Co-designing Community-based ICTs Interventions to Enhance Maternal and Child Health in South Africa
Lead Research Organisation:
Cardiff University
Department Name: Computer Science
Abstract
Digital interventions to support maternal and child health (MCH) are widespread. Yet, the impact of these interventions in low-income communities is limited. We believe this is in part due to the top-down nature of digital health development, and propose to take a participatory and community-centred approach to this domain. We will form a multidisciplinary, cross-cultural, and cross-geographical consortium of researchers, technology designers, healthcare professionals and community stakeholders, policy makers, and grassroots citizens' organizations to explore the potential of information and communication technologies (ICTs) to enhance maternal and child health and wellbeing during the antenatal and postnatal period in South Africa.
Planned Impact
The project aims to form a network with ambitious long-term goals that will advantage a variety of beneficiaries. Maternal and child health (MCH) is one of the foremost public health challenges in around the world and even more in South Africa. We will explore the potential impact afforded by information and communication technologies (ICTs) to enhance MCH in South Africa. We will engage in dissemination, knowledge exchange and impact activities to maximise impact across the identified beneficiaries including South African women, their families, healthcare workers and their communities, academic researchers, industry and policymakers in South Africa, as well as the industry within and beyond South Africa and society in general. We will harness existing social media outlets in the UK and South Africa to increase public awareness of the everyday challenges of MCH in South Africa. Overall, the named research team and collaborators have a strong history of public engagement and outreach so their skills and experience will facilitate impact activities within the network.
Organisations
- Cardiff University (Lead Research Organisation)
- Fraunhofer Portugal Research (Collaboration)
- Dimagi (United States) (Collaboration)
- UNIVERSITY OF NOTTINGHAM (Collaboration)
- UNIVERSITY OF LEICESTER (Collaboration)
- LOUGHBOROUGH UNIVERSITY (Collaboration)
- Human Sciences Research Council (HSRC) (Collaboration)
- Jembi Health Systems (Collaboration)
- University of the Witwatersrand (Collaboration)
- Stanford University (Collaboration)
- Srishti Institute of Art, Design and Technology (Collaboration)
- University of Limpopo (Collaboration)
- University of Cape Town (Collaboration)
Publications
Klingberg S
(2022)
"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
in PLOS Global Public Health
Till S
(2023)
Digital Health Technologies for Maternal and Child Health in Africa and Other Low- and Middle-Income Countries: Cross-disciplinary Scoping Review With Stakeholder Consultation.
in Journal of medical Internet research
Muthelo L
(2023)
Reflections on Digital Maternal and Child Health Support for Mothers and Community Health Workers in Rural Areas of Limpopo Province, South Africa
in International Journal of Environmental Research and Public Health
| Title | Challenge and Design Cards for communicating research challenges and support Co-Design Activities |
| Description | The Challenge and Design Cards aim to visualize community priorities based on fieldwork and outline a number of Stakeholders, Places, and Technology that are important to consider in the maternal and child health context in South Africa |
| Type Of Art | Image |
| Year Produced | 2022 |
| Impact | Community participants with low literacy became more aware of the existing challenges by the use of the challenge Cards and related to the design cards to support their ideation process |
| Title | CoMaCH Network Outcomes Poster |
| Description | This is a "graphic harvest" created by a professional illustrator to document the outcomes of the CoMaCH network, as reported during our final close-out workshop. It consists of test supported by line drawings with some color highlights. |
| Type Of Art | Image |
| Year Produced | 2022 |
| Impact | None yet. |
| URL | https://comach.melissadensmore.com/420-2/ |
| Description | - From the literature review and stakeholder consultation, we highlighted key challenges: little attention has been paid given to understanding the lived experiences of the communities targeted by these interventions; key role players (eg, fathers, grandparents, and other family members) are often excluded from studies and technologies, and many studies are designed considering nuclear families that do not represent the family structures of the local cultures. - Our work also raised 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 (from Soweto study) - Our work highlighted how existing digital support apps (e.g,. MoMConnect, Pregnancy+, WhatsApp) and non-digital resources were perceived as useful ways of communication that assist in improving maternal and child health. However, challenges still exist and addressing the lack of digital resources could improve access to health instructions for pregnant women and mothers. - Our work reflected on the multi-linguistic, social, and cultural challenges conducting workshops across geographic locations, and highlighted how cultural nuances influenced co-design workshops and co-created artefacts. - Our work provides parent-centred design opportunities and tensions we discovered for digital MCH in South African contexts, such as designing for local contexts and languages, designing for accessibility and connectedness, and highlighting the underdeveloped digital MCH niches to design for. - Our work also highlights the importance of facilitators in co-design workshops as intermediaries and the role of design cards to support ideation |
