How to choose a mobile phone for an ICT4D project

At the beginning of an ICT4D project where mobile phones will be used, the question that researchers and practitioners ponder is: what mobile device will be best for the project? In this paper, we present guidelines for making this choice, based on lessons drawn from a review of 30 ICT4D projects, and the reflection of our own work with Community Health Workers in Lesotho in the last four years, during which we used three types of devices in the field. We discuss the considerations that can guide the process of selecting the best device or mobile platform for each project and context, and discuss the recent upsurge of smartphone preference over feature phones in ICT4D projects, and the factors to consider when selecting smartphones for fieldwork

Apps and Skits: Enabling New Forms of Village-To-Clinic Feedback for Rural Health Education

We present the results of deploying a feedback mechanism in a community health education project, which enables rural-based nurses to elicit feedback from rural villages in order to improve their efforts in health education and service delivery in these areas. We implemented a mobile asynchronous-voice platform, through which Community Health Workers (CHWs) in rural Lesotho report previously unknown health challenges and knowledge gaps to the nurses, who then create new digital content and redesign service delivery to address these challenges. Beyond this, we also used role-play both as an additional feedback channel and a design tool. Our results demonstrate the combined benefits of implementing creative methods for effective human-to-technology and human-to-human communication in ways that enable new forms of expression; and highlight the importance of using role play in HCI4D contexts. We also present the benefits of incorporating an effective village-to-clinic feedback mechanism in health education programs

Designing with community health workers: feedback-integrated multimedia learning for rural community health

Community Health Workers (CHWs) are an integral part of the rural health system, and it is imperative that their voices are accommodated in digital health projects. In the mobile health education project discussed in this thesis (The Bophelo Haeso project), we sought to find ways to amplify CHWs' voices, enabling them to directly influence design and research processes as well as technological outcomes. The Bophelo Haeso (BH) project equips CHWs with health videos on their mobile phones to use for educating and counselling the rural public. We investigated how to best co-design, with CHWs, a feedback mechanism atop the basic BH health education model, thus enabling their voices in the design process and in the process of community education. This thesis chronicles this inclusive design and research process - a 30-month process that spanned three sub-studies: an 18-month process to co-design the feedback mechanism with CHWs, a 12-month deployment study of the feedback mechanism and, overlapping with the feedback deployment study, a 17-month study looking at the consumption patterns of the BH educational videos. This work contributes to the field of Human Computer Interaction (HCI) in three distinct ways. First, it contributes to the growing knowledge of co-design practice with participants of limited digital experience by introducing a concept we termed co-design readiness. We designed and deployed explorative artefacts and found that by giving CHWs increased technical, contextual, and linguistic capacity to contribute to the design process, they were empowered to unleash their innate creativity, which in turn led to more appropriate and highly-adopted solutions. Secondly, we demonstrate the efficacy of incorporating an effective village-to-clinic feedback mechanism in digital health education programs. We employed two approaches to feedback - asynchronous voice and roleplaying techniques. Both approaches illustrate the combined benefits of implementing creative methods for effective human-to-technology and human-tohuman communication in ways that enable new forms of expression. Finally, based on our longitudinal study of video consumption, we provide empirical evidence of offline video consumption trends in health education settings. We present qualitative and quantitative analyses of video-use patterns as influenced by the CHWs' ways of being and working. Through these analyses, we describe CHWs and their work practices in depth. In addition to the three main contributions, this thesis concludes with critical reflections from the lessons and experiences of the 30-month study. We discuss the introduction of smartphones in rural villages, especially among elderly, low-literate, and non-English-speaking users, and present guidelines for designing relevant and usable smartphones for these populations. The author also reflects on her position as an African-born qualitative researcher in Africa, and how her positionality affected the outcomes of this research

Internationalization prospects of Finnish language technology SMEs in rural India

Rural India is an emerging business area with a population of over 800 million people. Despite the strong two-decade long economic growth, most of these people have to cope with a poor selection of both private and public services due to consumer limitations and deficiencies in service infrastructure. Mobile services are rapidly becoming one important exception. Mobile phones are enabling access to various services from banking to agriculture and from healthcare to education for the rural people, and this consequently creates large scale business opportunities for international mobile service developers. In multilingual India, services have to be scaled to various languages and they have to overcome the obstacle of illiteracy in order to reach entire rural audience. The utilization of language technology is one possibility to deal with both issues cost-effectively. This thesis takes a novel approach on internationalization research by examining the prospects that Finnish language technology companies have in the commercial development of multilingual mobile services in rural India through a case study of six SMEs. The results suggest that the prospects are characterized by the internationalization orientation and knowledge orientation of the company, and that Finnish language technology companies are prone to reactive internationalization at best when it comes to developing areas

