizations, such as the ability to exchange good practices and 12
the combination of resources. Regarding this, a 2010 communication from the EC on the role of the EU in global health urged the EU to better streamline its work with other international bodies [27]. The high percentage of respondents without an opinion regarding the achievement of the EU in supporting ICT for development and cooperating with international organisations indicates that the evaluation of these EU actions remains a complicated task.
Objectives to be pursued by EU policies and priority sectors of intervention According to the majority of experts surveyed, the primary aim of EU policies for ICT for development should be the reduction of health inequalities, followed by the achievement of the MDGs and the reduction of the digital divide. E-health promotion does not appear to be central to EU development cooperation policies. Currently, DG DEVCO does not have a specific document or guidelines presiding over the use of ICT within the priority sector of health. A relevant strategy is provided by the EU eHealth Action Plan 2012-2020, which is however directed towards EU MSs [28]. Amongst the operational objectives of the Action Plan, the EU promotes policy dialogue and international cooperation on e-health at a global level. The purpose of this action is to remove obstacles towards a wider use of e-health solutions, such as the lack of interoperability and international standards. It is however unclear as to what extent this action is going to engage LMICs [28]. As a result of this loose strategic framework, the EU tends to adopt an ad hoc project/programme approach when it comes to e-health actions within the broader picture of development and cooperation. E-health appears to be a relatively unexplored area for EU development cooperation. The new European strategy on Global Health recognises the potential use of ICT to improve health service provision, but this has not translated yet into a more systematic use of ICT in health development projects [27]. In 2004, STOA carried out a study on the subject of health and ICT in LMICs. The study emphasised that there was little use of ICT in the EU's aid for the health sector. The report’s recommendations suggested that donors, overcome traditional concepts of health cooperation towards a gradual use of ICT innovations, improve coordination of health programmes and support LMICs by introducing ICT into their health strategies [29]. ICT have created new opportunities for education. However, e-learning is still in its infancy in LMICs which experiences unique challenges compared to developed countries. Many LMICs are interested in implementing e-learning but face obstacles in infrastructure and resources. They 13
also have cultural, political, and economic concerns affecting the implementation of e-learning [30]. The EC pledged to spend at least 20% of its EU development aid on human development and social inclusion, including education. The EU funding for education in LMICs is expected to total some €4.5 billion between 2014 and 2020 [31]. The EU and its MSs are the biggest donor to the Global Partnership for Education Fund [32]. At present, e-learning does not appear to be a sector where the EC is investing in, neither has a strategy or specific policy documents in support of this.
EU policy approaches and ICT integration in EU development strategy As for the EU policy approach, surveyed experts believe that the EU should try to balance the top-down approach that has traditionally characterised its initiatives for ICT for development, with bottom-up interventions. In 2001, a STOA study on ICT in LMICs identified two major weaknesses in the EU's ICT for development approach, namely: the lack of a focused strategy and the excessive use of a top-down approach. The study suggested that a combination of topdown interventions (e.g. policy and regulatory support for ICT) and bottom-up activities (e.g. direct support to ICT projects) would make EU development cooperation more effective [33]. Combining top-down with bottom-up approaches, as well as involving different stakeholders (e.g. local communities, international organizations, private actors, public actors), would promote a better management of projects and more effective monitoring and evaluation processes. This would also make project results better recognized by the local governments, making sure that sustainability is embedded in the project design, thus building local capacity. The suitability of different approaches depends on country-specific issues, such as the level of development, the strength of the government, and the strength of NGOs working in the field. For example, in countries in which the governments are relatively less active in supporting poorer groups, a bottom-up approach is advisable. However, some interviewees argued that the EU institutions might not have sufficient capacity to engage with small organizations operating on the ground. From a strategic point of view, there is consensus on the fact that ICT are instrumental and should be integrated in other areas of development rather than being seen as a self-standing priority. When asked to comment on the fact that EU development cooperation is not guided by a general policy on ICT, the majority see this as a positive factor, because to have strict policies in 14
place could support the adoption of a technology-driven approach, which is not beneficial in a LMICs context. Examining the approaches taken by other multilateral and bilateral donors in promoting ICT in LMICs could provide some further insight into this topic. The World Bank for example, has had a strategy to guide its ICT activities in LMICs since 2001. The World Bank supported ICT broadly, engaging in both the ICT sector (including networks, infrastructure, policy and regulatory frameworks), and ICT applications (such as the use of ICT in other sectors, e.g. mbanking, m-health). Compared to its past strategy, their more recent approach marked a shift from supporting voice telecommunication to broadband and high-speed Internet services, while connectivity infrastructure remains the top priority [34]. The ICT operations strategy of the African Development Bank (a major contributor to promoting ICT in Africa), supports the development of regional and national broadband infrastructure, and the creation of an enabling regulatory environment. It also includes crosscutting areas related to capacity building, coordination, and knowledge management and sharing [35]. Looking to some EU MSs, the Swedish International Development Cooperation Agency (SIDA) , the government agency working
on implementing Swedish aid programmes, considers ICT as a major contributor towards economic growth and poverty reduction. It addresses the digital divide by granting broader possible access to open and free Internet, and by improving capacity and infrastructure at country level [36]. The German development cooperation has recently released a number of priorities for ICT in LMICs. These are to improve regulation of the telecommunication market; to support the local ICT sector (e.g. by providing long-term financing to telecommunication infrastructure and service providers, and capacity development for local IT firms); and to increase the use of ICT in sector programmes (e.g. governance, healthcare, education, financial system, etc.) [37].
