Date of Award

2022

Document Type

Open Access Dissertation

Degree Name

Doctor of Philosophy in Rhetoric, Theory and Culture (PhD)

Administrative Home Department

Department of Humanities

Advisor 1

Victoria L. Bergvall

Advisor 2

Marika Seigel

Committee Member 1

Diane Shoos

Committee Member 2

Christa Teston

Abstract

mHealth, which is the use of mobile phones and other handheld information and communication technologies (ICTs), has been increasingly advocated as the solution to the problems, primarily infrastructure and personnel, facing the healthcare sector of many low-to-lower-middle-income countries (LMICs). Following a series of United Nations Foundation research and advisory publications (in 2012, 2014 and 2016) arguing that mobile phones are approaching ubiquity in Nigeria and across the world, the UN strongly recommended that LMICs undertake mHealth initiatives. Subsequently, Nigeria’s Federal Ministry of Health (FMOH) published a National Health ICT Strategic Framework (Strategic Framework), 2015-2020; the rallying call of this document is that “Health ICTs will deliver universal healthcare [in Nigeria] by 2020.” The document takes a techno-optimistic position that celebrates and advocates for the creation of mHealth technologies, yet it fails to acknowledge the dire lack of the basic, necessary infrastructures for such electronic health systems, particularly in rural areas, including a scarcity of reliable electrical systems or the trained personnel who would understand how to use such technologies. This creates and sustains a healthcare precarity for poor and rural Nigerians.

The rhetoric of health and medicine has taken up precarity as a framework for understanding how modern discourses contribute to the material positioning of humans with respect to technological systems. Using material-discursive critique and precarity as analytical frameworks, I tie the history of western medicine in Nigeria to the prevailing top-down approach which created widespread healthcare deserts. Using Critical (Policy) Discourse Analysis, I also examine discursive positioning of agents, e.g., “stakeholders” in the Strategic Framework and “heroes” in an mHealth technology developed and advertised locally in Nigeria, to reveal how policy documents and popular advertisements around mHealth are manipulated to camouflage these healthcare deserts with techno-optimistic rhetoric. Only when we address both the actual material conditions and the rhetorical and linguistic silencing of the people in these rural or poor areas will we be able to approach the promised benefits of mHealth systems in universal healthcare.

Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

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