| Exploitation Route | The Design and Challenge cards were used in another research project in Ghana |
| Sectors | Communities and Social Services/Policy,Digital/Communication/Information Technologies (including Software),Healthcare |
| Description | COVID-19 Vaccine Hesitancy studies in South Africa, Ghana and India, |
| Amount | £12,000 (GBP) |
| Organisation | University of Leicester |
| Sector | Academic/University |
| Country | United Kingdom |
| Start | 04/2021 |
| End | 09/2021 |
| Description | HEALTH DECISION-MAKING OF PREGNANT WOMEN IN TECHIMAN, GHANA |
| Amount | R10,119,494 (ZAR) |
| Organisation | University of Cape Town |
| Sector | Academic/University |
| Country | South Africa |
| Start | 07/2021 |
| End | 01/2022 |
| Description | UKRI GCRF and Newton Consolidation Accounts (GNCAs) |
| Amount | £31,600 (GBP) |
| Organisation | Department for Business, Energy & Industrial Strategy |
| Sector | Public |
| Country | United Kingdom |
| Start | 12/2022 |
| End | 03/2023 |
| Title | Challenge and Design Cards for Digital Maternal and Child Health Co-design |
| Description | We got 10 Challenge Cards: - Traditional healers: The impact of traditional healers on MCH healthcare-seeking behaviors - Parent well-being: The importance of and lack thereof parental well-being in these communities - Affordable and accessible MCH information: The challenge of accessing relevant information in local languages despite data costs and literacy - Misinformation: The challenge of sifting through competing and conflicting information sources. - COVID-19 vaccine hesitancy: Considering issues around vaccine uptake - Building parental skills in early life: Many parents felt like they did not have sufficient parenting skills, or were unaware of the importance of early childhood development - Health worker emotional support: Health worker empathy is a key problem in public healthcare; resulting in often hostile interactions - Personalized and timely support: Parents felt that support that was available during times of need was never appropriate for the immediate situation. - Postpartum care: The lack of and need for postpartum care in these communities - Involving Fathers: The absence of fathers and importance of increasing their involvement in MCH Then we got Ideation Cards including Technology Cards, Stakeholder Cards, Place Cards |
| Type Of Material | Improvements to research infrastructure |
| Year Produced | 2021 |
| Provided To Others? | No |
| Impact | Facilitate the involvement, contextual understanding, brainstorming, and ideation during Co-Design workshops for participants with low literacy |
| Description | Partnership with the Human Science Research Council, South Africa |
| Organisation | Human Sciences Research Council (HSRC) |
| Country | South Africa |
| Sector | Charity/Non Profit |
| PI Contribution | We worked together on a EPSRC/GCRF research proposal for which Prof Alastair van Heerden is a co-investigator from the University of Limpopo. Prof Paula Griffiths from Loughborough University and Dr Nicola Mackintosh are also co-investigators in this proposal and Dr Naveen Bagalkot is an international project partner in this proposal to share the experiences from India in South Africa |
| Collaborator Contribution | My partner at the Human Science Research Council, Prof Prof Alastair van Heerden brings expertise on information communication technologies for development (ICT4D) and their application on treatment and support of people living with HIV and AIDS as well as on early child development. |
| Impact | Our project entitled "Co-designing Community-based ICTs Interventions to Enhance Maternal and Child Health in South Africa" has been recently accepted for funding by the Digital Innovation for Development in Africa (DIDA) call. The project will bring togeter multidisciplinary expertise between UK and South African researchers on global health and nutrition, ethnography, co-design and participatory methods, psychology of child feeding behaviours, media and health communication, feminist geography, gender, care and inequalities, co-developing and delivering transferal capacity-building activities, and diverse areas of computer science including social and mobile computing, and artificial intelligence, human-computer interaction, internet of things, Information and communication technologies for development, anthropological understanding of maternal care, nursing and health sciences, neonatal care, medicine in regards to non-communicable diseases, maternal and child care, and mental health, community-based interventions in South Africa, e-health and m-health, HIV interventions. Regarding the last question below, after the formal confirmation a formal agreement will be signed by all institutions. |
| Start Year | 2020 |
| Description | Partnership with the School of Sport, Exercise and Health Sciences |
| Organisation | Loughborough University |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | We worked together on a research proposal for which I co-lead together with Prof. Paula Griffiths the second work package for the participatory design research |