Internationalization prospects of Finnish language technology SMEs in rural India

Rural India is an emerging business area with a population of over 800 million people. Despite the strong two-decade long economic growth, most of these people have to cope with a poor selection of both private and public services due to consumer limitations and deficiencies in service infrastructure. Mobile services are rapidly becoming one important exception. Mobile phones are enabling access to various services from banking to agriculture and from healthcare to education for the rural people, and this consequently creates large scale business opportunities for international mobile service developers. In multilingual India, services have to be scaled to various languages and they have to overcome the obstacle of illiteracy in order to reach entire rural audience. The utilization of language technology is one possibility to deal with both issues cost-effectively. This thesis takes a novel approach on internationalization research by examining the prospects that Finnish language technology companies have in the commercial development of multilingual mobile services in rural India through a case study of six SMEs. The results suggest that the prospects are characterized by the internationalization orientation and knowledge orientation of the company, and that Finnish language technology companies are prone to reactive internationalization at best when it comes to developing areas

The InclusiveMag Method: A Start Towards More Inclusive Software for Diverse Populations

How can software practitioners assess whether their software supports diverse users? Although there are empirical processes that can be used to find “inclusivity bugs” piecemeal, what is often needed is a systematic inspection method to assess software’s support for diverse populations. To help fill this gap, this thesis introduces InclusiveMag, a generalization of GenderMag that can be used to generate systematic inclusiveness methods for a particular dimension of diversity. We then present 1) a multicase study covering eight diversity dimensions, of eight teams’ experiences applying InclusiveMag to eight under-served populations and their “mainstream” counterparts and 2) the start of the application of InclusiveMag to making software more inclusive to individuals of low socioeconomic status, through means of a systematic mapping study

Évaluation de la fidélité des interventions en santé publique dans le cadre des essais randomisés en grappes dans les pays du Sud : revue systématique et étude de cas