Most effective actions to facilitate the dissemination of ICT in LMICs While rapid innovations in technology are making ICT both less expensive and easier to use, many bottlenecks remain in the dissemination of ICT in the LMICs. Lack of users’ capabilities to identify the right technology, insufficient infrastructure (from transportation to market facilities), lack of policies support, fragile legal systems (unsure property rights), and limited financial resources reduce the potential of ICT in the developing world [38, 39]. Respondents believed that technical and financial assistance (mostly for infrastructure) and support to LMICs in 15
developing their regulatory and legal frameworks are the main actions that the EU should take to facilitate the dissemination of ICT in the LMICs. From the survey however, it also emerged that research partnerships could be a useful tool in this regard. A number of strong collaborations and partnerships have been successfully carried out in other fields, such as health research [3942]. Similar effective, balanced, international partnerships between universities and research centres of LMICs and high-income countries can be essential in the tackling of ICT challenges in LMICs.
Study limitations This survey has some limitations common to those of other online surveys, including bias of predefined questions and number of respondents. It is possible that there was some selection bias and other conclusions would have been reached with a different group of respondents. Regarding the questions related to the EU's performance in the last 10 years and the collaboration with international organisation (Fig. 2 and 3) the percentage with no opinion was high. Despite the low response rate, the experts participating in the online survey represented all relevant stakeholders, thus increasing the generalisability of the results. The majority of survey participants (78%) have worked in the field of ICT for development, development cooperation and/or health sectors in LMICs for more than 5 years and 20% of them had more than 20 years of professional experience. This helped to ensure that the answers received were based upon an in-depth knowledge of the topic. In addition to the online survey, ten interviews were carried out in order to enrich the conclusion of the study.
Conclusions Some key aspects have distinctly emerged from the survey. The visibility of the EU's initiatives in ICT for development seems to be quite low. The current EU approach does not appear to be guided by a strategic framework able to identify priority areas for action. So far, the EU seems to have chosen to integrate ICT across sector programmes, instead of having a technology-driven approach. The EU's cooperation in ICT for development is not perceived to have improved 16
significantly over the last ten years. The top-down approach still appears to be prevalent in the EU’s support of ICT for development. In contrast, bottom-up initiatives appear to be scarce, and the EU is not perceived to have enough experience, or the appropriate instruments, to deliver these types of interventions. Evidence from the study suggests that there is room for EU institutions to enhance the effectiveness of their ICT for development interventions by having a more balanced approach combining bottom-up and top-down interventions in different contexts (such as the level of development of the recipient country, the strength of the government, the development of the private sector, etc.). Many EU MSs are also actively supporting ICT with their national cooperation systems. However, there appears to be little coordination of the approaches and interventions that could be achieved with the federating capacity of the EU. The EU has always been a world-leading innovator in many areas, including health and well-being [43]. We hope that the results of this survey may support decision-makers to better plan and implement ICT projects in LMICs, to make improved use of European resources, and make the case for a renewed commitment by the EU to innovative actions in ICT for development.
Acknowledgements We are grateful to Sarah McCormack, STOA trainee, for her comments and suggestions in the revision of the manuscript.
Disclaimer The views expressed in this publication are the sole responsibility of the authors and do not necessarily reflect the views of the affiliated organizations.
Funding The fieldwork for the present survey was carried out by CSIL-IDC and funded by the Directorate-General for Parliament Research Services (DG EPRS) of the European Parliament (grant number 04-0-03200-04).
Competing interests None declared. 17
Ethical approval Not required.
18
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22
at:
Figure 1
Breakdown of experts invited to the survey and survey participants by type of affiliation.
23
EU support to ICT in LMICs and cooperation with international organisations
40% 35% 30%
25% 20%
15% 10%
5% 0% Significantly improved
Improved
Neither improved nor weakened
Worsened
No opinion
Figure 2 In the last 10 years, to what extent have the EU institutions improved their support to ICT for development as compared to the past? (% of respondents).
40% 35% 30%
25% 20% 15% 10% 5% 0% Very good
Good
Sufficient
Insufficient
No opinion
Figure 3 How do you judge the EU cooperation with international organizations in the field of ICTs diffusion in LMICs? (% of respondents).