| Collaborator Contribution | My partners are experts in nutrition and population health with particular focus on developing countries. Prof. Paula Griffiths also acts as a mentor for follow up research activities |
| Impact | Our project entitled "New strategies to reduce anaemia and risk of overweight and obesity through complementary feeding of infants and young children in Peru" was funded by the Newton Fund UK-Peru: Relationship between Food, Nutrition and Health Call. REF: MR/S024921/1. Include multiple disciplines from Nutrition and population health as well human-computer interaction and health informatics. Project proposal submitted to the Royal Society - under review - entitled: "EmpComICT: Empowering Communities with Information and Communications Strategies to Help Prevent and Treat Iron-Deficiency Anaemia in Pregnancy in India" |
| Start Year | 2018 |
| Description | Partnership with the Sristhi Institute of Art, Design and Technology, Bangalore, India |
| Organisation | Srishti Institute of Art, Design and Technology |
| Country | India |
| Sector | Academic/University |
| PI Contribution | Contributions ranging from writing project proposals to writing research papers in different areas of digital health |
| Collaborator Contribution | Strong expertise in design in particular for adapting methods to low-income communities |
| Impact | Research papers submitted to the India 2018 conference, ECSCW 2019 (under review), InfraHealth 2019 (Under review). Collaboration is multidisciplinary between design and human-computer interaction and health informatics. IndiaHCI 2018 paper - DOI: 10.1145/3297121.3297130 Project proposal submitted to the Royal Society - under review - entitled: "EmpComICT: Empowering Communities with Information and Communications Strategies to Help Prevent and Treat Iron-Deficiency Anaemia in Pregnancy in India" |
| Start Year | 2018 |
| Description | Partnership with the University of Cape Town, South Africa |
| Organisation | University of Cape Town |
| Country | South Africa |
| Sector | Academic/University |
| PI Contribution | We worked together on a EPSRC/GCRF research proposal for which I co-lead together with Dr. Melissa Densmore from Univesity of Cape Town. Prof Paula Griffiths from Loughborough University and Dr Nicola Mackintosh are also co-investigators in this proposal and Dr Naveen Bagalkot is an international project partner in this proposal to share the experiences from India in South Africa |
| Collaborator Contribution | My partners at the University of Cape Town bring diverse expertise including human computer interaction for development (Dr Melissa Densmore), medical expertise with particular focus on the public sector in women's health (Prof Simone Honikman), medical expertise on neonatology, paediatrics and child health (Dr Yaseen Joolay), and anthropology in particular around the The First Thousand Days of Life (Prof Fiona Ross) |
| Impact | Our project entitled "Co-designing Community-based ICTs Interventions to Enhance Maternal and Child Health in South Africa" has been recently accepted for funding by the Digital Innovation for Development in Africa (DIDA) call. The project will bring together multidisciplinary expertise between UK and South African researchers on global health and nutrition, ethnography, co-design and participatory methods, psychology of child feeding behaviours, media and health communication, feminist geography, gender, care and inequalities, co-developing and delivering transferal capacity-building activities, and diverse areas of computer science including social and mobile computing, and artificial intelligence, human-computer interaction, internet of things, Information and communication technologies for development, anthropological understanding of maternal care, nursing and health sciences, neonatal care, medicine in regards to non-communicable diseases, maternal and child care, and mental health, community-based interventions in South Africa, e-health and m-health, HIV interventions. Regarding the last question below, after the formal confirmation a formal agreement will be signed by all institutions. |
| Start Year | 2020 |
| Description | Partnership with the University of Leicester, UK |
| Organisation | University of Leicester |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | We have collaborated in previous grant proposals, and papers aligned with this project |
| Collaborator Contribution | Got colleagues from Social Sciences and Media and Communication bringing a different disciplinary perspectives. |
| Impact | Multidisciplinary collaboration across human-computer interaction, digital health and my colleagues working in health sciences applied to health and media and communication at University of Leicester. 'DEPAC': Digital enablement, promise and uncertainty in maternity care https://www2.le.ac.uk/departments/health-sciences/research/soc-sci/research-projects-1/2018depac2019-digital-enablement-promise-and-uncertainty-in-maternity-care Digitizing Reproduction: new technologies, intersectionality and the politics of inclusion https://www2.le.ac.uk/projects/digitizing-reproduction Papers: Verdezoto, N., Carpio-Arias, F., Carpio-Arias, V., Mackintosh, N., Eslambolchilar, P., Delgado, V., ... & Vásconez, G. (2020, October). Indigenous Women Managing Pregnancy Complications in Rural Ecuador: Barriers and Opportunities to Enhance Antenatal Care. In Proceedings of the 11th Nordic Conference on Human-Computer Interaction: Shaping Experiences, Shaping Society (pp. 1-9). Bagalkot, N., Verdezoto, N., Ghode, A., Purohit, S., Murthy, L., Mackintosh, N., & Griffiths, P. (2020, October). Beyond Health Literacy: Navigating Boundaries and Relationships During High-risk Pregnancies: Challenges and Opportunities for Digital Health in North-West India. In Proceedings of the 11th Nordic Conference on Human-Computer Interaction: Shaping Experiences, Shaping Society (pp. 1-15). |