La santé publique fondée sur des données probantes doit être basée sur les meilleures preuves disponibles pour prendre des décisions éclairées, afin de mettre en place des interventions dirigées vers le maintien et l’amélioration de la santé, ainsi que vers le bien-être de toute la population. Les essais contrôlés randomisés (ECR) sont souvent utilisés en recherche clinique pour tester les effets d’un médicament, d’une thérapie ou d’une intervention sur un groupe expérimental qui bénéficiera de l’intervention, en le comparant à un groupe contrôle qui recevra un placebo ou aucun traitement. Bien que le débat persiste, les essais randomisés constituent une source importante et, apparemment, de haute qualité pour évaluer l’efficacité des interventions en santé. Dû à de multiples facteurs, les essais randomisés en grappes (ERG) sont largement utilisés pour évaluer la prestation des services de santé et des interventions en santé publique. Dans ce type d’essai, ce ne sont plus des individus qui sont randomisés, mais des groupes d’individus tels que les familles, les médecins, les villages qui vont recevoir l’intervention. Ces interventions peuvent varier pendant la mise en œuvre en raison de divers facteurs liés à la conception de l’intervention, aux participants, aux intervenants ainsi qu’aux facteurs du contexte qui influencent les résultats. Ces facteurs doivent être pris en compte au moment de l’évaluation, et avant la réplication dans d’autres contextes. L’évaluation de la fidélité de la mise en œuvre, outil clé de l’évaluation du processus et élément essentiel du processus de mise à l’échelle, vise à mesurer le degré selon lequel une intervention a été implantée telle que conçue par les concepteurs. Cette thèse a comme objectif principal examiner la fidélité de la mise en œuvre des interventions en santé publique dans le cadre des essais randomisés en grappes, pour savoir si les interventions mises en place sous un modèle contrôlé doivent prendre en compte ce type d’évaluation pour renforcer ces résultats et faciliter leur réplication à grande échelle. Cette thèse comporte deux volets : une revue systématique et une étude de cas unique à trois unités d’analyse selon une approche mixte concomitante. Le premier article évalue la pratique de la fidélité de la mise en œuvre des interventions en santé publique dans le cadre des essais randomisés en grappes des études publiées qui ont été identifiées et incluses dans la révision systématique. La révision systématique met en lumière que les interventions mises en place sous ce modèle ne tiennent pas compte de cette évaluation de façon systématique, que la façon de la faire est très hétérogène, et que l’évaluation n’est pas bien documentée. Les deuxième et troisième articles sont les résultats de recherche de l’évaluation d’une intervention, à travers une étude de cas comme méthode de recherche, qui a été menée, dans un premier temps, pour examiner la plausibilité de la théorie de l’intervention, et, dans un deuxième temps, pour évaluer leur fidélité de la mise en œuvre et leur acceptabilité auprès des participants dans le but de l’améliorer, si nécessaire, avant sa mise en place à grande échelle. L’évaluation de l’intervention met en lumière plusieurs aspects. D’abord, la théorie sous-jacente et le modèle de l’intervention évaluée sont bien conçus pour parvenir aux résultats visés. L’évaluation fournit des points clés et des actions à prendre en considération, pendant le développement des interventions, pour servir les communautés difficiles à atteindre, et pour améliorer les résultats en matière de santé. Ensuite, les résultats ont démontré une fidélité de mise en œuvre élevée. La clarté de la théorie de l'intervention, la motivation et l'engagement des intervenants, ainsi que les réunions périodiques des superviseurs avec les intervenants-terrain expliquent largement le haut niveau de fidélité obtenu. Des facteurs contextuels tels que la distance géographique, l'accès à un téléphone portable, le niveau d'éducation et les normes de genre ont contribué à l'hétérogénéité de la participation du groupe cible de l’intervention. Finalement, cette évaluation souligne que la plateforme mobile combinée à la mobilisation communautaire, composantes clés de l’intervention, ont été bien accueillies par les participants, et pourraient être mis en place à grand échelle. Cette thèse contribue au développement des connaissances sur le plan méthodologique concernant l’évaluation de la fidélité de la mise en œuvre des interventions en santé publique en mettant en relief des lacunes dans ce domaine, et en suggérant un outil pour faire avancer cette pratique évaluative. Cette thèse participe également au renforcement de la recherche dans les sciences de l’implémentation, et apporte sur le plan empirique des éléments clés essentiels pour évaluer la fidélité de la mise en œuvre de ce type d’intervention à l’aide des essais randomisés en grappes, évaluation de cette fidélité qui est l’objet de cette recherche doctorale.Evidence-based public health should be based on the best available evidence to make informed decisions and to implement interventions aimed at maintaining and improving the health and well-being of all people. Randomized controlled trials (RCTs) are often used in clinical research to test the effects of a drug, therapy, or intervention on an experimental group that may benefit from the intervention, comparing it to a control group that received either a placebo or no intervention treatment. Although the debate persists, randomized controlled trials are an important and objectively high quality method for evaluating the effectiveness of health interventions. Due to multiple factors, cluster randomized trials (CRTs) are widely used to assess the delivery of health services and public health interventions. In this type of trial, it is no longer individuals who are randomized, but groups of individuals such as families, doctors, and village communities who receive the intervention. These interventions may differ during implementation as a result of various factors related to the complexity of the intervention design, context, participants, and stakeholders involved. These factors should be considered at the time of assessment and before replication in other contexts. Implementation fidelity assessment, a key tool in process evaluation, examines study processes to assess the extent to which the intervention was carried out as originally intended. The fidelity of implementation is an essential part of the scale-up process. This thesis aimed to examine the fidelity of implementation of public health interventions in the context of cluster randomized trials, to determine whether the interventions implemented under a controlled model should consider this type of evaluation to strengthen their results and facilitate their replication on a large scale. This thesis has two parts: a systematic review and a single case study with three units of analysis using a mixed triangulated approach. The first article assessed the implementation fidelity of public health interventions in the context of cluster randomized trials. The systematic review highlighted the finding that public health interventions implemented under this model did not systematically consider this type of evaluation, that the way of doing it was very heterogeneous, and that the evaluation was not adequately documented. The second and third articles were the research findings of the evaluation of an intervention, using a case study as the research method, that was conducted to first examine the plausibility of the intervention theory and to better understand the design and context of the intervention being evaluated, and second, to evaluate implementation fidelity and its acceptability among the participants with the aim of making improvements (if necessary) before large-scale replication. The evaluation of the case study highlighted several key findings. First, the results of the evaluation reflected that the underlying theory and model of the public health intervention were well designed to achieve the desired results. The evaluation provided key points and actions to consider during intervention development to serve hard-to-reach communities and improve health outcomes. Further, it was shown that the results demonstrated a high degree of implementation fidelity. The clarity of the theory of the intervention, the motivation and commitment of the stakeholders as well as the periodic meetings of supervisors with the field team largely explained the high level of fidelity obtained. Contextual factors such as geographical distance to the intervention, access to a mobile phone, level of education, and gender norms contributed to the heterogeneity of the participation of the intervention target group. Finally, this evaluation underlined the finding that the mobile platform coupled with community mobilization, both key components of the intervention, were well received by the participants and may be an effective means of improving health knowledge and changing health-related behaviors. This thesis contributes to the development of methodological knowledge concerning the evaluation of the fidelity of implementation of public health interventions by identifying gaps in this field, and by suggesting a tool that facilitates advancing this evaluation practice. This thesis also contributes to the strengthening of research in implementation sciences, and empirically provides key elements essential to assess the fidelity of the implementation of this type of intervention using CRT studies and evaluation of this fidelity, which is the subject of this doctoral research

