Collective empowerment through information and communication technologies: co-creation processes in underserved communities in Cape Town

This research investigates the potential of Information and Communication Technology (ICT) to provide opportunities for groups of people to improve their lives and their communities. Further, the study explores innovative methodological approaches which could be conducive for collective empowerment. Grounded in current ICT4D research, the thesis tries to resolve the gap related to how to include collective approaches and participation in design. The study is framed by critical social theory and the capability approach but with special attention to collective and relational dimensions of agency, capabilities and empowerment. The analysis is based on three digital co-creation case studies which unfolded over a four-year project in underserved settlements in Cape Town, South Africa. The study employed a qualitative methodological approach and followed abductive logic. The research evolved through cycles of ethnographic studies; co-design; and theoretical phases. Each cycle built on the previous one in theory and practice. The initial inductive approach employed open coding followed by content analysis to reflect on the discourses and meanings of ICTs originating from the focus groups in the communities. In the design phase, three case studies were analysed using strategies suitable for research involving cultural differences between researcher and participants. The processes were further evaluated during their development from the theoretical lenses of participatory design, frugal innovation and social capital theory. Five papers provide an analysis of the research project highlighting its evolution, from the creation of digital storytelling until the development of social businesses, and discussing how social relations and group actions determine uses of ICTs and encourage collective ways for information access, information production, creativity development and networking. These concepts supported the analysis of the findings to deepen the use of the theories and to develop a process model for ICT4D projects. The outcome of the research are four propositions and three principles for a sensible emergent approach for ICT4D projects. Their chances of success and sustainability increase if based on grassroots, collective, socially engaged co-creation initiatives. Theoretically, the process model has the potential to improve our understanding and support our way of operating to make ICT4D initiatives more inclusive, more empowering to participants, including the researchers, and to become oriented towards community development and people’s emancipation

Collective creative processes in underserved contexts. Lessons of grassroots frugal social innovations

When limited resources are available, creativity and imagination have better opportunities to develop. Through an emergent approach where the process is left free to unfold and rules are relaxed, new ideas transpire and innovation happens. A multiple case study in the townships of Cape Town, South Africa, will describe the evolution of three processes that brought innovations driven by active groups in their underserved communities. In particular, the unguided process approach allowed the innovations to unfold in an ecosystem characterized by frugality and by the desire to bring about social changes. The active collective participation and the social aims are the driving forces of the processes while their un-designed evolving development is the main element of innovation from the bottom. More than any information and communication technology creation

Collective Digital Storytelling in Community-based co-design projects. An Emergent Approach

Digital storytelling (DST) can play a critical role in co-design initiatives involving local communities, as a method for bridging exploratory phases and co-design processes. The paper draws on three case studies of collective DST in underserved locations. While DST enabled groups to present themselves and their communities, its evolution showed that activities crystallized into creative concepts and community-driven projects that generated new ideas, new collaboration pathways and new networking capabilities. The structured analysis of these case studies can be used by researchers looking to spur grassroots initiative and encourage local participation and engagement in community-based design.La narration numérique peut jouer un rôle essentiel dans les initiatives de co-design avec des communautés locales, en tant que méthode pour passer de la phase exploratoire de la recherche au processus de co-design. L’article se fonde sur trois études de cas de narration numériques collectives dans des communautés défavorisées. La narration numérique a donnée aux groups la possibilité de se présenter tandis que son processus génératif a cristallisé dans des concepts créatifs et des projets communautaires porteurs de nouvelles idées, voies de collaboration et capacités de réseautage. L'analyse structurée de ces études peut être utilisée par les chercheurs intéressés à stimuler l'initiative locale et à encourager la participation et l'engagement communautaires

Collective digital storytelling in community- based co-design projects: An emergent approach

This paper contributes a critical examination of the role that digital storytelling (DST) can play in co-design initiatives involving local underserved communities. We argue that DST brings value as a method for bridging initial, exploratory phases and co-design processes. The paper draws on three case studies of collective DST in two townships of Cape Town, South Africa. The research adopted a participatory ethnographic approach to involve groups socially active in their respective communities. DST was employed initially as a means to enable groups to present themselves and their communities and to deepen the ongoing process of data generation. During the creative processes, the activities evolved and crystallized into something more than a short video production: self-contained and community-driven projects, generation of new ideas and the development of new collaboration pathways and new digital networking capabilities. Through the analysis of these case studies the article advances considerations that can be used by researchers and practitioners looking to spur grassroots initiatives and encourage local participation and engagement in community-based co-design. In particular, we offer a series of design principles, proposed as sensitising concepts that can inspire and guide researchers and designers, or local communities, to engage in DST activities within community co-design projects

Localize-It: Co-designing a Community-Owned Platform

One of the most difficult, yet undocumented, aspects of information and communications technologies and development (ICTD) projects is that of establishing partnerships around which researchers’ interventions will develop, be tested and grow. Constraints on timing and funding usually lead to short-term projects, in which benefits are biased towards researchers rather than the partner community. In order to avoid empty and unethical promises and to increase the potential benefit for the community, we consider the process of developing participatory partnerships in ICTD projects. The objective is to make the project community owned, allowing the participants to develop what they value as important. Using the case of a township-based wireless community content sharing network, we describe the potential and some of the challenges with this approach. The paper highlights building blocks, such as ethical behaviour and trust, to avoid recreating the dichotomy between research and practice, and building a constructive collaboration

