Research in Human-Computer Interaction has begun to examine women’s midlife health and their experiences with menopause. This research has found that menopause has a geography—it is shaped by the places in which it is experienced, from homes to workplaces. In this paper, we further explore this idea in two ways. One is how the intertwining of these places shapes implications for health technologies. Additionally, we examine menopause and technology in cultural contexts beyond the Global North. We present a study of women’s experiences with menopause in urban Pakistan, drawing on surveys and interviews incorporating visual prompts, as well as supplementary interviews with physicians. Using feminist theories of geography and labor, we analyze how space, place, and labor shape women’s experiences of menopause. We draw on our findings to surface implications for technology design that work towards more supportive environments that enable women’s well-being and meaningful choice in care-seeking.

Gathering information about AI systems is essential for contesting their use; it forms the basis of arguments about how and to what extent AI is causing harm. Information thus plays a central role for advocates like lawyers, journalists, and auditors contesting harmful AI systems. However, there is little systematic understanding of how these actors, many of whom are newly encountering AI in their advocacy work, access and use information effectively in this process. Understanding this information work can offer valuable insights for supporting effective contestation of harmful AI systems—work that is typically taken on by underresourced advocacy groups to begin with. To better understand information work in AI contestation, we interviewed 18 advocates in the United States (US) who have contested the use of AI in high-stakes domains, such as public benefits and housing. We characterize advocates’ strategies for accessing information that is useful for contestation, including a range of creative yet resource-intensive and risky workarounds that they use to overcome opacity. We discuss implications of our findings for the effectiveness of popular transparency policy strategies in the US and offer additional ways to support the social fabric that makes advocates’ information work effective.

Amidst the increasing datafication of healthcare, deep digital phenotyping is being explored in clinical research to gather comprehensive data that can improve understanding of neurological conditions. However, participants currently do not have access to this data due to researchers' apprehension around whether such data is interpretable or useful. This study focuses on patient perspectives on the potential of deep digital phenotyping data to benefit people with neurodegenerative diseases, such as ataxias, Parkinson's disease, and multiple system atrophy. We present an interview study (n=12) to understand how people with these conditions currently track their symptoms and how they envision interacting with their deep digital phenotyping data. We describe how participants envision the utility of this deep digital phenotyping data in relation to multiple stages of disease and stakeholders, especially its potential to bridge different and sometimes conflicting understandings of their condition. Looking towards a future in which patients have increased agency over their data and can use it to inform their care, we contribute implications for shaping patient-driven clinical research practices and deep digital phenotyping tools that serve a multiplicity of patient needs.

Policymakers have established that the ability to contest decisions made by or with algorithms is core to responsible artificial intelligence (AI). However, there has been a disconnect between research on contestability of algorithms, and what the situated practice of contestation looks like in contexts across the world, especially amongst communities on the margins. We address this gap through a qualitative study of follow-up and contestation in accessing public services for land ownership in rural India and affordable housing in the urban United States. We find there are significant barriers to exercising rights and contesting decisions, which intermediaries like NGO workers or lawyers work with communities to address. We draw on the notion of accompaniment in global health to highlight the open-ended work required to support people in navigating violent social systems. We discuss the implications of our findings for key aspects of contestability, including building capacity for contestation, human review, and the role of explanations. We also discuss how sociotechnical systems of algorithmic decision-making can embody accompaniment by taking on a higher burden of preventing denials and enabling contestation.

Artificial Intelligence for Social Good (AI4SG) has emerged as a growing body of research and practice exploring the potential of AI technologies to tackle social issues. This area emphasizes interdisciplinary partnerships with community organizations, such as non-profits and government agencies. However, amidst excitement about new advances in AI and their potential impact, the needs, expectations, and aspirations of these community organizations--and whether they are being met--are not well understood. Understanding these factors is important to ensure that the considerable efforts by AI teams and community organizations can actually achieve the positive social impact they strive for. Drawing on the Data Feminism framework, we explored the perspectives of community organization members on their partnerships with AI teams through 16 semi-structured interviews. Our study highlights the pervasive influence of funding agendas and the optimism surrounding AI's potential. Despite the significant intellectual contributions and labor provided by community organization members, their goals were frequently sidelined in favor of other stakeholders, including AI teams. While many community organization members expected tangible project deployment, only two out of 14 projects we studied reached the deployment stage. However, community organization members sustained their belief in the potential of the projects, still seeing diminished goals as valuable. To enhance the efficacy of future collaborations, our participants shared their aspirations for success, calling for co-leadership starting from the early stages of projects. We propose data co-liberation as a grounding principle for approaching AI4SG moving forward, positing that community organizations' co-leadership is essential for fostering more effective, sustainable, and ethical development of AI.

