Towards Equitable Futures in Frontline Health:Design of Intelligent Systems for Supporting (Gendered) Care Work in Resource-Constrained Settings
Author: 
Azra IsmailAuthors Info & Claims
Azra IsmailAuthors Info & ClaimsApril 2022
Article No.: 62, Pages 1 - 5
Abstract
Frontline health workers in many countries are responsible for filling gaps in essential primary health infrastructure, as witnessed during the COVID-19 pandemic. Their work increasingly involves the use of purportedly “intelligent” systems or data collection for such systems, to support diagnosis, disease forecasting, and information delivery. My research aims to inform the design of data-driven and automated systems in frontline health work, particularly for women workers in low-level and precarious roles in the Global South. Drawing from literature in the fields of human-computer interaction (HCI), gender and development studies, and health informatics, I will critically examine health workers’ experiences and relationships with “intelligent” systems, and engage in the participatory design of technology that might better serve worker needs while strengthening the frontline health ecology overall.
References
[1]
Carrie J Cai, Samantha Winter, David Steiner, Lauren Wilcox, and Michael Terry. 2019. ” Hello AI”: Uncovering the Onboarding Needs of Medical Practitioners for Human-AI Collaborative Decision-Making. Proceedings of the ACM on Human-computer Interaction 3, CSCW(2019), 1–24.
[2]
Andrew Cross, Rashmi Rodrigues, George D’Souza, and William Thies. 2014. 99DOTS: using mobile phones to monitor adherence to tuberculosis medications. In Washington, Global mHealth Forum.
[3]
Nicola Dell, Trevor Perrier, Neha Kumar, Mitchell Lee, Rachel Powers, and Gaetano Borriello. 2015. Paper-Digital Workflows in Global Development Organizations. In Proceedings of the 18th ACM Conference on Computer Supported Cooperative Work & Social Computing. ACM, 1659–1669.
[4]
Brian DeRenzi, Nicola Dell, Jeremy Wacksman, Scott Lee, and Neal Lesh. 2017. Supporting Community Health Workers in India through Voice-and Web-Based Feedback. In Proceedings of the 2017 CHI Conference on Human Factors in Computing Systems. ACM, ACM, 2770–2781.
[5]
Brian DeRenzi, Jeremy Wacksman, Nicola Dell, Scott Lee, Neal Lesh, Gaetano Borriello, and Andrew Ellner. 2016. Closing the feedback Loop: A 12-month evaluation of ASTA, a self-tracking application for ASHAs. In Proceedings of the Eighth International Conference on Information and Communication Technologies and Development(ICTD ’16). ACM, New York, NY, USA, Article 22, 10 pages. event-place: Ann Arbor, MI, USA.
[6]
Hamid R Ekbia and Bonnie A Nardi. 2017. Heteromation, and other stories of computing and capitalism. MIT Press.
[7]
Asha George. 2008. Nurses, community health workers, and home carers: gendered human resources compensating for skewed health systems. Global Public Health 3, S1 (2008), 75–89.
[8]
Mary L Gray and Siddharth Suri. 2019. Ghost work: how to stop Silicon Valley from building a new global underclass. Eamon Dolan Books.
[9]
Carl Hartung, Adam Lerer, Yaw Anokwa, Clint Tseng, Waylon Brunette, and Gaetano Borriello. 2010. Open data kit: tools to build information services for developing regions. In Proceedings of the 4th ACM/IEEE international conference on information and communication technologies and development. 1–12.
[10]
Samia Ibtasam, Lubna Razaq, Haider W Anwar, Hamid Mehmood, Kushal Shah, Jennifer Webster, Neha Kumar, and Richard Anderson. 2018. Knowledge, Access, and Decision-Making: Women’s Financial Inclusion In Pakistan. In Proceedings of the 1st ACM SIGCAS Conference on Computing and Sustainable Societies. ACM, 22.
[11]
Azra Ismail, Naveena Karusala, and Neha Kumar. 2018. Bridging Disconnected Knowledges for Community Health. Proceedings of the ACM on Human-Computer Interaction 2, CSCW (Nov. 2018), 1–27.
[12]
Azra Ismail and Neha Kumar. 2018. Engaging Solidarity in Data Collection Practices for Community Health. Proceedings of the ACM on Human-Computer Interaction 2, CSCW(2018), 76.
