Picture yourself going to the doctor. You arrive by car, park nearby, and when you enter a receptionist greets you and checks your information on a computer. You’re led into a comfortable, well-lit office; the cabinets are fully stocked. Your records are on hand. The nurses and doctors are well educated and knowledgeable, their equipment at the ready. If they can’t help you, they refer you to someone who can.
Now try to picture the same scene in sub-Saharan Africa. If you’re wealthy, your experience may be similar. But if you’re not, it’s altogether different. The roads are unpaved and riddled with potholes; it might take all day to get to the clinic by public transport. The queue to see the doctor is long–an eight-hour wait is not unusual–and there’s nowhere to sit. You might have to bribe someone to be seen. The electricity is unreliable; the clinic’s supplies are running low. Your medical records are incomplete, perhaps even non-existent. The doctors and nurses, while trained and dedicated, are not up-to-date on current treatments, and lack access to the tools they need.
I grew up in Nairobi, Kenya, and so my research on M-PESA, the cell phone-based payment system that has spread like wildfire across the country, strikes a deeply personal chord. Most of my research on this has been in collaboration with William (Billy) Jack at Georgetown who lived in Kenya himself for a few years. We both experienced the frustrations of what in the US would be the simplest of money transactions, and felt that M-PESA could fulfill a need of many Kenyans.
In practice, the adoption of M-PESA has been faster than we, and most other observers, had anticipated. In four short years it has been widely embraced by Kenyans, and has already had a big impact on the lives of people I’ve known for years. I did my dissertation on the adoption of farming technologies in Africa, and it’s still a subject that interests me a great deal. I’ve looked at the implementation of seed technologies in Kenya, and the diffusion of improved coffee farming practices in Rwanda. It often takes decades for these kinds of technologies to fully penetrate a population.