How to Situate Technology in the Capability Approach: The Case of Technologies for Health

Haenssgen, Marco; Ariana, Proochista (2014). 'How to Situate Technology in the Capability Approach: The Case of Technologies for Health' Paper presented at the annual conference of the HDCA, 2-5 September 2014, Athens, Greece.

Technology is not an inherent analytical category of the Capability Approach. The recent years have therefore seen an increase in writing about how to integrate technology within the basic framework. Despite extensive debate and a number of proposals focusing on applied frameworks (e.g. the sustainable livelihoods framework), the literature has not produced a consensus on how to integrate technology consistently into the Capability Approach. Broadly speaking, most of these authors agree that technology deserves special attention in the CA. But should this attention derive from technology being a special kind of input (like food), or because the idea of 'technology' is fundamentally different from the idea of 'inputs?'

Technology as a 'special input to expand human capabilities' has been the intuitive starting point for almost all existing technology-augmented capability frameworks. However, narrow notions of 'technology as an input' are insufficient to appreciate the arguably special characteristics of technological artefacts. Moreover, by conceiving of technology as being merely an input to valued capabilities, the analyst is prone to defining technology as something inherently conducive to human lives. More complex definitions of technology introduce interactions between technology and social norms and other conversion factors. Such broader notions also point at the relationship between technology on the one hand and choice and agency on the other. But also these definitions start from the premise that the main feature of technology is to directly enhance human capabilities. The additional complexity of the concept then only introduces contradictions within the Capability Approach. Still being defined as an input, the question remains as to what, then, is the defining characteristic of technology, and why not other inputs, too, should interact with conversion factors and human agency.

We propose to reconcile the conflicting perspectives by addressing the role of technology on two levels. Firstly, we conceive of 'Technology' (i.e. the various ways of applying solutions to given problems) as a group of conversion factors. As such, Technology shares the features of other (e.g. individual or environmental) conversion factors, namely the influence on the translation of inputs into valued capabilities and the interaction with other conversion factors. On the second level, we consider individual technical artefacts (e.g. hammers, mobile phones, or calculators). These artefacts can be considered 'technical' because they have a dual nature. On the one hand, they can carry intrinsic characteristics that serve as inputs for valued capabilities. Such characteristics may for example pertain to the symbolic and aesthetic nature of technical objects (i.e. their 'generative' dimension). But technical artefacts only considered in their generative capacity are conceptually indistinguishable from other inputs. We argue that the defining feature of technical artefacts is a second dimension: their 'transformative' nature (rather than the generative dimension that they share with other inputs). By being used to influence humans' ability to act on the world, technological objects fulfil functions that are otherwise the domain of conversion factors, namely moderating the translation of inputs into valued capabilities. What counts as technological object (i.e. what becomes part of these techniques to act on the world) is context specific and defined by Technology as a conversion factor. Technical objects therefore acquire their transformative nature from the socio-technical context, and their role is defined in relation to it. In this sense, a technical artefact is different from an ordinary input as it acts on behalf or as extension of the human body in the translation of inputs' characteristics into valued capabilities. This translation, however, cannot be considered in isolation as it may be more or less expedient than other techniques at people's disposal. In a nutshell, we maintain that this analytical distinction between generative and transformative qualities of technical objects allows a more nuanced enquiry into the use of technology and its implications for human lives.

We argue that this discussion is non-trivial in that it permits a more nuanced and conservative exploration of the impact of technology on human lives, and a better appreciation of the multiple roles that technology plays. Yet, not unlike the basic framework of the Capability Approach, our augmented framework remains abstract and requires operationalization to the specific case in question. We provide an example within the area of mobile technologies and their role in healthcare access. This operationalization reframes existing theoretical strands of technology adoption and healthcare-seeking behaviour, thereby shifting away from a techno-centric and supply-driven approach to one in which human actions and their objectives are at the centre of the analysis. We demonstrate how this procedure leads us to ask research questions that are fundamentally different from conventional explorations of mobile technology and healthcare access.

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