[13]
Azra Ismail and Neha Kumar. 2019. Empowerment on the Margins: The Online Experiences of Community Health Workers. In Proceedings of the 2019 CHI Conference on Human Factors in Computing Systems. ACM, 99.
[14]
Azra Ismail and Neha Kumar. 2021. AI in Global Health: The View from the Front Lines. In Proceedings of the 2021 CHI Conference on Human Factors in Computing Systems. 1–21.
[15]
Anirudha Joshi, Mandar Rane, Debjani Roy, Nagraj Emmadi, Padma Srinivasan, N. Kumarasamy, Sanjay Pujari, Davidson Solomon, Rashmi Rodrigues, D.G. Saple, Kamalika Sen, Els Veldeman, and Romain Rutten. 2014. Supporting Treatment of People Living with HIV / AIDS in Resource Limited Settings with IVRs. In Proceedings of the SIGCHI Conference on Human Factors in Computing Systems(CHI ’14). ACM, New York, NY, USA, 1595–1604. https://doi.org/10.1145/2556288.2557236
[16]
Annika Kaltenhauser, Verena Rheinstädter, Andreas Butz, and Dieter P Wallach. 2020. ” You Have to Piece the Puzzle Together” Implications for Designing Decision Support in Intensive Care. In Proceedings of the 2020 ACM Designing Interactive Systems Conference. 1509–1522.
[17]
Naveena Karusala, Ding Wang, and Jacki O’Neill. 2020. Making Chat at Home in the Hospital: Exploring Chat Use by Nurses. In Proceedings of the 2020 CHI Conference on Human Factors in Computing Systems. 1–15.
[18]
Elizabeth Kaziunas, Michael S Klinkman, and Mark S Ackerman. 2019. Precarious Interventions: Designing for Ecologies of Care. Proceedings of the ACM on Human-Computer Interaction 3, CSCW(2019), 1–27.
[19]
Stuti Khemani, Sarang Chaudhary, and Thiago Scot. 2020. Strengthening Public Health Systems: Policy Ideas from a Governance Perspective.
[20]
Neha Kumar. 2015. The gender-technology divide or perceptions of non-use?First Monday 20, 11 (2015).
[21]
Neha Kumar and Richard J Anderson. 2015. Mobile phones for maternal health in rural India. In Proceedings of the 33rd Annual ACM Conference on Human Factors in Computing Systems(CHI ’15). ACM, ACM, New York, NY, USA, 427–436. event-place: Seoul, Republic of Korea.
[22]
Neha Kumar and Tapan S. Parikh. 2013. Mobiles, Music, and Materiality. In Proceedings of the SIGCHI Conference on Human Factors in Computing Systems(CHI ’13). ACM, New York, NY, USA, 2863–2872. event-place: Paris, France.
[23]
Neha Kumar, Trevor Perrier, Michelle Desmond, Kiersten Israel-Ballard, Vikrant Kumar, Sudip Mahapatra, Anil Mishra, Shreya Agarwal, Rikin Gandhi, Pallavi Lal, and Richard Anderson. 2015. Projecting health: community-led video education for maternal health. In Proceedings of the Seventh International Conference on Information and Communication Technologies and Development(ICTD ’15). ACM, New York, NY, USA, Article 17, 10 pages. https://doi.org/10.1145/2737856.2738023 event-place: Singapore, Singapore.
[24]
Indrani Medhi, Mohit Jain, Anuj Tewari, Mohini Bhavsar, Michael Matheke-Fischer, and Edward Cutrell. 2012. Combating rural child malnutrition through inexpensive mobile phones. In Proceedings of the 7th Nordic conference on human-computer interaction: making sense through design. ACM, 635–644.
[25]
Apurv Mehra, Srihari Muralidhar, Sambhav Satija, Anupama Dhareshwar, and Jacki O’Neill. 2018. Prayana: Intermediated Financial Management in Resource-Constrained Settings. In Proceedings of the 2018 CHI Conference on Human Factors in Computing Systems. ACM, 389.
[26]
Sonali R. Mishra, Shefali Haldar, Ari H. Pollack, Logan Kendall, Andrew D. Miller, Maher Khelifi, and Wanda Pratt. 2016. “Not Just a Receiver”: Understanding Patient Behavior in the Hospital Environment. In Proceedings of the 2016 CHI Conference on Human Factors in Computing Systems(CHI ’16). ACM, New York, NY, USA, 3103–3114. https://doi.org/10.1145/2858036.2858167 event-place: Santa Clara, California, USA.
