“Same; Same but Different”: Reflections on the GIEP Experience

It is almost hard to believe that our GIEP internship experience is coming to an end in one week. After spending time working with iKure over the past month and a half—and over three months developing our project with them from Ann Arbor—we have definitely come to know both the employees at the organization, and the ins and outs of their operations, both positive and not-so-positive.

Over the last month, our team has pushed relentlessly to have iKure staff arrange field visits to rural communities to get information and feedback from health workers on our application. We only had three 4-hour visits in this time period and interacted with two iKure Community Health Workers and four ASHAs. That was essentially all we were allowed for the formative evaluation process that needed to be done to carry our project forward.

However, we learned vastly more information from these visits than we had in the last four months, in which we tried to gather knowledge about health workers from the iKure project manager and operations manager, who only go out into these communities every once in a while.

We no longer have the time to conduct another field visit to help inform the design of our mobile application. However, what we definitely will finish by the time we leave Kolkata is a detailed documentation “packet” that contains evaluation reports on the field testing we did, an application style guide to standardize iKure’s existing technology frameworks, and a recommendations manual to help iKure move forward sustainably and appropriately in the mHealth sphere.

As we continue to write these documents, we are not only considering the health workers’ contexts that could shape future trainings and usage of the KOL-Health Application (and potentially other electronic health tools), but also the aspects of iKure’s system that can be improved to better support successful implementation and evaluation of technology in community health work.

Our project over the course of the last five months has been somewhat the same, but different altogether:

  • We are still looking at maternal-child health and how to integrate an MCH program of sorts into iKure’s framework. However, rather than helping guide health worker training in MCH, we are creating public health surveys and embedding it into an application that will hopefully improve health workers’ activities in the field—especially for visits to mothers, newborns and children.
  • We initially thought back in January that a design probe testing messaging
    Our plan for design probes back in March.

    between health workers in the field and doctors in distant clinics would be beneficial. Although this feature is a component of a mobile application, and is no longer a stand-alone feature used via SMS or IVR, we were still able to look at the messaging feature as a “probe” to determine if doctor-CHW communication would actually occur.

  • Our focus on health workers as the primary users of this technology still stands. Although our project scope largely focused on developing design probes and training materials that could be tailored for the health workers’ contexts once we arrived to India, our actual development timeline has not panned out this way. Instead, most of our time has been spent troubleshooting and revising the application through field-testing and evaluation, and we are trying to get to the training documentation completed and handed off to iKure in the last few days we are here.

There is much that needs to be accomplished in the last week working with iKure, but one thing that is important for us to keep in mind is that the core of our project—building a tool with and for health workers—is the same. It is our significantly shortened timeline that has affected what we can feasibly accomplish, given our partners’ high expectations and the amount of research and design that goes into this project.