The Datafication of Community Health Work: Discipline, Visibility and the State

ABSTRACT There has been a concerted drive to expand the scope of ‘data for development’, with a focus on novel technologies. This article highlights a relatively overlooked category of worker in the large‐scale production of such data: volunteers. The authors examine community health as the last frontier of the ‘datafication’ of health, but which forms part of longer‐term, data‐driven dynamics. Building on the notion of ‘data relations’, the study draws on qualitative fieldwork in Kenya and Burundi to explore how health volunteers are shaping and being shaped by everyday ‘data work’. Three themes emerge. First, the activities of Community Health Workers (CHWs) have become increasingly tied to the production of quantifiable data, altering work dynamics and compounding stresses, while not necessarily reducing precarity. Second, CHWs welcome these schemes, as they afford new pathways for visibility and validation through their data production, although these have not fundamentally altered their status. Last, datafication challenges the voluntary, bottom‐up ethos of community health, whereby state actors contract CHWs as data collectors and de facto workers, subject to top‐down managerial control and discipline. In these respects, the authors discern surprising convergence between two very different political regimes, wherein the presence of digital technologies also diverged. The article thus concludes that state actors need to be folded back in to understanding how datafication is powered.