While chronic disease afflicts a large Indian population, the technologies used to manage chronic diseases have largely been informed by studies conducted in other sociocultural contexts. To address this gap, we conducted qualitative interviews with 21 patients clinically diagnosed with abnormal blood pressure (BP) living in low-resourced communities of Haryana, Uttarakhand and Uttar Pradesh in India. We found that patients’ trust in the BP ecosystem and social ties plays a significant role in shaping their perceptions of technology and chronic care. Trust in one actor of the ecosystem fosters trust in another, e.g., trust in BP reading depended on the type of device and the person measuring the BP. We also observed nuanced sharing and intermediation of BP devices. Based on our findings, we recommend designs to boost patients’ trust, familiarity, and access to technologies used in BP management and improve their experience of care in low-resource settings in India.

India has been witnessing a steady increase in smartphone penetration since 2016 after Reliance Jio introduced inexpensive internet plans. Much of HCI research in the Global South has been conducted before smartphones became more widespread. More recent work on smartphone use in India has been either domain-focused or studied specific features. In this work, we investigate how emergent users from low-income communities in India currently use their smartphones, and what they use them for. We draw on semi-structured interviews with emergent smartphone users across rural and urban India demonstrating their experiences and challenges related to low- textual and digital literacy, infrastructure, privacy, and motivations of use. Our findings revealed that while there is a lack of understanding of basic features such as accounts and passwords, there is sophisticated use spanning user-generated media, remote education, skilling, etc. We close with recommendations for future research and design for emergent smartphone users.

Many designers and artists in India, because of limited domestic patronage, are interested in international opportunities. However, they experience difficulties in discovering such opportunities. Finding relevant grants, funds, residencies, jobs, and collaborators takes significant time and effort. Typically, this is best done via a human matchmaker - someone who knows of opportunities and makes introductions. However, this person might be limited by their own social circles and knowledge. The few websites available are usually intimidating and not personalized. Our vision is to design and develop Dara, a conversational chatbot that asks a series of questions to its users and is able to suggest relevant opportunities. As a first step we built a Wizard-of-Oz prototype and interviewed 9 users about their experience. We then designed the personality, conversation flow and referral nomination system for our next-level prototype. We conducted a preliminary evaluation with 14 users in Bangalore, India. We discuss the implications for design of chatbots targeted at the creative community in the developing world.

While researchers have studied the benefits and hazards of crowdsourcing for diverse classes of workers, most work has focused on those having high familiarity with both computers and English. We explore whether paid crowdsourcing can be inclusive of individuals in rural India, who are relatively new to digital devices and literate mainly in local languages. We built an Android application to measure the accuracy with which participants can digitize handwritten Marathi/Hindi words. The tasks were based on the real-world need for digitizing handwritten Devanagari script documents. Results from a two-week, mixed-methods study show that participants achieved 96.7% accuracy in digitizing handwritten words on low-end smartphones. A crowdsourcing platform that employs these users performs comparably to a professional transcription firm. Participants showed overwhelming enthusiasm for completing tasks, so much so that we recommend imposing limits to prevent overuse of the application. We discuss the implications of these results for crowdsourcing in low-resource areas.

Visually impaired people (VIPs) face significant usability and privacy challenges using digital finance technologies. In this paper, we focus on investigating these challenges in the context of Automated Teller Machines (ATMs) in India. To find out the accessibility status of ATMs across India, we first reach out to public banks, and then conduct in-person field surveys and an online crowd sourcing survey of 107 ATM machines across 4 cities in India. We find that less than 18% of surveyed machines are accessible, and follow up with 22 interviews with VIPs regarding challenges using ATMs. Based on insights, we design PocketATM: a system that enables VIPs to use ATMs using their own smartphones - a user can pre-authorize a cash withdrawal using a phone application, then go to any nearby ATM to receive the pre-authorized amount. Our usability evaluation with 19 VIPs demonstrates that PocketATM is usable, practical, and could be embraced by VIPs in India.

In rural parts of the developing world, spreading awareness about critical issues in health, governance, and other topics is challenging and costly. Traditional media such as print, radio and TV each have limitations and offer little guarantee that new information is absorbed or retained by the target population. This paper describes Learn2Earn, a system that leverages mobile payments to bolster public awareness campaigns in rural India. Users call an Interactive Voice Response (IVR) system, listen to a brief audio tutorial, and take a multiple-choice quiz to check their understanding. People who pass the quiz receive a mobile top-up (about $0.14) and have the opportunity to earn additional credits by referring others to the system. We describe a pilot deployment of Learn2Earn in rural India that spread via word-of-mouth to over 15,000 people within seven weeks. Usage was concentrated among young men, many of them students. In a mixed-methods study, we draw upon call logs, electronic surveys, qualitative interviews, and other sources of data to suggest that Learn2Earn could be an effective way to build awareness about important topics.

