Exploring Co-Design with Breastfeeding Mothers

Designing mobile applications for breastfeeding mothers can be challenging; creating spaces to foster co-design -- when a mother's primary focus is on her child rather than on design activities - is even more so. In this paper we discuss the development of the Milk Matters mobile application, a tool developed to motivate women to donate their surplus breast milk to the local milk bank. We look at the importance of different approaches to understanding the mothers, comparing workshops, surveys, and cultural probes. Through our work we identify three factors to consider when co-designing with and for mothers: 1) interrupted interactions 2) elements that might distract a baby and 3) the importance of empowering mothers through positive reinforcement. Based on these factors we examine our methodological approaches, suggesting ways to make future research with breastfeeding mothers more productive

Maternal Satisfaction Through Breastfeeding: An empirical study

A growing body of research indicates that both mothers and children benefit from breastfeeding. Reflecting such research, public health officials and organizations promote the practice of breastfeeding. Despite such research, advocacy, and gradually increasing breastfeeding rates over the past decade, a large fraction of mothers do not breastfeed for a shorter period than the recommended six months. We have identified maternal satisfaction (MS) as a predictor variable and six criterion variables namely maternal knowledge (MK), a socio-cultural attitude of mothers (SCI), mother-baby bonding (MBB), family tradition (FT), concerns for health and figure (CHF), and government initiatives (GI). Primary data were collected from hospitals, tabulated and processed to draw the inferences and relationships among the variables. Results show that there is weak maternal knowledge among the mothers, especially for the first baby delivery. Moreover, there are many concerns like family traditions, social and cultural attitudes, mothers concerns on health and physical figure, government initiatives with maternal satisfaction in our study. Keywords: Maternal satisfaction, breastfeeding DOI: 10.7176/JHMN/95-08 Publication date: November 30th 202

Milk Matters 4.0: Challenges in deploying university-led mobile application development for small NGOs

Milk Matters is a small Cape Town based non-profit milk bank. Their primary role is to collect expressed breastmilk from donor mothers, pasteurize it and distribute it to recipient infants in need. Previous postgraduate projects from the University of Cape Town (UCT) have co-designed a donor facing mobile application with Milk Matters, however no mobile application is currently deployed or promoted by the non-governmental organization (NGO). This project will build upon the work already done with Milk Matters and aims to update the full system for deployment. While post-deployment evaluation will also analyse the uptake and usage of the application, this poster will focus on discussing the challenges in the deployment of university-led mobile application development for small NGOs

SENSEI:Harnessing Community Wisdom for Local Environmental Monitoring in Finland

The way people participate in decision making has radically changed over the last few decades. Technology has facilitated the sharing of knowledge, ideas and opinions across social structures and, has allowed grass-root initiatives to flourish. Participatory civic technology has helped local communities to embrace civic action on matters of shared concern. In this case study, we describe SENSEI, a year-long participatory sensing movement. Local community organisations, decision makers, families, individuals and researchers worked together to co-create civic technologies to help them address environmental issues of shared interest, such as invasive plant species, abandoned items in the forests and nice places. Over 240 local participants have taken part to the different stages of this year long process which included ten community events and workshops. As a result, over hundred concrete ideas about issues of common interest were generated, nearly thirty civic tech prototypes were designed and developed, along hundreds of environmental observations. In this paper, we describe the process or orchestration of this initiative and present key reflections from it

Co-designing with Mothers and Neonatal Unit Staff: Use of Technology to Support Mothers of Preterm Infants

There are several digital technologies which have been designed and successfully used to support mothers of preterm infants. However, none have been designed for application in the developing world context. For the existing interventions, none have involved mothers (who are the intended beneficiaries of these technologies) in the design process. This paper reports on a process that involved Neonatal Intensive Care Unit (NICU) staff and mothers in the design of technological interventions that focus on enhancing communication between mothers and staff in the NICU context. We used the co-design approach, focusing on identifying methods that ensure participants fully participate in the design process despite facing co-design dynamics such as power imbalances and conflict. Our results demonstrate the benefits of choosing an approach that focuses on building trust with stakeholders before delving into co-design process and empowering participants thus enabling them to fully participate in a design process. We argue that while working with multiple stakeholders, co-design readiness is dependent on methodological choice, stakeholders’ relationship with the researcher and stakeholders’ cohesion

