7 July, 2024 saw CITAPP research scholars draw a curtain on the chapter of their lives as students of IIIT-Bangalore. Here is a glimpse of their work.
Deepa Austin, PhD Scholar, under the supervision of Prof. Amit Prakash
Designing Through the Complexity of Malnutrition Management: Using Systems Approaches for Integrated Health Information Applications
Abstract:
In the field of global health, there is a rising tendency to harness the potential of Information and Communications Technologies (ICTs) to accelerate progress on health-related Sustainable Development Goals (SDGs). SDG Target 2.2 aims to end all forms of malnutrition by 2030. With 7.7% of its children under 5 years of age afflicted with Severe Acute Malnutrition (SAM), the most fatal form of malnutrition, India is amongst the worst affected in the world.
Fragmentation in the care continuum is an important challenge encountered in modern health systems, negatively impacting the multi-sectoral intervention strategies advocated for managing critical concerns like SAM. Although there have been substantial advancements in the use of ICTs for health to connect systems and integrate data for timely and coordinated care, recent research studies indicate disconnects between the digital and public health systems, along with an increased fragmentation in care.
One of the most persistent factors affecting ICT implementations is the difficulty in dealing with the inherent complexity of public health systems, particularly when it comes to the involvement of heterogeneous systems and their interdependence, nonlinear stakeholder interactions, and local and collective behavioural patterns that lead to emergence and self-organisation in such systems. Furthermore, methodological approaches that could help systematically uncover such complexity traits remain elusive. Therefore, in this research study, I investigate the overarching question: ‘How can we unravel the complexity features in public health to design and develop integrated information and communication technologies (ICTs) addressing fragmentation in care?’ To accomplish this, I strive to 1) establish approaches for unravelling the complexity of the problem situation, 2) get a contextual understanding of the present concerns on fragmentation-in- SAM care, and 3) operationalise the design and development of ICT-enabled solutions for integrating care in complex health settings.
I employ the Systems Thinking in Practice framework (STiP) as my theoretical framework and Participatory Action Research (PAR) as the methodology to engage effectively with stakeholders. Using the case study of ICT-enabled tracking and management of SAM in the state of Karnataka, I examine the everyday work practices of relevant stakeholders in their functional contexts, to identify and translate the complexity features. The approach was episodic, iterative, and cyclical, acknowledging newer requirements to adapt to the changing conditions and involved a field engagement spread over four years.
I propose a methodological framework by operationalising STiP through the use of common question tags; ‘what’ to develop frameworks for contextual realities depicting the ‘world as expected’, ‘who’ and ‘how’ to develop frameworks for practice exemplifying the ‘world as existing’ and ‘which’ and ‘why’ to develop frameworks for responsibility. The deviations seen in the ‘world as expected’ and the ‘world as existing’ revealed non-linear interactions in the functional context. Furthermore, an inquiry into ‘why they do what they do’ helped to reveal the self-organising capabilities of public health systems. The framework allowed the development of a systematic approach to identify and translate the characteristic features of complex social systems.
The research also throws light on various layers of fragmentation existing in the SAM care continuum and elucidates the reasons for the fragmentation. It provides recommendations to address the four layers of fragmentation – in processes, data, resources and policies. As an action outcome, the research findings have aided in the development of two versions of ICT applications for integrating SAM care; one is already operational throughout the Karnataka state, while the other is in the pilot phase. The research has contributed to operationalising the design and implementation of ICT-enabled solutions for complex social settings through four stages of participation, action and research – Exploratory, Experimentation, Emplacement and Enhancement.
Based on the research, I propose critical design elements for ICTs that are required for integrating care: multiple user interfaces to balance the non-linear practices and carry out shared responsibilities; understanding design requirements by leveraging the self-organizing capabilities of local and global systems; and collaborating with users’ motivation sources to encourage sustained usage. Future studies of ICTs in public health programmes, designed using the proposed methodology, will be useful to ascertain the level of improvements in outcomes that accrue as a result.