With the wide penetration of mobile internet, social networking (SN) systems are becoming increasingly popular in the developing world. However, most SN sites are text heavy, and are therefore unusable by low-literate populations. Here we ask what would an SN application for low-literate users look like and how would it be used? We designed and deployed KrishiPustak, an audio-visual SN mobile application for low-literate farming populations in rural India. Over a four month deployment, 306 farmers registered through the phones of eight agricultural mediators making 514 posts and 180 replies. We conducted interviews with farmers and mediators and analyzed the content to understand system usage and to drive iterative design. The context of mediated use and agricultural framing had a powerful impact on system understanding (what it was for) and usage. Overall, KrishiPustak was useful and usable, but none-the-less we identify a number of design recommendations for similar SN systems.

Designing ICT systems for rural users in the developing world is difficult for a variety of reasons ranging from problems with infrastructure to wide differences in user contexts and capabilities. Developing regions may include huge variability in spoken languages, and users are often low- or non-literate, with very little experience interacting with digital technologies. Researchers have explored the use of text-free graphical interfaces as well as speech-based applications to overcome some of the issues related to language and literacy. While there are benefits and drawbacks to each of these approaches, they can be complementary when used together. In this work, we present VideoKheti, a mobile system using speech, graphics, and touch interaction for low-literate farmers in rural India. VideoKheti helps farmers to find and watch agricultural extension videos in their own language and dialect. In this paper, we detail the design and development of VideoKheti and report on a field study with 20 farmers in rural India who were asked to find videos based on a scenario. The results show that farmers could use VideoKheti, but their success still greatly depended on their education level. While participants were enthusiastic about using the system, the multimodal interface did not overcome many obstacles for low-literate users.

One of the greatest challenges in designing applications for economically poor communities is that potential users may have little or no education. We investigated how limited education appears to impact the ability to navigate a hierarchical UI, even when it has no text. We scored 60 participants from low-income communities in India using tests of textual literacy and Raven's Progressive Matrices. These were used as proxies for educational level and a subset of cognitive abilities. We then evaluated participants' performance on a UI task involving hierarchical navigation. First, our results confirm that textual literacy is correlated with scores on the Raven's test. In addition, we found that performance on both instruments are predictive of performance in navigating UI hierarchies, even when the UI is text-free. This provides statistically significant confirmation of previous anecdotal hypotheses. We conclude with design recommendations for UI hierarchies for people with limited education.

Although HCI researchers and practitioners frequently work with groups of people that differ significantly from themselves, little attention has been paid to the effects these differences have on the evaluation of HCI systems. Via 450 interviews in Bangalore, India, we measure participant response bias due to interviewer demand characteristics and the role of social and demographic factors in influencing that bias. We find that respondents are about 2.5x more likely to prefer a technological artifact they believe to be developed by the interviewer, even when the alternative is identical. When the interviewer is a foreign researcher requiring a translator, the bias towards the interviewer's artifact increases to 5x. In fact, the interviewer's artifact is preferred even when it is degraded to be obviously inferior to the alternative. We conclude that participant response bias should receive more attention within the CHI community, especially when designing for underprivileged populations.

While mobile phones have found broad application in bringing health, financial, and other services to the developing world, usability remains a major hurdle for novice and low-literacy populations. In this article, we take two steps to evaluate and improve the usability of mobile interfaces for such users. First, we offer an ethnographic study of the usability barriers facing 90 low-literacy subjects in India, Kenya, the Philippines, and South Africa. Then, via two studies involving over 70 subjects in India, we quantitatively compare the usability of different points in the mobile design space. In addition to text interfaces such as electronic forms, SMS, and USSD, we consider three text-free interfaces: a spoken dialog system, a graphical interface, and a live operator. Our results confirm that textual interfaces are unusable by first-time low-literacy users, and error prone for literate but novice users. In the context of healthcare, we find that a live operator is up to ten times more accurate than text-based interfaces, and can also be cost effective in countries such as India. In the context of mobile banking, we find that task completion is highest with a graphical interface, but those who understand the spoken dialog system can use it more quickly due to their comfort and familiarity with speech. We synthesize our findings into a set of design recommendations.