Introduction to development engineering: a framework with applications from the field

This open access textbook introduces the emerging field of Development Engineering and its constituent theories, methods, and applications. It is both a teaching text for students and a resource for researchers and practitioners engaged in the design and scaling of technologies for low-resource communities. The scope is broad, ranging from the development of mobile applications for low-literacy users to hardware and software solutions for providing electricity and water in remote settings. It is also highly interdisciplinary, drawing on methods and theory from the social sciences as well as engineering and the natural sciences. The opening section reviews the history of “technology-for-development” research, and presents a framework that formalizes this body of work and begins its transformation into an academic discipline. It identifies common challenges in development and explains the book’s iterative approach of “innovation, implementation, evaluation, adaptation.” Each of the next six thematic sections focuses on a different sector: energy and environment; market performance; education and labor; water, sanitation and health; digital governance; and connectivity. These thematic sections contain case studies from landmark research that directly integrates engineering innovation with technically rigorous methods from the social sciences. Each case study describes the design, evaluation, and/or scaling of a technology in the field and follows a single form, with common elements and discussion questions, to create continuity and pedagogical consistency. Together, they highlight successful solutions to development challenges, while also analyzing the rarely discussed failures. The book concludes by reiterating the core principles of development engineering illustrated in the case studies, highlighting common challenges that engineers and scientists will face in designing technology interventions that sustainably accelerate economic development. Development Engineering provides, for the first time, a coherent intellectual framework for attacking the challenges of poverty and global climate change through the design of better technologies. It offers the rigorous discipline needed to channel the energy of a new generation of scientists and engineers toward advancing social justice and improved living conditions in low-resource communities around the world

Introduction to Development Engineering

This open access textbook introduces the emerging field of Development Engineering and its constituent theories, methods, and applications. It is both a teaching text for students and a resource for researchers and practitioners engaged in the design and scaling of technologies for low-resource communities. The scope is broad, ranging from the development of mobile applications for low-literacy users to hardware and software solutions for providing electricity and water in remote settings. It is also highly interdisciplinary, drawing on methods and theory from the social sciences as well as engineering and the natural sciences. The opening section reviews the history of “technology-for-development” research, and presents a framework that formalizes this body of work and begins its transformation into an academic discipline. It identifies common challenges in development and explains the book’s iterative approach of “innovation, implementation, evaluation, adaptation.” Each of the next six thematic sections focuses on a different sector: energy and environment; market performance; education and labor; water, sanitation and health; digital governance; and connectivity. These thematic sections contain case studies from landmark research that directly integrates engineering innovation with technically rigorous methods from the social sciences. Each case study describes the design, evaluation, and/or scaling of a technology in the field and follows a single form, with common elements and discussion questions, to create continuity and pedagogical consistency. Together, they highlight successful solutions to development challenges, while also analyzing the rarely discussed failures. The book concludes by reiterating the core principles of development engineering illustrated in the case studies, highlighting common challenges that engineers and scientists will face in designing technology interventions that sustainably accelerate economic development. Development Engineering provides, for the first time, a coherent intellectual framework for attacking the challenges of poverty and global climate change through the design of better technologies. It offers the rigorous discipline needed to channel the energy of a new generation of scientists and engineers toward advancing social justice and improved living conditions in low-resource communities around the world