Kartik Joshi, MS (by research) Scholar, under the supervision of Prof. Preeti Mudliar
Reselling Practices in a Textile Bazaar: Translating E-Commerce Platforms to WhatsApp Interactive Selling
Abstract:
E-Commerce platforms provide a framework to navigate online selling. However, sellers and traders in India have resented E-Commerce platforms since they entered the Indian retail market. The deep discounts, commission charges, inventory mandates, and customer-friendly return policies threatened the business models of the sellers and the traders who typically preferred to reassess their inventory based on everyday sales and did not entertain return requests from the customers. Against this backdrop, growing mobile internet penetration across India opened new possibilities for online commerce. With the turn towards Instant Messaging (IM) platform-driven interactive commerce and reselling, sellers and traders are leveraging WhatsApp to take their business ‘digital’ by leveraging the social influence of women working as resellers to sell garments through WhatsApp.
In this thesis, I trace the WhatsApp reselling trajectory from sellers and traders at the Surat Textile markets to resellers and customers spread across the country. Through interviews and observations at the textile markets of Surat, I examined sellers’ and traders’ technology practices as they coordinate with resellers across the country who sell garments to their customers. I observe the labor by all actors as they engage in WhatsApp reselling. I further demonstrate how actors translate E-Commerce features offered through a platform interface into WhatsApp by relying on the messaging platform’s interactive features. Without an arbitrator like an E-Commerce platform to supervise their trading, actors in the WhatsApp reselling ecosystem rely on exchanging digital artifacts to establish a common ground amongst each other.
Drawing from Science and Technology Studies (STS) and translation studies (TS), I show how WhatsApp emerged as a site and tool for translating E-Commerce platforms. I argue that WhatsApp-based selling is an act of translation performed by the sellers and traders to participate, on their terms, in the culture of buying and selling online through digital platforms. With colloquial and culturally relevant conversations, resellers mediate the buying and selling process for the customers. I contribute to the contemporary research on Human-Computer Interaction and Marketplaces by mobilizing the concept of technology translation to discuss the collaborative practices of actors to translate platform interfaces into IM apps. The study has implications for designing social, interactive platforms that facilitate online commerce.
Sandeep Kumar Agarwal, M.S. (by Research) scholar, under the supervision of Prof. V. Sridhar
Study of Economic, Regulatory and Sustainability aspects of Public Wi-Fi Programmes in India
Abstract:
Public Wi-Fi is considered as suitable alternative for mobile broadband connectivity for affordable Internet access. India still lags behind in Wi-Fi penetration across the country. The Indian Government launched the Prime Minister’s Wi-Fi Access Network Interface (PMWANI) as an approved Public Wi-Fi program with the objective of providing affordable high-speed broadband through last mile Wi-Fi providers called Public Data Offices (PDO). The program aims to create millions of micro entrepreneurs as PDOs, in line with Public Call Offices (PCOs). Public Wi-Fi, in many countries, is deemed as Digital Public Good and is state funded. However, the same is not the case in India. The approach of considering Public Wi-Fi in line with telecom services offered by licensed service providers and subjecting it to market forces has not yielded much of the success so far.
Though PDO market exhibits characteristics of a competitive market with no entry barriers, there can be market failures due to demand uncertainty and lack of level playing field for these PDOs to operate in a market dominated by telecom and internet service providers. Regulatory interventions either at supply side or demand side or both are required to correct such market failures. The objective of supply side intervention through regulation may be to foster competition or to reduce barrier to entry. The objective of demand side intervention may be to increase awareness of the product or services or promote usage of broadband. Allowing PDOs to continue in the market till a profitable business model is devised may also require government intervention in the form of funding or subsidy.
In our study, we model the marketplace of PDOs and examine various aspects including demand and supply, competition, sustainability of PDOs, and policy interventions for the sustainability of such a market place. We build an analytical model of the marketplace using Bass Diffusion Theory, resulting in an S-shaped curve of Wi-Fi user adoption. We then use Agent Based Modelling and simulation to develop a number of scenarios with parameters such as backhaul tariff capping, supply capping, various subsidy options for the PDOs, technologies choices for backhaul and willingness to pay of the consumers to determine sustainability of such marketplace. We conducted a survey of PDOs to determine the validity of our model results. Our simulations indicate that
1. PDO market in the current form is not sustainable
2. Measures required to increase awareness of the program to accelerate the diffusion
3. Sustainability of PDO market requires regulatory intervention in the form of
- Fixing internet backhaul tariff ceiling price near to home Broadband prices offered by telecom and Internet service providers to create a level playing field for PDOs.
- One-time Fixed Subsidy on Access cost to PDO to increase supply and continue operating in the market by offsetting loss due to demand uncertainty.
