Exploring the mismatch between mobile phone adoption and use through survey data from rural India and China

Persistent disciplinary and methodological divides between technology diffusion and adoption studies and the study of use and engagement with technology raise obstacles to understanding the development implications of mobile technology diffusion, for example in the area of healthcare access. As quantitative assessments in the area of health and technology almost exclusively rely on binary indicators of mobile phone adoption, it is not clear whether this is indeed a reasonable proxy that does not obscure the distributional implications of mobile phone use. This paper therefore compares patterns of mobile phone adoption and utilisation using original survey data from rural India and China. "Utilisation" here is assessed through a simple yet novel multidimensional index. The paper further assesses the role of these concepts as determinants of locally emerging forms of mobile-phone-aided healthcare-seeking behavior ("health action"). The investigation uses descriptive statistical analysis and multilevel logistic regression analysis, which provide evidence in support of the claims that (a) patterns of mobile phone diffusion and utilisation are related yet incongruent, that (b) mobile phones facilitate health action in both field sites to a notable extent, and that (c) the mobile phone utilisation index is a better predictor for phone-aided health action than mobile phone adoption. In light of the superiority of the utilisation index vis-à-vis binary measures of mobile phone adoption, other researchers can apply the survey instrument and technology utilisation concept developed in this paper to support the analysis of the social implications of technology diffusion.