"Must you make an app?" A qualitative exploration of socio-technical challenges and opportunities for designing digital maternal and child health solutions in Soweto, South Africa

Participatory and digital health approaches have the potential to create solutions to health issues and related inequalities. A project called Co-Designing Community-based ICTs Interventions for Maternal and Child Health in South Africa (CoMaCH) is exploring such solutions in four different sites across South Africa. The present study captures initial qualitative research that was carried out in one of the urban research sites in Soweto. The aim was twofold: 1) to develop a situation analysis of existing services and the practices and preferences of intended end-users, and 2) to explore barriers and facilitators to utilising digital health for community-based solutions to maternal and child health from multiple perspectives. Semi-structured interviews were conducted with 28 participants, including mothers, other caregivers and community health workers. Four themes were developed using a framework method approach to thematic analysis: coping as a parent is a priority; existing services and initiatives lack consistency, coverage and effective communication; the promise of technology is limited by cost, accessibility and crime; and, information is key but difficult to navigate. Solutions proposed by participants included various digital-based and non-digital channels for accessing reliable health information or education; community engagement events and social support; and, community organisations and initiatives such as saving schemes or community gardens. This initial qualitative study informs later co-design phases, and raises ethical and practical questions about participatory intervention development, including the flexibility of researcher-driven endeavours to accommodate community views, and the limits of digital health solutions vis-à-vis material needs and structural barriers to health and wellbeing

Digital health technologies for maternal and child health in Africa and other low- and middle-income countries: cross-disciplinary scoping review with stakeholder consultation

Background: Maternal and child health (MCH) is a global health concern, especially impacting low- and middle-income countries (LMIC). Digital health technologies are creating opportunities to address the social determinants of MCH by facilitating access to information and providing other forms of support throughout the maternity journey. Previous reviews in different disciplines have synthesized digital health intervention outcomes in LMIC. However, contributions in this space are scattered across publications in different disciplines and lack coherence in what digital MCH means across fields. Objective: This cross-disciplinary scoping review synthesized the existing published literature in 3 major disciplines on the use of digital health interventions for MCH in LMIC, with a particular focus on sub-Saharan Africa. Methods: We conducted a scoping review using the 6-stage framework by Arksey and O'Malley across 3 disciplines, including public health, social sciences applied to health, and human-computer interaction research in health care. We searched the following databases: Scopus, PubMed, Google Scholar, ACM Digital Library, IEEE Xplore, Web of Science, and PLOS. A stakeholder consultation was undertaken to inform and validate the review. During the search, 284 peer-reviewed articles were identified. After removing 41 duplicates, 141 articles met our inclusion criteria: 34 from social sciences applied to health, 58 from public health, and 49 from human-computer interaction research in health care. These articles were then tagged (labeled) by 3 researchers using a custom data extraction framework to obtain the findings. First, the scope of digital MCH was found to target health education (eg, breastfeeding and child nutrition), care and follow-up of health service use (to support community health workers), maternal mental health, and nutritional and health outcomes. These interventions included mobile apps, SMS text messaging, voice messaging, web-based applications, social media, movies and videos, and wearable or sensor-based devices. Second, we highlight key challenges: little attention has been given to understanding the lived experiences of the communities; key role players (eg, fathers, grandparents, and other family members) are often excluded; and many studies are designed considering nuclear families that do not represent the family structures of the local cultures. Conclusions: Digital MCH has shown steady growth in Africa and other LMIC settings. Unfortunately, the role of the community was negligible, as these interventions often do not include communities early and inclusively enough in the design process. We highlight key opportunities and sociotechnical challenges for digital MCH in LMIC, such as more affordable mobile data; better access to smartphones and wearable technologies; and the rise of custom-developed, culturally appropriate apps that are more suited to low-literacy users. We also focus on barriers such as an overreliance on text-based communications and the difficulty of MCH research and design to inform and translate into policy.