We present the results of a qualitative study of the sharing and consumption of entertainment media on low-cost mobile phones in urban India, a practice which has evolved into a vibrant, informal socio-technical ecosystem. This wide-ranging phenomenon includes end users, mobile phone shops, and content distributors, and exhibits remarkable ingenuity. Even more impressive is the number of obstacles which have been surmounted in its establishment, from the technical (interface complexity, limited Internet access, viruses), to the broader socioeconomic (cost, language, legality, institutional rules, lack of privacy), all seemingly due to a strong desire to be entertained.

One of the greatest challenges in designing applications for developing communities is that potential users may have limited literacy. Past work in UI design for low-literate users has focused on illiteracy as the inability to read per se, with little recognition to other cognitive differences between literate and non-literate users.

Due to the increasing penetration of mobile phones even into poor communities, mobile payment schemes could bring formal financial services to the "unbanked". However, because poverty for the most part also correlates with low levels of formal education, there are questions as to whether electronic access to complex financial services is enough to bridge the gap, and if so, what sort of UI is best.

We present work that explores whether the asynchronous peer-to-peer communication capabilities of email can be made accessible to illiterate populations in the developing world. Building on metaphors from traditional communication systems such as postal mail, and relevant design principles established by previous research into text-free interfaces, we designed and evaluated a prototype asynchronous communication application built on standard email protocols. We considered different message formats -- text, freeform ink, audio, and video + audio -- and via iterative usage and design sessions, determined that video + audio was the most viable. Design alternatives for authentication processes were also explored. Our prototype was refined over three usability iterations, and the final version evaluated in a two-stage study with 20 illiterate users from an urban slum in Bangalore, India. Our results are mixed: On the one hand, the results show that users can understand the concept of video mail. They were able to successfully complete tasks ranging from account setup to login to viewing and creating mail, but required assistance from an online audio assistant. On the other hand, there were some surprising challenges such as a consistent difficulty understanding the notion of asynchronicity. The latter suggests that more work on the paradigm is required before the benefits of email can be brought to illiterate users.

This paper presents the use of full-context video to motivate and aid non-literate, first-time users of PCs to successfully navigate a computer application with minimal assistance. Following previous work focused on non-literate users, we observed that in spite of our subjects' understanding of the UI mechanics, they experienced barriers beyond illiteracy in interacting with the computer: lack of awareness of what the PC could deliver, fear and mistrust of the technology, and lack of comprehension about how information relevant to them was embedded in the PC. In this paper, we address these challenges with full-context video, which includes dramatizations of how a user might use the application and how relevant information comes to be contained in the computer, in addition to a tutorial of the UI. In experiments conducted with 35 non-literate residents of Bangalore slums, the introduction of full-context video dramatically improved task completion for a job-search task.

We present research leading toward an understanding of the optimal audio-visual representation for illustrating concepts for illiterate and semi-literate users of computers. In our user study, which to our knowledge is the first of its kind, we presented to 200 illiterate subjects each of 13 different health symptoms in one representation randomly selected among the following ten: text, static drawings, staticphotographs, hand-drawn animations, and video, each with and without voice annotation. The goal was to see how comprehensible these representation types were for an illiterate audience. We used a methodology for generating each of the representations tested in a way that fairly stacks one representational type against the others.

We describe work toward the goal of a user interface designed such that even novice, illiterate users require absolutely no intervention from anyone at all to use. Our text-free user interface is based on many hours of ethnographic design conducted in collaboration with a community of illiterate domestic labourers in three Bangalore slums. An ethnographic design process was used to understand what kind of application subjects would be interested in, how they respond to computing technology, and how they react to specific UI elements. We built two applications using these principles, one for job search for domestic labourers, and another for a generic map that could be used for navigating a city. The resulting designs are based on key lessons that we gained through the design process. The paper describes the design process, the design principles which evolved out of the process, the final application design, and results from initial user testing. Our results confirm previous work that emphasizes the need for semi-abstracted graphics and voice feedback, but we additionally find that some aspects of design for illiterate users that have been previously overlooked (such as a consistent help feature). Results also show that the text-free designs are strongly preferred over standard text-based interfaces by the communities which we address, and that they are potentially able to bring even complex computer functions within the reach of users who are unable to read