| Start Year | 2020 |
| Description | Partnership with the University of Limpopo, South Africa |
| Organisation | University of Limpopo |
| Country | South Africa |
| Sector | Academic/University |
| PI Contribution | We worked together on a EPSRC/GCRF research proposal for which Prof Tebogo Mothiba is a co-investigator from the University of Limpopo. Prof Paula Griffiths from Loughborough University and Dr Nicola Mackintosh are also co-investigators in this proposal and Dr Naveen Bagalkot is an international project partner in this proposal to share the experiences from India in South Africa |
| Collaborator Contribution | My partner at the University of Limpopo, Prof Tebogo Mothiba brings expertise on nursing management, healthcare delivery, health equity, healthcare education, promotion and management. |
| Impact | Our project entitled "Co-designing Community-based ICTs Interventions to Enhance Maternal and Child Health in South Africa" has been recently accepted for funding by the Digital Innovation for Development in Africa (DIDA) call. The project will bring together multidisciplinary expertise between UK and South African researchers on global health and nutrition, ethnography, co-design and participatory methods, psychology of child feeding behaviours, media and health communication, feminist geography, gender, care and inequalities, co-developing and delivering transferal capacity-building activities, and diverse areas of computer science including social and mobile computing, and artificial intelligence, human-computer interaction, internet of things, Information and communication technologies for development, anthropological understanding of maternal care, nursing and health sciences, neonatal care, medicine in regards to non-communicable diseases, maternal and child care, and mental health, community-based interventions in South Africa, e-health and m-health, HIV interventions. Regarding the last question below, after the formal confirmation a formal agreement will be signed by all institutions. |
| Start Year | 2020 |
| Description | Partnership with the University of Nottingham, UK |
| Organisation | University of Nottingham |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | We worked together on a EPSRC/GCRF research proposal for which Dr Mercedes Torres who is a co-investigator from the University of Nottingham. Prof Paula Griffiths from Loughborough University and Dr Nicola Mackintosh are also co-investigators in this proposal and Dr Naveen Bagalkot is an international project partner in this proposal to share the experiences from India in South Africa |
| Collaborator Contribution | My partner at the University of Nottingham, Dr Mercedes Torres brings expertise on machine learning algorithms applied to gestational age estimation. |
| Impact | Our project entitled "Co-designing Community-based ICTs Interventions to Enhance Maternal and Child Health in South Africa" has been recently accepted for funding by the Digital Innovation for Development in Africa (DIDA) call. The project will bring togeter multidisciplinary expertise between UK and South African researchers on global health and nutrition, ethnography, co-design and participatory methods, psychology of child feeding behaviours, media and health communication, feminist geography, gender, care and inequalities, co-developing and delivering transferal capacity-building activities, and diverse areas of computer science including social and mobile computing, and artificial intelligence, human-computer interaction, internet of things, Information and communication technologies for development, anthropological understanding of maternal care, nursing and health sciences, neonatal care, medicine in regards to non-communicable diseases, maternal and child care, and mental health, community-based interventions in South Africa, e-health and m-health, HIV interventions. Regarding the last question below, after the formal confirmation a formal agreement will be signed by all institutions. |
| Start Year | 2020 |
| Description | Partnership with the University of the Witwatersrand, South Africa |
| Organisation | University of the Witwatersrand |
| Country | South Africa |
| Sector | Academic/University |
| PI Contribution | We worked together on a EPSRC/GCRF research proposal for which Prof Shane Norris from the University of the Witwatersrand is a co-investigator. Prof Paula Griffiths from Loughborough University and Dr Nicola Mackintosh are also co-investigators in this proposal and Dr Naveen Bagalkot is an international project partner in this proposal to share the experiences from India in South Africa |