[27]
Maletsabisa Molapo, Melissa Densmore, and Brian DeRenzi. 2017. Video Consumption Patterns for First Time Smartphone Users: Community Health Workers in Lesotho. In Proceedings of the 2017 CHI Conference on Human Factors in Computing Systems. ACM, ACM, 6159–6170.
[28]
David Nemer. 2016. Rethinking social change: The promises of Web 2.0 for the marginalized. First Monday 21, 6 (2016).
[29]
Fabian Okeke, Lucas Nene, Anne Muthee, Stephen Odindo, Dianna Kane, Isaac Holeman, and Nicola Dell. 2019. Opportunities and challenges in connecting care recipients to the community health feedback loop. In Proceedings of the Tenth International Conference on Information and Communication Technologies and Development. ACM, ACM, 13.
[30]
Joyojeet Pal. 2017. The Technological Self in India: From Tech-savvy Farmers to a Selfie-tweeting Prime Minister. In Proceedings of the Ninth International Conference on Information and Communication Technologies and Development(ICTD ’17). ACM, New York, NY, USA, 11:1–11:13. event-place: Lahore, Pakistan.
[31]
Joyojeet Pal, Anjuli Dasika, Ahmad Hasan, Jackie Wolf, Nick Reid, Vaishnav Kameswaran, Purva Yardi, Allyson Mackay, Abram Wagner, Bhramar Mukherjee, Sucheta Joshi, Sujay Santra, and Priyamvada Pandey. 2017. Changing data practices for community health workers: Introducing digital data collection in West Bengal, India. In Proceedings of the Ninth International Conference on Information and Communication Technologies and Development(ICTD ’17). ACM, ACM, New York, NY, USA, 1–12. event-place: Lahore, Pakistan.
[32]
Arjun Panesar. 2019. Future of Healthcare. In Machine Learning and AI for Healthcare. Springer, 255–304.
[33]
Trevor Perrier, Nicola Dell, Brian DeRenzi, Richard Anderson, John Kinuthia, Jennifer Unger, and Grace John-Stewart. 2015. Engaging Pregnant Women in Kenya with a Hybrid Computer-Human SMS Communication System. In Proceedings of the 33rd Annual ACM Conference on Human Factors in Computing Systems(CHI ’15). ACM, New York, NY, USA, 1429–1438. https://doi.org/10.1145/2702123.2702124 event-place: Seoul, Republic of Korea.
[34]
Trevor Perrier, Elizabeth K Harrington, Keshet Ronen, Daniel Matemo, John Kinuthia, Grace John-Stewart, Richard Anderson, and Jennifer A Unger. 2018. Male partner engagement in family planning SMS conversations at Kenyan health clinics. In Proceedings of the 1st ACM SIGCAS Conference on Computing and Sustainable Societies. ACM, ACM, 1–11.
[35]
Laura R Pina, Sang-Wha Sien, Teresa Ward, Jason C Yip, Sean A Munson, James Fogarty, and Julie A Kientz. 2017. From personal informatics to family informatics: Understanding family practices around health monitoring. In Proceedings of the 2017 ACM Conference on Computer Supported Cooperative Work and Social Computing(CSCW ’17). ACM, New York, NY, USA, 2300–2315. event-place: Portland, Oregon, USA.
[36]
Divya Ramachandran, John Canny, Prabhu Dutta Das, and Edward Cutrell. 2010. Mobile-izing health workers in rural India. In Proceedings of the SIGCHI Conference on Human Factors in Computing Systems. ACM, ACM, 1889–1898.
[37]
Nimmi Rangaswamy and Melissa Densmore. 2013. Understanding Jugaad: ICTD and the Tensions of Appropriation, Innovation and Utility. In Proceedings of the Sixth International Conference on Information and Communications Technologies and Development: Notes - Volume 2(ICTD ’13). ACM, New York, NY, USA, 120–123. event-place: Cape Town, South Africa.
[38]
Sunil Rodger and Kenton O’Hara. 2019. Exploring the Potential for Technology to Improve Cystic Fibrosis Care Provision: Patient and Professional Perspectives. Proceedings of the ACM on Human-Computer Interaction 3, CSCW(2019), 1–26.
