Healthcare studies in the information and communication technology for development (ICT4D) domain have attempted to understand how technology can be used to support healthcare organisations in developing countries; organisations whose performance is negatively impacted by resource constraints. Current studies, predominantly informed by positivist and interpretivist paradigms - produce analyses and prescriptions designed without an in-depth understanding of the underlying mechanisms influencing performance. The result is limited ability to explain how organisational performance is enabled by ICT. Critical realism as a philosophy of science provides a deeper ontological and broader epistemological approach that makes it possible to theorise the micro-level mechanisms that hold potential for explaining observed outcomes. The study reported here, informed by the critical realism paradigm, uses interviews, observation and organisational data collected from a single case study to identify the resource optimisation micro-level generative mechanisms that have improved emergency medical services. The study integrates the technological affordances lens to explain ICT-enabled organisational performance. Additionally, the paper proposes and tests an understanding of the Bygstad, Munkvold, and Volkoff stepwise framework as a methodology for doing critical realist research using affordances.
Human Sciences Research Council (Sat,) studied this question.