| Collaborator Contribution | My partner at the University of the Witwatersrand, Prof Shane Norris brings expertise on life course nutrition and epidemiology. Shane is the Director of the South African Medical Research Council's Developmental Pathways for Health Research Unit (DPHRU), and Director of the South African Department of Science and Technology and National Research Council's Centre of Excellence in Human Development (CoE-HUMAN). He is an elected Fellow of the Academy of Science of South Africa, and President of the Africa Chapter of the International Society of Developmental Origins of Health and Disease |
| Impact | Our project entitled "Co-designing Community-based ICTs Interventions to Enhance Maternal and Child Health in South Africa" has been recently accepted for funding by the Digital Innovation for Development in Africa (DIDA) call. The project will bring togeter multidisciplinary expertise between UK and South African researchers on global health and nutrition, ethnography, co-design and participatory methods, psychology of child feeding behaviours, media and health communication, feminist geography, gender, care and inequalities, co-developing and delivering transferal capacity-building activities, and diverse areas of computer science including social and mobile computing, and artificial intelligence, human-computer interaction, internet of things, Information and communication technologies for development, anthropological understanding of maternal care, nursing and health sciences, neonatal care, medicine in regards to non-communicable diseases, maternal and child care, and mental health, community-based interventions in South Africa, e-health and m-health, HIV interventions. Regarding the last question below, after the formal confirmation a formal agreement will be signed by all institutions. |
| Start Year | 2020 |
| Description | Project Partner Digital Medic - Stanford Centre for Health Education |
| Organisation | Stanford University |
| Department | Digital MEdIC, South Africa |
| Country | South Africa |
| Sector | Academic/University |
| PI Contribution | Through the CoMaCH network we have enabling Digital Medic to disseminate their projects and get in touch with the wider network of co-investigators and project partners |
| Collaborator Contribution | Digital Medic is an active participant of the CoMaCH webinar series as well as participated in our CoMaCH workshops |
| Impact | Webinar: Community Voices in Implementing Maternal and Child Health Interventions https://comach.melissadensmore.com/192-2/ |
| Start Year | 2020 |
| Description | Project Partner: Dimagi |
| Organisation | Dimagi |
| Department | Dimagi South Africa |
| Country | South Africa |
| Sector | Private |
| PI Contribution | Through the CoMaCH network we have enabling Dimagi to disseminate their projects and get in touch with the wider network of co-investigators and project partners |
| Collaborator Contribution | Dimagi is an active participant of the CoMaCH webinar series as well as participated in our CoMaCH workshops |
| Impact | Webinar: Community Voices in Implementing Maternal and Child Health Interventions https://comach.melissadensmore.com/192-2/ |
| Start Year | 2020 |
| Description | Project Partner: Fraunhofer AICOS |
| Organisation | Fraunhofer Portugal Research |
| Department | Center for Assistive Information and Communication Solutions (AICOS) |
| Country | Portugal |
| Sector | Charity/Non Profit |
| PI Contribution | Through the CoMaCH network we have enabling Fraunhofer AICOS to disseminate their projects and get in touch with the wider network of co-investigators and project partners |
| Collaborator Contribution | Fraunhofer AICOS is an active participant of the CoMaCH network and participated in our CoMaCH workshops and stakeholder's interviews |
| Impact | https://doi.org/10.1145/3411764.3445662 |
| Start Year | 2020 |
| Description | Project Partner: Jembi Health Systems |
| Organisation | Jembi Health Systems |
| Country | South Africa |
| Sector | Charity/Non Profit |
| PI Contribution | Through the CoMaCH network we have enabling Jembi Health Systems to disseminate their projects and get in touch with the wider network of co-investigators and project partners |
| Collaborator Contribution | Jembi is an active participant of the CoMaCH webinar series as well as participated in our CoMaCH workshops |
| Impact | Webinar: Community Voices in Implementing Maternal and Child Health Interventions https://comach.melissadensmore.com/192-2/ Webinar: Digitization and the Road to Health Booklet https://comach.melissadensmore.com/webinar-digitization-and-the-road-to-health-booklet/ |
| Start Year | 2020 |
| Title | You and Your Baby |
| Description | This is a customized installation of wordpress that allows our partner NGO to share videos with their parent beneficiaries. This was co-designed with parents and BBP staff. |
| Type Of Technology | Webtool/Application |
| Year Produced | 2022 |
| Open Source License? | Yes |
| Impact | This is newly deployed and we are evaluating the impacts. |
| URL | https://youandyourbaby.bhabhisana.org.za/ |
| Description | CoMaCH Webinars - 2021 |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Postgraduate students |
| Results and Impact | There is an incredible amount of innovation happening in the space of digital maternal and child health! The webinar series provide an opportunity to learn more from the experts about what is happening in South Africa and beyond in the area of community-based co-design of ICT interventions for maternal and child health. |
| Year(s) Of Engagement Activity | 2021 |
| URL | https://comach.melissadensmore.com/webinars/ |