Designing with Community Health Workers: Enabling Productive Participation Through Exploration

In this paper, we present the results of an 18-month engagement with community health workers (CHWs) in Lesotho, through which we designed a feedback-integrated platform for community health education using mobile multimedia. We initiated a co-design process using participatory action research to empower CHWs to use their own knowledge and experiences to define our shared design and research agenda. We present our process and its outcomes, noting the importance of engaging with CHWs using techniques considerate of their literacy and experience, and the necessity of separating the concept from the artefact in the process of co-design. Further, we demonstrate how deep engagement and multiple participatory action research cycles give CHWs time to develop confidence and experience around the use of technology in their work. We argue that when CHWs are empowered to contribute their creativity and local experiences in this manner, the outcome is technology that is best suited for their unique context of work, in ways that would not be achieved using conventional approaches to co-design. Finally, we present early outcomes of the co-design efforts, articulating design requirements for a feedback mechanism for CHWs

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