Empowerment on the Margins: The Online Experiences of Community Health Workers

Research in Human-Computer Interaction for Development (HCI4D) routinely relies on and engages with the increasing penetration of smartphones and the internet. We examine the mobile, internet, and social media practices of women community health workers, for whom internet access has newly become possible. These workers are uniquely positioned at the intersections of various communities of practice---their familial units, workplaces, networks of health workers, larger communities, and the online world. However, they remain at the margins of each, on account of difference in gender, class, literacies, professional expertise, and more. Our findings unpack the legitimate peripheral participation of these workers; examining how they appropriate smartphones and the internet to move away from the peripheries to fully participate in these communities. We discuss how their activities are motivated by moves towards empowerment, digitization, and improved healthcare provision. We consider how future work might support, leverage, and extend their efforts.

[1]  Naveena Karusala,et al.  Bridging Disconnected Knowledges for Community Health , 2018, Proc. ACM Hum. Comput. Interact..

[2]  Carsten S. Østerlund,et al.  Planet hunters and seafloor explorers: legitimate peripheral participation through practice proxies in online citizen science , 2014, CSCW.

[3]  Tara J. Yosso,et al.  Whose culture has capital? A critical race theory discussion of community cultural wealth , 2005, Critical Race Theory in Education.

[4]  Melissa Densmore,et al.  Understanding Jugaad: ICTD and the tensions of appropriation, innovation and utility , 2013, ICTD.

[5]  Kate Ehrlich,et al.  Diversity among enterprise online communities: collaborating, teaming, and innovating through social media , 2012, CHI.

[6]  Susan Wyche,et al.  Mobile Phones as Amplifiers of Social Inequality among Rural Kenyan Women , 2016, ACM Trans. Comput. Hum. Interact..

[7]  Christoph Pimmer,et al.  Mobile instant messaging for rural community health workers: a case from Malawi , 2017, Global health action.

[8]  Joyojeet Pal,et al.  The Technological Self in India: From Tech-savvy Farmers to a Selfie-tweeting Prime Minister , 2017, ICTD.

[9]  Kentaro Toyama,et al.  From needs to aspirations in information technology for development , 2018, Inf. Technol. Dev..

[10]  Nicola Dell,et al.  Supporting Community Health Workers in India through Voice- and Web-Based Feedback , 2017, CHI.

[11]  Jonathan Donner,et al.  The Rules of Beeping: Exchanging Messages Via Intentional "Missed Calls" on Mobile Phones , 2007, J. Comput. Mediat. Commun..

[12]  Joyojeet Pal,et al.  Changing data practices for community health workers: Introducing digital data collection in West Bengal, India , 2017, ICTD.

[13]  Neha Kumar,et al.  Facebook for self-empowerment? A study of Facebook adoption in urban India , 2014, New Media Soc..

[14]  Melissa Densmore,et al.  Video Consumption Patterns for First Time Smartphone Users: Community Health Workers in Lesotho , 2017, CHI.

[15]  Edward Cutrell,et al.  Anthropology, development and ICTs: slums, youth and the mobile internet in urban India , 2012, ICTD.

[16]  Syed Ishtiaque Ahmed,et al.  Protibadi: A platform for fighting sexual harassment in urban Bangladesh , 2014, CHI.

[17]  Gary Marsden,et al.  After access: challenges facing mobile-only internet users in the developing world , 2010, CHI.

[18]  Amy Bruckman,et al.  Becoming Wikipedian: transformation of participation in a collaborative online encyclopedia , 2005, GROUP.

[19]  Aaron Halfaker,et al.  Making peripheral participation legitimate: reader engagement experiments in wikipedia , 2013, CSCW.

[20]  Patrick Olivier,et al.  Sangoshthi: Empowering Community Health Workers through Peer Learning in Rural India , 2017, WWW.

[21]  Nicola Dell,et al.  Engaging Pregnant Women in Kenya with a Hybrid Computer-Human SMS Communication System , 2015, CHI.

[22]  Madeline E. Smith,et al.  Limiting, leaving, and (re)lapsing: an exploration of facebook non-use practices and experiences , 2013, CHI.

[23]  Richard J. Anderson,et al.  Mobile Phones for Maternal Health in Rural India , 2015, CHI.

[24]  Modernity in material form? Mobile phones in the careers of Ghanaian market women , 2014 .

[25]  Eric Baumer,et al.  Socioeconomic Inequalities in the Non use of Facebook , 2018, CHI.

[26]  Waylon Brunette,et al.  Open Data Kit 2.0: A Services-Based Application Framework for Disconnected Data Management , 2017, MobiSys.

[27]  Maurice Mars,et al.  WhatsApp in Clinical Practice: A Literature Review. , 2016, Studies in health technology and informatics.

[28]  J. Burrell Invisible Users: Youth in the Internet Cafés of Urban Ghana , 2012 .

[29]  W. Keith Edwards,et al.  Intersectional HCI: Engaging Identity through Gender, Race, and Class , 2017, CHI.

[30]  Gaetano Borriello,et al.  Closing the Feedback Loop: A 12-month Evaluation of ASTA, a Self-Tracking Application for ASHAs , 2016, ICTD.