A Knowledge, Attitude, and Perception Study on Flu and COVID-19 Vaccination during the COVID-19 Pandemic: Multicentric Italian Survey Insights

In January 2020, Chinese health authorities identified a novel coronavirus strain never before isolated in humans. It quickly spread across the world, and was eventually declared a pandemic, leading to about 310 million confirmed cases and to 5,497,113 deaths (data as of 11 January 2022). Influenza viruses affect millions of people during cold seasons, with high impacts, in terms of mortality and morbidity. Patients with comorbidities are at a higher risk of acquiring severe problems due to COVID-19 and the flu-infections that could impact their underlying clinical conditions. In the present study, knowledge, attitudes, and opinions of the general population regarding COVID-19 and influenza immunization were evaluated. A multicenter, web-based, cross-sectional study was conducted between 10 February and 12 July 2020, during the first wave of SARS-CoV-2 infections among the general population in Italy. A sample of 4116 questionnaires was collected at the end of the study period. Overall, 17.5% of respondents stated that it was unlikely that they would accept a future COVID-19 vaccine (n = 720). Reasons behind vaccine refusal/indecision were mainly a lack of trust in the vaccine (41.1%), the fear of side effects (23.4%), or a lack of perception of susceptibility to the disease (17.1%). More than 50% (53.8%; n = 2214) of the sample participants were willing to receive flu vaccinations in the forthcoming vaccination campaign, but only 28.2% of cases had received it at least once in the previous five seasons. A higher knowledge score about SARS-CoV-2/COVID-19 and at least one flu vaccination during previous influenza seasons were significantly associated with the intention to be vaccinated against COVID-19 and influenza. The continuous study of factors, determining vaccination acceptance and hesitancy, is fundamental in the current context, in regard to improve vaccination confidence and adherence rates against vaccine preventable diseases

Clinical guidelines for perioperative hemodynamic management of non cardiac surgical adult patients.

Perioperative hemodynamic management, through monitoring and intervention on physiological parameters to improve Cardiac Output and Oxygen Delivery (Goal-directed therapy, GDT), may improve outcome. However, an Italian survey has revealed that hemodynamic protocols are applied by only 29,1% of anesthesiologists. Aim of this paper is to provide clinical guidelines for a rationale use of perioperative hemodynamic management in non cardiac surgical adult patients, oriented for Italy and updated with most recent studies. Guidelines were elaborated according to NICE (National Institute for Health and Care Excellence) and GRADE system (Grading of Recommendations of Assessment Development and Evaluations). Key questions were formulated according to PICO system (Population, Intervention, Comparators, Outcome). Guidelines and systematic reviews were identified on main research databases and strategy was updated to June 2018. There is not enough good quality evidence to support the adoption of a GDT protocol in order to reduce mortality, although it may be useful in high risk patients. Perioperative GDT protocol to guide fluid therapy is recommended to reduce morbidity. Continuous monitoring of arterial pressure may help to identify short periods of hemodynamic instability and hypotension. Fluid strategy should aim to a near zero balance in normovolemic patients at the beginning of surgery, and a slight positive fluid balance may be allowed to protect renal function. Drugs such as inotropes, vasocostrictors, and vasodilatator should be used only when fluids alone are not sufficient to optimize hemodynamics. Perioperative GDT protocols are associated with a reduction in costs, although no economic study has been performed in Italy

Clinical guidelines for perioperative hemodynamic management of non cardiac surgical adult patients

Perioperative hemodynamic management, through monitoring and intervention on physiological parameters to improve cardiac output and oxygen delivery (goal-directed therapy, GDT), may improve outcome. However, an Italian survey has revealed that hemodynamic protocols are applied by only 29.1% of anesthesiologists. Aim of this paper is to provide clinical guidelines for a rationale use of perioperative hemodynamic management in non cardiac surgical adult patients, oriented for Italy and updated with most recent studies. Guidelines were elaborated according to NICE (National Institute for Health and Care Excellence) and GRADE system (Grading of Recommendations of Assessment Development and Evaluations). Key questions were formulated according to PICO system (Population, Intervention, Comparators, Outcome). Guidelines and systematic reviews were identified on main research databases and strategy was updated to June 2018. There is not enough good quality evidence to support the adoption of a GDT protocol in order to reduce mortality, although it may be useful in high risk patients. Perioperative GDT protocol to guide fluid therapy is recommended to reduce morbidity. Continuous monitoring of arterial pressure may help to identify short periods of hemodynamic instability and hypotension. Fluid strategy should aim to a near zero balance in normovolemic patients at the beginning of surgery, and a slight positive fluid balance may be allowed to protect renal function. Drugs such as inotropes, vasocostrictors, and vasodilatator should be used only when fluids alone are not sufficient to optimize hemodynamics. Perioperative GDT protocols are associated with a reduction in costs, although no economic study has been performed in Italy