- iii. Supply capping in short run to ensure equitable distribution of demand, increased competition to maximise the number of profitable PDOs.
Our study concludes that government programs similar to PMWANI require an economic and regulatory analysis to create an ecosystem that is conducive for stakeholders to make it sustainable. Along with new technology adoption, the public Wi-Fi program need to incorporate the supply and demand side regulatory interventions, including conducting mass awareness programmes for sustainable adoption.
Shyam Beriwal, M.S. (by Research) scholar, under the supervision of Prof. V. Sridhar
Modelling and Analysis of Open and Managed Digital Marketplaces Platforms in E-commerce
Abstract:
As marketplaces continue to evolve, understanding the contrasting dynamics of Open and Managed Marketplaces, within the digital commerce landscape, becomes critical. Open Marketplaces are defined as digital platforms that offer minimal entry barriers for sellers, fostering a wide array of product offerings and competitive pricing due to the high number of participants. Managed Marketplaces, in contrast, are characterized by their selective seller inclusion criteria and stricter regulatory oversight. The study examines how these marketplace models impact the utilities and experiences of both sellers and consumers, delving into aspects such as seller addition rates, total seller growth, average volume per seller, selling prices, and the overall volume and value of goods sold. It reveals that Open Marketplaces, through their competitive nature, enhance consumer utility with lower prices, yet pose challenges for sellers in achieving profitability. Managed Marketplaces, on the other hand, provide sellers with opportunities for economies of scale, offering a trade-off between consumer utility and price stability.
This study employs Agent-Based Modeling (ABM) technique to analyze and model the dynamics of these two market types, considering factors such as customer utility, seller utility, market value, and other economic parameters.
Taru Jain, M.S. (by Research) scholar, under the supervision of Prof. Preeti Mudliar
Platforming PCOS Treatment Online: FemTech Logics of Care
Abstract:
The agenda of promoting women’s access to sexual and reproductive health (SRH) services and growing interests in digitizing healthcare have coalesced into the emergence and rapid growth of the FemTech (female-oriented technologies) market. In India, there has been a recent surge of FemTech platforms insistently foregrounding care for chronic and stigmatized SRH concerns like Polycystic Ovary Syndrome (PCOS) with claims to respond to the marginalization of such health concerns in offline gynaecological infrastructures such as hospitals and medical clinics. Healthcare professionals remain overburdened in these offline infrastructures owing to the increasing population size in India and are under-compensated for their care labor, especially in rural health contexts. Against the backdrop of these concerns, FemTech platforms centre `care’ as their core brand value, which they can digitally platform to meet the needs of healthcare professionals and PCOS patients and consequently package into a marketable entity.
To examine the claims and mechanisms of platforms centring on care, I delve into the infrastructuring of PCOS care in offline gynaecological infrastructures and FemTech platforms. This thesis explores how these platforms appropriate the term `care’ in attempts to create a collaborative, non-judgmental, long-term, and data-driven approach for a health condition like PCOS. In contrast, offline healthcare systems for PCOS fall short due to disruptions in treatment, gynaecological indifference, and a lack of time and attention to patient concerns. Building on an 18-month-long ethnographic study involving observations and interviews with FemTech platform founders, gynaecologists, and people with PCOS, I uncover FemTech’s approach to designing and delivering care.
I show how a subset of digital health platforms targeting SRH concerns in India uses `care’ as an entry point into the FemTech market. In particular, this study highlights how FemTech start-ups, led by engineering and management professionals, capitalize on the shortcomings of traditional offline gynaecological infrastructures to establish a unified digital PCOS care approach, which operates under the neoliberal market logics of customer segmentation and retention. In doing so, this study details a logic of care that is reflected in the FemTech platforms’ operations and unpacks its implications and shortcomings towards designing women’s healthcare systems.
Towards this end, this work contributes an analysis of the interplay of care and profit-driven agendas embedded in a FemTech logic of care, drawing out limitations to its sustainability and inclusivity as a digital alternative to offline gynaecological care. Building on this examination, I offer recommendations to FemTech founders and healthcare policymakers to develop sustainable and inclusive offline and online health infrastructures. As this thesis focuses on the design and delivery of care by FemTech platforms, I broadly situate this work within the Human-Computer Interaction (HCI) scholarship on digital healthcare interventions. In particular, this thesis seeks to contribute to ongoing discourses on designing for women’s health and the future of care work.