Design opportunities to facilitate tangible play and promote healthy nutrition in low-resource healthcare settings in Peru

Complementary feeding is crucial to promote healthy nutrition in infant and young children (IYC) and prevent malnutrition. Mothers, families, and healthcare professionals (HCPs) are crucial in helping IYC develop healthy eating habits. However, limited access to adequate nutritional information and health services impacts children's nutrition, especially in low-resource settings. Technology opens up opportunities to address these challenges and potentially improve IYC feeding practices. Taking a co-design approach, we conducted low-fidelity prototyping workshops with caregivers and HCPs to explore the potential of tangible interfaces to facilitate play and promote healthy nutrition for IYC in two low-resource healthcare settings in Peru. Participants envisioned diverse tangible objects and interactions that could augment the waiting spaces of the healthcare centres, encouraging play and enhancing children's and caregivers' experiences, while promoting healthy nutrition and dietary diversity. We outline design opportunities to facilitate tangible play, shared playful experiences, and promote healthy nutrition in low-resource healthcare settings

Digital Health Technologies for Maternal and Child Health in Africa and Other Low- and Middle-Income Countries: Cross-disciplinary Scoping Review With Stakeholder Consultation

Background: Maternal and child health (MCH) is a global health concern, especially impacting low- and middle-income countries (LMIC). Digital health technologies are creating opportunities to address the social determinants of MCH by facilitating access to information and providing other forms of support throughout the maternity journey. Previous reviews in different disciplines have synthesized digital health intervention outcomes in LMIC. However, contributions in this space are scattered across publications in different disciplines and lack coherence in what digital MCH means across fields. Objective: This cross-disciplinary scoping review synthesized the existing published literature in 3 major disciplines on the use of digital health interventions for MCH in LMIC, with a particular focus on sub-Saharan Africa. Methods: We conducted a scoping review using the 6-stage framework by Arksey and O'Malley across 3 disciplines, including public health, social sciences applied to health, and human-computer interaction research in health care. We searched the following databases: Scopus, PubMed, Google Scholar, ACM Digital Library, IEEE Xplore, Web of Science, and PLOS. A stakeholder consultation was undertaken to inform and validate the review. Results: During the search, 284 peer-reviewed articles were identified. After removing 41 duplicates, 141 articles met our inclusion criteria: 34 from social sciences applied to health, 58 from public health, and 49 from human-computer interaction research in health care. These articles were then tagged (labeled) by 3 researchers using a custom data extraction framework to obtain the findings. First, the scope of digital MCH was found to target health education (eg, breastfeeding and child nutrition), care and follow-up of health service use (to support community health workers), maternal mental health, and nutritional and health outcomes. These interventions included mobile apps, SMS text messaging, voice messaging, web-based applications, social media, movies and videos, and wearable or sensor-based devices. Second, we highlight key challenges: little attention has been given to understanding the lived experiences of the communities; key role players (eg, fathers, grandparents, and other family members) are often excluded; and many studies are designed considering nuclear families that do not represent the family structures of the local cultures. Conclusions: Digital MCH has shown steady growth in Africa and other LMIC settings. Unfortunately, the role of the community was negligible, as these interventions often do not include communities early and inclusively enough in the design process. We highlight key opportunities and sociotechnical challenges for digital MCH in LMIC, such as more affordable mobile data; better access to smartphones and wearable technologies; and the rise of custom-developed, culturally appropriate apps that are more suited to low-literacy users. We also focus on barriers such as an overreliance on text-based communications and the difficulty of MCH research and design to inform and translate into policy