Hello
I'm Deepika Yadav
and I'm presenting our paper
"should I visit the clinic": analyzing
whatsapp mediated online health support
for expectant and new mothers
in rural India
transition to pregnancy
and parenthood brings
overwhelming changes
which significantly increases
the support needs
this phase
can become even more
challenging when there are barriers from
the infrastructure or society
talking about the resource constraints settings
such as rural india
the basic access to healthcare is difficult
because of the high overload of patients in
public health facilities
one consultation visit
with the doctor
lasts less than five minutes
this leaves little scope
to understand
and meet the needs of expectant
and new mothers
In this setup of healthcare
the recently increased
ownership of smartphone
by women in rural India
opens new opportunities
to think of
designing alternative
support mechanisms for them.
In this study
we analyze one such initiative
being run by an NGO
in north India
which is using WhatsApp
to design and provide digital support groups
in the Haryana state.
So, this organization
is providing
stage based guidance to
improve awareness on the importance of
first thousand days
and they have created multiple Whatsapp groups
where they share educational material
and interact with the group members
since the project started in 2019
they have reached out to
more than 3000 families
and their team comprise
8 to 10 moderators
where one of them is a senior pediatrician
we analyzed three such groups
two groups of pregnant women
and one group of mothers with newborns
we qualitatively examined
their conversations
and also applied social support theory lens
I would like to highlight here that
our work contributes the intersection of
social support theory, HCI, and maternal health
which is an understudied area
in the sense that
there is little empirical understanding
that if support mechanisms are available
for women in such settings
where they can freely access to
professionals and peers then what form of social support will be provided,
sought
or may be missed
In our data, the most frequent form of support seeking
was informational support
and here it was mainly about
consultation seeking
on health problems
within this, our analysis about the
role of digital support groups
observed three kinds of themes
the first, is the ease of access to professionals through Whatsapp
acted as a convenient first point of help
their day to day anxieties
and and they could seek help in identifying symptoms and danger signs
this is important given that
previous studies have reported that women
delay care seeking more than men and they may not have the resources or
the agency to move out of the house immediately
the second theme was related to the use of group to compensate for ongoing treatments
uh one of the most frequent conversation in this category was
related to the uhh sharing of
ultrasound scan reports test reports and asking for interpretation
and this pointed towards the barrier
that arise in navigating health care because of
the high use of technical jargons
and English language which is not the language for all
and contrary to some prior studies we also observed some group members who actively
asked the explicit explanation of the technical parameter of these reports
the third theme is related to the educational support
periodic discussion and updates of health parameters
such as body mass index, hemoglobin levels,
led to active participation of women in
these groups and they could also use the group to track their health and health of the baby
and development of the baby.
the second form of social support which is emotional support
was very less in these groups
the presence of the doctor was the major attraction for the group members and
everyone wanted to ask their query from the moderators or the doctor
and this points to the potential factors
that might have affected the expression for emotional support
one of them could be the moderation of these groups
we tried to analyze this to some extent
by comparing two groups
at two different duration
in one of the groups
uh the doctor played the main role in
initiating conversations
around uh subjective topics
for example how do you feel during pregnancy
but here the conversation
was mainly one to one
and group members replied to the doctor's question
instead of having a discussion among themselves
and let the other female moderators encourage the group members to discuss among themselves and this
led to slightly higher number of peer-to-peer exchanges but still overall it was less
and we also observed a missed opportunity related to moderation here
it is related to the topic and the environment that was created in these groups mainly
the focus was on fetus infants and their health rather than mother and her aspirations the second
factor would be the tool itself because uh the ngo used whatsapp to design digital support groups
the features were not supportive for example the privacy is not safeguarded the phone numbers are
revealed to everyone and and there is only one channel for communication with peers and doctors
finally in the discussion section we discuss about the potential opportunities
to supplement traditional health care from the design of alternative support mechanisms
around certain themes such as measures for expediency
these kinds of services enable users to interact with experts in a lightweight fashion with little
or no overhead and this is useful given that scarcity of resources and professional is a
known problem in healthcare all around the world and people might not have immediate access due to
various constraints we also discuss about how can we extend the scope for providing clinical health
in these groups we observed that the moderators did not shy away from participating
uh in discussing the clinical cases that the group members brought though on one hand it also um
poses the ethical risk but they allow the group members to call them and seek help
and this aligns well with hughes argument who analyzes online consultation forums and says that
redirecting patients to see their doctor might not be the best strategy and it then uh points
to think about the relationship between providers and patient and perhaps we can think about
enhancing this provided to patient coupling to involve a broader set of providers for instance
if there is a prescription given by a physician then it can be authentically used by another
professional for explanation purpose a use that we frequently observe in our groups
finally in the end we discuss about the trade-off that arises uh by taking a non-uh unplatform
design approach that gives the benefit of reaching out to people in their familiar digital spaces
versus using a bespoke application which risks the adoption rate thank you very
much i would like you to read our paper for further insights i'm happy to take questions