Trace of the tracer: Techno-solutionism, surveillance and the ambivalent experiences of digital health in Türkiye's COVID-19 response.

Abstract

This study examines how digital health technologies were implemented in pandemic response, based on interviews and focus groups with frontline health workers in Türkiye. While the COVID-19 pandemic accelerated the adoption of digital tools as essential solutions for crisis management, the findings reveal a more ambivalent reality.Digital systems improved coordination, replaced paper-based chaotic workflows, and enabled real-time data sharing. However, their effectiveness was constrained by infrastructural shortcomings, uneven digital skills, and misalignment with field conditions. Digitalisation also introduced new surveillance and performance monitoring, blurring professional boundaries and increasing bureaucratic burdens. Privacy concerns emerged as health workers used personal devices, while metric-driven oversight reduced their work to quantifiable outputs and obscured qualitative aspects of care. Furthermore, social inequalities, including limited digital literacy among older adults and the exclusion of migrants from official records, revealed the limits of technology-centred approaches and underscored the importance of human-centred interactions.This study argues that digital technologies function as socio-technical systems shaped by institutional structures, material resources, and practice. Türkiye's experience shows that digital tools can enhance coordination in public health emergencies when frontline experience, quality of care, and equity are prioritised. Otherwise, digitalisation risks reproducing the inefficiencies and inequalities it aims to resolve.