24
Objectives to be pursued by EU policies and priority sectors of intervention
45% 40% 35%
30% 25% 20% 15% 10% 5% 0% Reduce health inequalities
Reduce the digital divide
Support the Increase economic achievement of growth the MDGs
No opinion
Other
Figure 4 Please select the objective that in your opinion should be the key priority of the EU policies in ICT for development (% of respondent).
25
% on total respondents
Score
90%
5.0
80%
4.5
70%
4.0
60% 3.5 50% 3.0 40% 2.5 30% 2.0
20%
1.5
10% 0%
1.0 Health
Education
Economic growth
Human development
Food and Agriculture
Infrastructure Human rights Energy and Migration and and Environment Asylum governance
Other
Figure 5 In which priority sector should the EU increase the use of ICTs in LMICs? (% of respondents and score).
EU policy approaches and ICT integration in EU development strategy
60%
50%
40%
30%
20%
10%
00% Top-down/bottom-up combination
Bottom-up approach
No opinion
Top-down approach
Minor/No support to the development of ICTs in LMICs
Other potential policy options
Figure 6 Which instruments are more effective in promoting ICTs within the EU development 26
cooperation? (% of respondents).
40% 35% 30% 25% 20% 15% 10%
05% 00% Focus on applying ICTs to two/three key sectors
Integrating ICTs in Establishing ICTs as all priority areas of a priority area of the the EU Development EU Development Cooperation Cooperation
No opinion
Strengthening the PPPs in ICTs in LMICs between EU and industry
Other
Figure 7 Please select the policy approach that, in your opinion, should be followed by the EU institutions in ICT for development (% of respondents).
27
Most effective actions to facilitate the dissemination of ICT in the developing world % on total respondents
Weighed average of preferences
60%
5.0 4.5
50%
4.0 40%
3.5
30%
3.0 2.5
20%
2.0 10%
1.5
0%
1.0 Technical assistance to specific eprojects
Research partnerships
Infrastructure financing
Rising LMICs policy makers’ awareness on ICTs benefits
Policy/regulatory Rising EU policy dialogue on ICTs makers’ at central level awareness on ICTs
Other
Figure 8 Which instruments are more effective in promoting ICTs within the EU development cooperation? (% of respondents and score).
% on total respondents
Weighed average of preferences
50%
5.0
45%
4.5
40% 4.0 35% 3.5
30% 25%
3.0
20%
2.5
15% 2.0 10% 1.5
5% 0%
1.0 Allocate more Support LMICs in Rise LMICs policy financial resources developing ICTs makers’ awareness to ICT development regulatory and on ICTs benefits programmes legal frameworks
Contribute to telephone and internet cost reduction
Build ICTs capacity Stimulate local Rise donors’ at international ICTs Public-Private awareness on ICTs level, enhancing Partnerships benefits co-ordination among actors
28
Other
Figure 9 In order to remove the obstacles hampering the dissemination of ICTs in LMICs, which action should EU take? (% of respondents and score).
Table 1 Questions of section D.
Section 1. EU support to ICT in LMICs and cooperation with international organisations
Section 1 assessed the EU’s support of ICT for development in the last 10 years (Q1) and evaluated the EU’s cooperation with international organisations on ICT for development (Q2).
Section 2. Objectives to be pursued by EU policies and priority sectors of intervention
Section 2 analysed the objectives that should be pursued by the EU’s policies for ICT for development (Q3) and the priority sectors where the EU should increase the use of ICT in LMICs (e.g. health, education, agriculture, etc.) (Q4).
Section 3. EU policy approaches and ICT integration in EU development strategy
Section 3 explored the approach that should be followed to promote ICT for development (e.g. top down, bottom up, a combination of the two, or other approaches) (Q5), and the choice that should be taken between an integrated approach or a priority area approach (i.e. to support ICT for development that is integrated into different areas of development, or to have ICT as a specific priority area) (Q6).
Section 4. Most effective actions to facilitate the dissemination of ICT in LMICs
The final section explored the most effective instruments in promoting ICT (e.g. technical assistance, research partnerships, regulatory dialogue, etc.) (Q7) and the major obstacles hampering the dissemination of ICT in LMICs (Q8).
29
IMPROVING EU POLICIES FOR ICT FOR DEVELOPMENT: RESULTS FROM A SURVEY OF ICT EXPERTS
Highlight
The visibility of the EU's initiatives in ICT for development seems to be quite low. So far, the EU seems to have chosen to integrate ICT across sector programmes, instead of having a technology-driven approach. The EU's cooperation in ICT for development is not perceived to have improved significantly over the last ten years. The top-down approach still appears to be prevalent in the EU’s support of ICT for development. There is room for EU institutions to enhance the effectiveness of their ICT for development interventions by having a more balanced approach combining bottom-up and top-down interventions. Many EU MSs are also supporting ICT with their national cooperation systems. However, there appears to be little coordination of the approaches and interventions that could be achieved with the federating capacity of the EU.
30