Information services for maternal and child health are increasingly being implemented at scale and integrated into public health infrastructures in Global South countries. These services often disseminate tailored health information and provide channels for families to ask questions to health workers. With increasing uptake, these services are intervening into a highly gendered space and shaping care work and information-seeking in new ways. We present a study of a patient education program and associated WhatsApp-based information service deployed across multiple states in India, drawing on observations, interviews, and analysis of chat records. Building on notions of “unsettling care” [63], we examine what it means to deploy such an intervention in inequitable, fragmented health systems. We find that even as the intervention focuses on individual behavior change, it also runs up against structural issues, such as the overburden of health workers, an illegible health system, and gendered power dynamics that extend beyond the realm of the home. We use our findings to unsettle notions of how the intervention provides care, and to reframe how we might think about the design and implementation of health information services to also engage with structural issues.

Seeking to address barriers to in-person care, governments and non-governmental organizations (NGOs) globally have been pushing for scaling chat- or phone-based information services that rely on care workers to engage with users. Despite theoretical tensions between care and scale and the essential role of care workers, workers' perspective on scale and its impact on care provision is rarely centered early on in decisions to scale. In this paper, we examine care and scale from the perspective of medical support executives (MSEs) who support a chat-based health information service for maternal and child health deployed across multiple states in India. We draw on observations of MSEs' work, interviews with MSEs, NGO staff who implement the service, and families who use the service, and speculative design sessions conducted with MSEs. We find that by centering MSEs' perspectives, we can differentiate between growth of the relationships and heterogeneity that enable social impact, versus scale-thinking that promotes the decontextualization of care. We leverage our findings to discuss implications for scale and automation in chat-based health information services, including the importance of human connection, place, and support for care workers.

HCI is increasingly concerned with health information quality and spread of misinformation on social media. Despite many major platforms having been adopted across the world, the situated evaluation and sharing of health information is underexplored across diverse health systems and cultural and political contexts. Drawing on semi-structured interviews, we study the navigation of health information on social media in urban and rural South India, backdropped by plural knowledges around health and the specific politics and sociality of health and social media in this setting. We use Ivan Illich’s concept of tools for conviviality [49] to distinguish between how people creatively use tools versus how tools manage and impose values on people—participants aimed to use health information towards care beyond institutionalized healthcare, but insidious misinformation and information-sharing practices served to commodify, spark uncertainty in, and discipline caring behavior. We use our findings to expand understandings of the use of health information on social media and how positionality shapes how people are affected by and respond to misinformation. We also draw attention to the structural aspects of health misinformation in the Indian context and how the design of social media platforms might play a role in addressing it.

We present a qualitative study of a six-month pilot of WhatsApp-based facilitated peer support groups, serving youth living with human immunodeficiency virus (HIV) in an informal settlement in Nairobi, Kenya. Popular chat apps are increasingly being leveraged to make a combination of patient-provider communication and peer support more accessible beyond formal healthcare settings. However, how these interventions are experienced in Global South contexts with phone sharing and intermittent data access is understudied. The context of stigmatized illnesses like HIV further complicates privacy concerns. We draw on chat records and interviews with youth and the facilitator to describe their experience of the intervention. We find that despite tensions in group dynamics, intermittent participation, and contingencies around privacy, youth were motivated by newfound aspirations and community to manage their health. We use our findings to discuss implications for the design of chat-based peer interventions, negotiation of privacy in mobile health applications, and the role of aspirations in health interventions.

In this paper, we examine WhatsApp use by nurses in India. Globally, personal chat apps have taken the workplace by storm, and healthcare is no exception. In the hospital setting, this raises questions around how chat apps are integrated into hospital work and the consequences of using such personal tools for work. To address these questions, we conducted an ethnographic study of chat use in nurses' work in a large multi-specialty hospital. By examining how chat is embedded in the hospital, rather than focusing on individual use of personal tools, we throw new light on the adoption of personal tools at work — specifically what happens when such tools are adopted and used as though they were organisational tools. In doing so, we explicate their impact on invisible work [77] and the creep of work into personal time, as well as how hierarchy and power play out in technology use. Thus, we point to the importance of looking beyond individual adoption by knowledge workers when studying the impact of personal tools at work.

In this article, we present 6 cases (contained in 13 studies) variously connected with women’s health in a range of Indian contexts. Analyzing these cases, we highlight that “women’s health” is inextricably linked with extrinsic factors that also need addressing, to propose a broadened focus of “women’s wellbeing,” as defined through the lens of Martha Nussbaum’s central human capabilities . Drawing again on our cases, we discuss the importance of taking a long, holistic, and intersectional view to women’s wellbeing. Consolidating lessons learned across studies, we emphasize the potential of framing challenges around women’s health as learning problems, rather than problems of information access alone. Leveraging this perspective, we propose the use of design-based implementation research as a potential approach in identified learning ecologies, given its emphasis on long-term engagement with multiple stakeholders in the learning process. Although the empirical research we draw from took place in various Indian contexts, we conclude by arguing that key contextual characteristics may translate to other cultures and geographies as well.

