Using technology in fragile, conflict, and violence (FCV) situations: Five key questions to be answered

This note provides guidance on how to effectively use technology in FCV contexts by answering five key questions related to the challenges, enabling factors, risks, and real-world applications of technology in these settings.

In this World Bank knowledge note, Garber and Carrette (2018) provide guidance on using technology in Fragile, Conflict, and Violence (FCV) situations by answering five key questions. They emphasize that while technology can enhance data collection, planning, and M&E in FCV contexts, it is not a one-size-fits-all solution. The note aims to help World Bank Group Task Team Leaders (TTLs) navigate the appropriate and effective use of technology in FCV health projects.

1. What Challenges Can Technology Help Address in FCV Settings?

• Planning and Data Collection: Remote technologies like satellite imagery, social media, and RFID enable data collection without strong ground presence. GIS helps manage and collate field data to identify needs, detect trends, and allocate resources efficiently.
• Flexibility and Adaptation: Technologies like SMS and tablet-based surveys offer quick deployment and real-time updates, adapting rapidly to changing conditions.
• Implementation and Service Delivery: Tools such as telemedicine, e-learning, and drones improve access to healthcare, supply chain management, and aid delivery in remote or insecure areas.
• Oversight and Monitoring: GPS tracking, social media, and geospatial mapping ensure transparency, track service delivery, and provide platforms for grievance redress.

2. What Basic Enabling Factors Should Be Assessed for Technologies in FCV Settings?

• Infrastructure Capacity: Evaluate the reliability of electricity, mobile, and wireless networks essential for technology deployment.
• Technology Saturation and Use: Assess cellphone ownership and social media use, which can be high among FCV populations but vary by demographics.
• Regulatory and Legal Frameworks: Understand local policies and regulations that may restrict certain technologies.
• Local Capacity: Ensure sufficient local capacity for technology maintenance, troubleshooting, and field testing.
• Appropriateness for Task: Tailor the choice of technology to specific tasks, such as using satellite imagery for large-scale damage assessment but not for detailed, street-level evaluations.

3. What Risks and Limitations Should Be Considered with These Technologies?

• Bias: Technologies like SMS-based surveys may disproportionately capture data from specific demographics, introducing bias.
• Verification: Remote data often requires triangulation with other sources to ensure accuracy and reliability.
• Safety: Some technologies may pose risks to in-country teams, such as making them targets for theft or harassment.
• Privacy: Ensure GPS data and other sensitive information are de-identified to protect participants' privacy.
• Perception: Technologies like satellite imagery and GPS tracking may be perceived as intrusive, requiring careful explanation to local partners.
• Sustainability: Many mobile health interventions lack plans for scale-up and sustainability.

• Cost: The deployment cost of technologies varies widely, from free mobile platforms to expensive satellite imagery.

4. How Have Technologies Been Used in World Bank FCV Health Projects?

• SMS Text Messaging: Used for early warning alerts, health education, surveys, feedback, and monitoring (e.g., Yemen Emergency Health and Nutrition Project).
• Mobile Apps: Facilitate data collection, medication compliance, diagnostics, and supply chain management (e.g., Pulse of South Sudan).
• Web-Based Platforms: Support e-health records, supply chain management, and e-learning (e.g., Democratic Republic of Congo Health Systems Strengthening Project).
• Electronic Payment Systems: Provide e-vouchers and cash-based aid to health workers and displaced populations (e.g., Sierra Leone Ebola Emergency Response).
• Satellite Imagery and Remote Sensing: Track population movements, assess infrastructure damage, and estimate IDP settlements (e.g., Syria ESIA, Somalia DINA).
• Social Media: Crowdsources data on health needs and infrastructure damage, predicts outbreaks, and serves as a grievance redress mechanism (e.g., Iraq Damage and Needs Assessment).
• GPS Tracking and GIS: Monitor mobile teams and health workers, analyze data, and ensure transparency (e.g., Nigeria Polio Eradication Support Project).

5. What “Disruptive Technologies” Are on the Horizon?

• Blockchain: Improves transparency in financial agreements and reduces corruption (e.g., UNICEF's blockchain initiatives).
• Artificial Intelligence (AI): Assists with medical diagnoses and medication compliance, though context-specific considerations are necessary.
• Big Data: Analyzes large datasets for trends in FCV countries (e.g., GDELT, UN Global Pulse).
• Ground Sensors: Detect foot traffic and population movements, potentially monitoring hospital utilization in real-time.
• Drones and ANTs: Map displaced populations, assess infrastructure damage, and deliver supplies (e.g., Zipline's blood delivery system in Rwanda).
• 3D Printers and Portable Medical Equipment: Produce supplies and medical devices in refugee settings.
• Geo-Enabling: Provides real-time project monitoring and supervision through geo-tagged data.
• Uber-Style Apps: Connect ambulances to patients, enabling remote triage and AED dispatch (e.g., Flare and GoodSAM apps).