[39]
Nithya Sambasivan, Garen Checkley, Amna Batool, Nova Ahmed, David Nemer, Laura Sanely Gaytán-Lugo, Tara Matthews, Sunny Consolvo, and Elizabeth Churchill. 2018. ” Privacy is not for me, it’s for those rich women”: Performative Privacy Practices on Mobile Phones by Women in South Asia. In Fourteenth Symposium on Usable Privacy and Security (SOUPS 2018). 127–142.
[40]
Richard Schulz and Lynn M Martire. 2004. Family caregiving of persons with dementia: prevalence, health effects, and support strategies. The American journal of geriatric psychiatry 12, 3(2004), 240–249.
[41]
Thomas N Smyth, Satish Kumar, Indrani Medhi, and Kentaro Toyama. 2010. Where there’s a will there’s a way: mobile media sharing in urban india. In Proceedings of the SIGCHI conference on Human Factors in computing systems. ACM, 753–762.
[42]
Jina Suh, Spencer Williams, Jesse R Fann, James Fogarty, Amy M Bauer, and Gary Hsieh. 2020. Parallel Journeys of Patients with Cancer and Depression: Challenges and Opportunities for Technology-Enabled Collaborative Care. Proceedings of the ACM on Human-Computer Interaction 4, CSCW1(2020), 1–36.
[43]
Divy Thakkar, Neha Kumar, and Nithya Sambasivan. 2020. Towards an AI-Powered Future that Works for Vocational Workers. In Proceedings of the 2020 CHI Conference on Human Factors in Computing Systems. 1–13.
[44]
Aditya Vashistha, Neha Kumar, Anil Mishra, and Richard Anderson. 2017. Examining localization approaches for community health. In Proceedings of the 2017 Conference on Designing Interactive Systems(DIS ’17). ACM, ACM, New York, NY, USA, 357–368. https://doi.org/10.1145/3064663.3064754 event-place: Edinburgh, United Kingdom.
[45]
Ding Wang, Santosh D Kale, and Jacki O’Neill. 2020. Please call the specialism: Using WeChat to support patient care in China. In Proceedings of the 2020 CHI Conference on Human Factors in Computing Systems. 1–13.
[46]
Susan Wyche and Jennifer Olson. 2018. Gender, Mobile, and Mobile Internet| Kenyan Women’s Rural Realities, Mobile Internet Access, and “Africa Rising”. Information Technologies & International Development 14 (2018), 15.
[47]
Susan P. Wyche, Sarita Yardi Schoenebeck, and Andrea Forte. 2013. “Facebook is a Luxury”: An Exploratory Study of Social Media Use in Rural Kenya. In Proceedings of the 2013 Conference on Computer Supported Cooperative Work(CSCW ’13). ACM, New York, NY, USA, 33–44. event-place: San Antonio, Texas, USA.
[48]
Deepika Yadav, Anushka Bhandari, and Pushpendra Singh. 2019. LEAP: Scaffolding Collaborative Learning of Community Health Workers in India. Proceedings of the ACM on Human-Computer Interaction 3, CSCW(2019), 1–27.
[49]
Deepika Yadav, Prerna Malik, Kirti Dabas, and Pushpendra Singh. 2019. Feedpal: Understanding opportunities for chatbots in breastfeeding education of women in india. Proceedings of the ACM on Human-Computer Interaction 3, CSCW(2019), 1–30.
[50]
Deepika Yadav, Pushpendra Singh, Kyle Montague, Vijay Kumar, Deepak Sood, Madeline Balaam, Drishti Sharma, Mona Duggal, Tom Bartindale, Delvin Varghese, and Patrick Olivier. 2017. Sangoshthi: Empowering Community Health Workers through Peer Learning in Rural India. In Proceedings of the 26th International Conference on World Wide Web(WWW ’17). International World Wide Web Conferences Steering Committee, International World Wide Web Conferences Steering Committee, Republic and Canton of Geneva, Switzerland, 499–508.
[51]
Qian Yang, Aaron Steinfeld, and John Zimmerman. 2019. Unremarkable ai: Fitting intelligent decision support into critical, clinical decision-making processes. In Proceedings of the 2019 CHI Conference on Human Factors in Computing Systems(CHI ’19). ACM, New York, NY, USA, 1–11. https://doi.org/10.1145/3290605.3300468 event-place: Glasgow, Scotland Uk.
[52]
Mary K Zimmerman and Shirley A Hill. 2006. Health care as a gendered system. In Handbook of the sociology of gender. Springer, 483–518.
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April 2022
3066 pages
ISBN:9781450391566
DOI:10.1145/3491101
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