Technology use in India is highly gendered across diverse socioeconomic backgrounds, and women have only recently come to widely adopt smartphones, mobile internet, and social media---even in urban India. We present an in-depth qualitative investigation of the appropriation of social computing technologies by women from urban, middle-income households in New Delhi and Bangalore, India. Our findings highlight the additional burden that these women must contend with, on account of gender, as they engage on social media. We discuss these findings to make three contributions. First, we extend conversations on gender in Human-Computer Interaction (HCI) by discussing how design in patriarchal contexts might be rooted in existing efforts towards change and appropriation. Second, we expand understandings of privacy in HCI as being situated in the relationship between the individual and the collective. Third, we discuss how looking at our participants' social media use across multiple platforms leads to greater insight into the link between social media engagement and privacy.

We examined the integration of VR into informal and less-structured learning environments in Atlanta (USA) and Mumbai (India) through a process of co-design, co-creation, and co-learning with students and teachers where students learned to use VR to engage with their economic, social, and cultural realities. Using qualitative methods, we engaged students and teachers at both sites in VR content creation activities; through these activities, we attempt to uncover a deeper understanding of the challenges and opportunities of introducing low-cost mobile VR for content generation, consumption, and sharing in underserved learning contexts. We also motivate future work that looks at integrating VR in new contexts, using flexible methods, across borders. The larger vision of our research is to advance us towards greater accessibility and inclusivity of VR across diverse learning environments.

Mental illness is rapidly gaining recognition as a serious global challenge. Recent human-computer interaction (HCI) research has investigated mental health as a domain of concern, but is yet to venture into the Global South, where the problem exhibits a more complex, intersectional nature. In this paper, we review work on mental health in the Global South and present a case for HCI for Development (HCI4D) to look at mental health-both because it is an inarguably important area of concern in itself, and also because it impacts the efficacy of HCI4D interventions in other domains. We consider the role of cultural and resource-based interactions towards accessibility challenges and continuing stigma around mental health. We also identify participants' mental health as a constant consideration for HCI4D and present best practices for measuring and incorporating it. As an example, we demonstrate how both the process and the lens of aspirations-based design, a recently proposed approach for HCI4D research and design, may benefit from the consideration of mental health concerns. Our paper thus recommends a path forward for considering mental health in HCI4D, potentially leading to new research directions in addition to enriching existing ones.

We present an initial qualitative exploration of Twitter data on autism spectrum disorders (ASDs) and acquired immunodeficiency syndrome (AIDS) from India and the United States, conducted with the goal of learning more about the nature of existing online awareness around ASDs in India. We collected tweets from both locations during and around World Autism Awareness Day and World AIDS Day. We then qualitatively analyzed these tweets, finding differences in how each country talks about stigmatized health issues and how Indian users talk about ASDs. We use these findings to discuss potential avenues for research on supporting and extending existing levels of autism awareness in India.

We present a case for aspirations-based design by drawing on a qualitative inquiry into the lives of young girls in rural West Bengal (India). These girls form a particularly vulnerable population, coming from an area known to be susceptible to sex trafficking and crimes against women. We leverage our findings to engage with Kentaro Toyama's call for greater attention to aspirations in designing technology for development [51]. We highlight the aspirations of and for these girls and reflect on the embedded, temporal, and mutable qualities of these aspirations. Finally, we examine how an aspirations-based design approach might factor these qualities into technology design. Although our analysis draws on empirical findings from rural/suburban India, the insights derived from this research are relevant for the process of designing technologies towards fulfillment of aspirations, more generally.

We contribute to the growing conversation on assets-based approaches to design in Computer-Supported Cooperative Work (CSCW) and Human-Computer Interaction (HCI) with a qualitative study of resilience. Our study is situated within a community health infrastructure in a rural county in southwest Kenya, where health organizations pay community health workers' salaries via digital payments, backdropped by ongoing issues with missing and delayed payments. Through the lens of intersectionality, we examine how community health workers of diverse backgrounds and contracted status respond to the mandated use of digital payment methods and long payment delays. We highlight how resilience in this context is situated in workers' intersecting socioeconomic and professional identities, which shape the assets and constraints that workers engage with in efforts to be resilient. We leverage our findings to discuss how assets-based approaches to design can be further operationalized and used to sustainably support resilience.

