Value-sensitive design and global digital health

Abstract

In the field of digital ethics, value-sensitive design is one of the most influential normative methodologies. The basic aim of value-sensitive design is to integrate human values in technologies from the very start of the design process. While value-sensitive design is widely discussed and applied to various technologies in the western European context, in low- and middle-income countries this approach is only rarely applied. This neglect is surprising, as the hopes for digital health are especially high in the context of global health. Local values, habits and practices that are shaped by local circumstances, including socioeconomic contexts, influence which digital technologies get adopted and how they are used. For instance, in Bangladesh, mobile phones are often shared with family members, partners and children due to economic conditions, but also because sharing is a deeply embedded social and cultural practice. A digital health application for a community of users in Bangladesh should thus be aligned with these local values, including notions of privacy, rather than designing privacy features based on the western assumption that a mobile phone only has one user. Value-sensitive design may be helpful to integrate such local practices and values in developing digital technologies in low- and middle-income countries. Our aim here is to explain the approach of value-sensitive design, illustrating its strengths with an example, and to flag some important limitations and challenges of this approach.