Healthy Crossroads in Pregnancy Care (HCPC) - A Scoping and Participatory Design Study of the Potential for ICTs to Improve Maternal Health in India

This partnership aims to co-inquire what roles Information and Communication Technologies (ICTs) might play in enhancing and shaping (individual and community-based) socio-cultural practices around pregnancy care in India. Maternal health is one of the foremost public health challenges in India. Additional disorders and complications such as anaemia and gestational diabetes makes the self-care management of pregnant women more challenging in particular in urban slums and rural areas in India. In addition, the low utilization of maternal and reproductive healthcare services together with the exacerbating socio-cultural and economic inequalities have jeopardised pregnant women's health especially at the lower level of the socio-cultural system in India. For instance, pregnant women often find themselves in subordinate positions, and cultural everyday practices (e.g., serving the husband food first), family structures and traditions challenges women's autonomy, the delivery process and and the postnatal period, whilst engaging in unhealthy practices that can potentially be harmful to both the mother and the baby. Exploring the socio-cultural practices around pregnancy and the everyday experiences of pregnant women can provide opportunities to enhance pregnant women's autonomy, agency, self-efficacy and self-reflective practices through technology design.

As such, this partnership aims to explore the complexities of everyday pregnancy care and scope opportunities and concerns for the design of technological interventions that can support and reshape the maternity journey, accounting for the autonomy and agency of pregnant women within and beyond households, to improve their health and wellbeing. We have brought together a multi-disciplinary, cross-cultural, and cross-geographical group of researchers, technology designers, public & community health workers, and grassroots citizens' organisations to explore the opportunities afforded by ICTs to help identify, promote and/or restrict the consequences of (un)healthy practices and lifestyle behaviors in the health of pregnant women, the newborns, and the community. To meet our project's aim, we will, over a period of nine months (between March and November 2018), engage in 2 stages of co-inquiring studies (ethnographic work and co-design work), and meet as a team to hold 3 scoping, networking and dissemination workshops in India: at the beginning of the project, after 4 months of the ethnographic work, and at the end of the project. The partnership will gain further understanding of (un)healthy practices around pregnancy care, as well as explore and create a collection of design probes and innovative ideas and experiences to empower, enhance and promote the active and positive participation of pregnant women, their families and communities in maternal care. The insights from the ethnographic work and the generated design ideas and prototypes will be shared with the participants, their communities and the public in general. We will develop a larger research study to further explore the implementation of the generated ideas on national scale across India. The project will provide the basis for additional further collaborations and strengthen our individual practices through sharing best practice and methods across fields.

This proposal seeks to better understand the (un)healthy socio-cultural practices, beliefs and power structures that can strengthen or weaken pregnant women's self-care practices, and explore the opportunities afforded by information and communication technologies (ICTs) to reshape the socio-cultural practices that affect pregnancy care in India. The proposed research benefits multidisciplinary researchers, practitioners, care workers, and pregnant women & their families.

Firstly, the proposed project will benefit national and international researchers and practitioners working at the intersection of health, social sciences, and design, including the disciplines of as human-computer interaction, sociology of health and anthropology, healthcare design research and user-driven healthcare innovation. In particular, the findings from the ethnographic and co-design workshops will highlight the complexities of everyday pregnancy care in India, and scope opportunities and concerns to inform the design of ICT interventions to enhance healthy pregnancies. Active dissemination of the project's' findings and charting future collaborations within and beyond the project's network of academia, grass-roots organizations, industry and healthcare innovators, and governmental and non-governmental policy agencies, will impact the design of novel ICT products and services that will facilitate autonomy and agency of pregnant women within and beyond households, enabling them to engage in healthy practices while being aligned to public health initiatives in rural India and in similar conditions in other countries.

Secondly, the project will benefit grassroots community care workers, who are mostly women in India. Through engaging a representative set of such care workers as close collaborators in the research work the project will enhance their skills sets in using research methods to enhance their care work. This will not only help them offer better care services, but will also help them gain more employable capabilities. With the help of our partner organization the project will document the methods and tools used in the research in formats that are easily accessible for care workers as materials for training, and disseminate it to other organizations across India and to countries in the Global South for wider reach.

Finally, the project will benefit pregnant women and their families. Through encouraging an active participation of pregnant women in the rural and urban slums of the project's site, the project will give an opportunity for the young women to 'voice' their concerns and shape the research agenda, findings, and future work. Furthermore, through the participation in the research and co-design sessions will enhance their self-efficacy levels particularly towards socializing and use of ICTs. The project will document the voices and ideas expressed, and make them available as key concerns to be considered in the design of ICT aimed at enhancing pregnancy care.