Quantification and standardization of concepts like risk and vulnerability are increasingly being used in high-stakes, client-facing social services, also presenting the potential for data-driven tools for decision-making in this context. These trends necessitate an understanding of the role of quantitative data in the work of street-level decision-makers in social services. We present a qualitative study of existing data practices and perceptions of potential data-driven tools in housing allocation, engaging the perspective of service providers and policymakers in homeless services in a large urban county in the United States. Our findings highlight participants' concerns around centering clients' choices and ensuring integrity in a resource-constrained, high-stakes context. We also highlight differences between the perspectives of policymakers and service providers on standardization and fairness in the decision-making process. We discuss how use of and policies around data in social services need to consider the importance of the relationships that client-facing service providers have with other workers in the organization, with their work, and with clients.

Research in the fields of Computer Supported Cooperative Work (CSCW) and Human-Computer Interaction (HCI) is increasingly embracing and moving across borders. While universalism in such research is widely rejected, sole focus on the "particular'' is also commonly critiqued. Kentaro Toyama unpacks this tension, calling for balance via "deliberate efforts to understand the interplay of human universals and cultural differences, and how it pertains to design.'' In this paper, one such deliberate effort, we introduce the notion of feminist solidarity---as theorized by Chandra Mohanty---for drawing connections across borders in CSCW and HCI research, design, and practice. To enable contributions in these fields to cross cultures and geographies in productive ways, we draw attention to commonalities in the struggles and processes of resistance operating in different contexts of study. To do this, we present lessons learned from conducting three comparative studies in six contexts, which were located across various borders. The primary contribution of our analysis is to leverage a feminist solidarity-based approach towards extending conversations on comparative, transnational, and feminist CSCW and HCI research, design, and practice. Our focus remains on resource-constrained regions across the world, in both the Global North and South.

In response to the recent call for a more intersectionally-aware field of human-computer interaction (HCI), we aim to operationalize intersectionality for technology design in HCI. We develop our lens of intersectionality by drawing on the work of Rita Kaur Dhamoon, and use it to analyze data collected from a multi-sited ethnographic study of seven low-resource learning environments in the Indian states of Maharashtra, Tamil Nadu, and West Bengal. Our research contributions are threefold. First, we extend conversations in Intersectional HCI by expanding its scope from understanding users to recognizing social processes. Second, we emphasize the importance of factoring in both penalties and privileges when conducting research in underserved contexts. Finally, we engage situated comparisons as a methodology to identify pathways for designing interactive systems across intersectionally diverse environments.

We contribute to the intersection of multilingualism and human-computer interaction (HCI) with our investigation of language preferences in the context of the interface design of interactive systems. Through interview data collected from avid smartphone users located across distinct user groups in India, none of whom were native English speakers, we examine the factors that shape language choice and use on their mobile devices. Our findings indicate that these users frequently engage in English communication proactively and enthusiastically, despite their lack of English fluency, and we detail their motivations for doing so. We then discuss how language in technology use can be a way of putting forth mobility as an aspect of one's identity, making the case for an intersectional approach to studying language in HCI.

We conducted a field study of Mohalla Clinics in Delhi (India), drawing on Haraway's work to highlight the importance of considering disparate, partial perspectives in the ecologies of such clinics. We emphasized that inadequate attention given to patients' and health workers' perspectives, and the low preparedness of the doctors at the clinics, resulted in the clinics being unable to address the needs of target patient groups. We concluded by contributing to ongoing, important conversations in the fields of ICTD, CSCW, and HCI towards redesigning healthcare interventions, revisiting patient empowerment, and redefining the role of ASHAs as infomediaries.

We present a qualitative inquiry through the lens of feminist Human-Computer Interaction (HCI) into women's perceptions of personal safety in New Delhi, India. Since a brutal gang-rape incident took place in Delhi in December 2012 and received global attention, women's safety has been the focus of much attention India-wide. In April 2016, the Indian government issued a mandate that all mobile phones sold in India 2017 onwards must include a panic button for women's safety. We draw on interview and survey data to examine women's responses to the mandate, also investigating what factors influence their perceptions of safety, positively and negatively. Our findings indicate that women's sense of safety may be deconstructed into a multitude of factors--personal, public, social, technological--that must align for this sense of safety to be preserved. We then discuss the implications these factors have for the success and (re-)design of the panic button and similar interventions.

We present results from an ethnographic inquiry of technology-based learning at an after-school learning center in Mumbai (India) that caters to students from neighboring slum communities.We conducted participant observation for 120 hours and 58 semi-structured interviews with different stakeholders (including teachers, staff, parents, and students) at the center over nine weeks from December 2015 to July 2016. Taking an assets-based approach in an underserved context, we uncover the role of care as a resource and present the rich and varied caring behaviors enacted in this sociotechnical system.We then discuss how care effects a greater sense of ownership, interdependency, and community. Examining the role of aligning values in motivating caring behavior, we conclude with recommendations for supporting, leveraging, and extending care via technology design in an underserved, technology-enhanced learning environment.