[31]  Jay Chen,et al.  Digital Privacy Challenges with Shared Mobile Phone Use in Bangladesh , 2017, Proc. ACM Hum. Comput. Interact..

[32]  Phoebe Sengers,et al.  Design Within a Patriarchal Society: Opportunities and Challenges in Designing for Rural Women in Bangladesh , 2018, CHI.

[33]  Hamid Mehmood,et al.  Knowledge, Access, and Decision-Making: Women’s Financial Inclusion In Pakistan , 2018, COMPASS.

[34]  Susan Wyche,et al.  Exploring mobile phone and social media use in a Nairobi slum: a case for alternative approaches to design in ICTD , 2015, ICTD.

[35]  Manveen Kaur,et al.  Revisiting the State of Cellular Data Connectivity in India , 2015, ACM DEV.

[36]  Naveena Karusala,et al.  Designing for Intersections , 2018, Conference on Designing Interactive Systems.

[37]  Anushree Deb Viability of Public-Private Partnership in Building Affordable Housing , 2016 .

[38]  David Nemer,et al.  "Privacy is not for me, it's for those rich women": Performative Privacy Practices on Mobile Phones by Women in South Asia , 2018, SOUPS @ USENIX Security Symposium.

[39]  Neha Kumar,et al.  The gender-technology divide or perceptions of non-use? , 2015, First Monday.

[40]  M. Grant,et al.  Communities of practice. , 2020, Health progress.

[41]  N. Yuval‐Davis,et al.  Intersectionality and Feminist Politics , 2006 .

[42]  Nicola Dell,et al.  The Ins and Outs of HCI for Development , 2016, CHI.

[43]  W. Keith Edwards,et al.  Understanding the Role of Community in Online Dating , 2015, CHI.

[44]  C. Mohanty,et al.  FEMINISM WITHOUT BORDERS , 2011 .

[45]  Raghu S. Thota,et al.  WhatsApp: What an App! , 2015, Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine.

[46]  Etienne Wenger,et al.  Situated Learning: Legitimate Peripheral Participation , 1991 .

[47]  J. Dasgupta,et al.  The safety of women health workers at the frontlines. , 2017, Indian journal of medical ethics.

[48]  Kentaro Toyama,et al.  Where there's a will there's a way: mobile media sharing in urban india , 2010, CHI.

[49]  Alcides Velasquez,et al.  Motivations to participate in online communities , 2010, CHI.

[50]  Edward Cutrell,et al.  Combating rural child malnutrition through inexpensive mobile phones , 2012, NordiCHI.

[51]  Jan-Willem Strijbos,et al.  Designing for interaction: Six steps to designing computer-supported group-based learning , 2004, Comput. Educ..

[52]  Jacki O'Neill,et al.  Prayana: Intermediated Financial Management in Resource-Constrained Settings , 2018, CHI Extended Abstracts.

[53]  Haroon Sajjad,et al.  Assessment of Socio-Economic Vulnerabilities among Urban Migrants in South-East Delhi, India , 2014 .

[54]  David Nemer,et al.  Rethinking social change: The promises of Web 2.0 for the marginalized , 2016, First Monday.

[55]  John F. Canny,et al.  Mobile-izing health workers in rural India , 2010, CHI.

[56]  Richard J. Anderson,et al.  Projecting health: community-led video education for maternal health , 2015, ICTD.

[57]  Steve Wheeler,et al.  Instagram and WhatsApp in Health and Healthcare: An Overview , 2016, Future Internet.

[58]  Jenna Burrell,et al.  Evaluating Shared Access: social equality and the circulation of mobile phones in rural Uganda , 2010, J. Comput. Mediat. Commun..

[59]  S. Merriam Qualitative research in practice : examples for discussion and analysis , 2002 .

[60]  Pasquale De Meo,et al.  On Facebook, most ties are weak , 2012, Commun. ACM.

[61]  N. Winters,et al.  Enhancing the Supervision of Community Health Workers With WhatsApp Mobile Messaging: Qualitative Findings From 2 Low-Resource Settings in Kenya , 2016, Global Health: Science and Practice.

[62]  Kentaro Toyama,et al.  Intermediated technology use in developing communities , 2010, CHI.

[63]  Neha Kumar,et al.  Engaging Solidarity in Data Collection Practices for Community Health , 2018, Proc. ACM Hum. Comput. Interact..

[64]  Neha Kumar,et al.  Mobiles, music, and materiality , 2013, CHI.

[65]  Volker Wulf,et al.  Navigating Relationships and Boundaries: Concerns around ICT-uptake for Elderly People , 2017, CHI.

[66]  Susan P. Wyche,et al.  Gender, Mobile, and Mobile Internet| Kenyan Women’s Rural Realities, Mobile Internet Access, and “Africa Rising” , 2018 .

[67]  K. Crenshaw Demarginalizing the Intersection of Race and Sex: A Black Feminist Critique of Antidiscrimination Doctrine, Feminist Theory and Antiracist Politics , 1989 .

[68]  Neha Kumar,et al.  Goodbye Text, Hello Emoji: Mobile Communication on WeChat in China , 2017, CHI.