S. Revi Sterling

Considering failure: eight years of ITID research

This paper examines forty articles published in the journal Information Technologies & International Development between 2003 and 2010 in an effort to identify commonalities among projects that failed to meet some or all of their development objectives. We considered whether the selected papers articulated clear development objectives, and whether baseline data was used to inform project design. We then considered two factors associated with how development objectives are implemented: the development perspective (top-down vs. bottom-up), and the project focus (the technology vs. the community). Our goal was not to find fault with our colleagues or their work, rather to advance the debate about the effectiveness of ICTD initiatives at a particularly important point in the history of the discipline. We conclude that top-down, technology-centric, goal-diffuse approaches to ICTD contribute to unsatisfactory development results. Careful consideration of development objectives, perspective and focus is essential in all phases of an ICTD project, from design to deployment. Honest and comprehensive reporting of failure (and success) helps ICTD researchers and practitioners focus on best practices in meeting critical development needs.

Constructing informed consent in ICT4D research

The field of Information and Communication Technology for Development includes participatory and action research pilots with a research and change agenda. Such ICT4D research does not fit traditional models for evaluating community risk and benefit. Looking at the history of informed consent and international development, uses of informed consent in development scenarios, and at efforts specific to ICTD research, we present how informed consent is currently addressed, as well as the inadequacy of adapting present academic informed consent models to development. Informed consent in ICT4D research provides academic rigor to the field, helps establish a fair, moral and candid relationship with the community to set expectations, and standards for other intervention-based research efforts. We suggest practical recommendations for models that contribute to community involvement and trust, while offering the target community an opportunity to negotiate their level of participation.

Advancement through interactive radio

This paper describes the rationale, design and implementation of a system for increasing the status women in developing communities. AIR (Advancement through Interactive Radio) gives female community radio listeners a voice with which to respond to programming and to create programming content. We first describe the cost of excluding women from Information and Communication Technologies (ICT) for development, and explore how community radio represents an opportunity for inclusion. We draw upon feasibility studies and site visits in Southeast Kenya to support the introduction of a mechanism that enables women to “talk back” to the community radio station. Using the principles of Participatory Action Research (PAR), we argue that women will be more likely to benefit from technology-mediated opportunities for development if they themselves produce information that contributes to their advancement, rather than simply consuming information provided by others. Finally, we describe the design and implementation of simple communications device that supports this model for use in communities that are, and will remain for some time, off the electrical and cellular grid. This hand-held device enables women to record voice feedback and news for community radio. This feedback is then routed asynchronously back to the radio station through a probabilistic, delay-tolerant network, where the feedback can inform subsequent broadcasts and facilitate additional discussion. We conclude with a technical summary of the AIR prototype.

The design and implementation of the PartoPen maternal health monitoring system

The World Health Organization advocates the paper partograph as the single most effective tool for monitoring labor and reducing labor complications in developing countries. Used correctly, the partograph can serve as a tool for early detection of serious maternal and fetal complications during labor, allowing sufficient time for an appropriate response. However, in order to be effective, the partograph must be used correctly. Recent studies in Kenya reported that less than one fourth of partographs were completed in accordance with WHO guidelines. In developing countries, lack of training and continuing education, exacerbated by limited resources, represents a serious barrier to effective partograph use. The goal of the PartoPen project is to increase the effectiveness of the partograph using an interactive digital pen with custom software, together with partograph forms printed with a background dot pattern that is recognized by the pen. This paper describes the design and implementation of the PartoPen system, and the technical evolution of the PartoPen system during studies that evaluated the PartoPen in use in Nairobi, Kenya from June 2012 -- August 2012.

Improving Maternal Labor Monitoring in Kenya Using Digital Pen Technology: A User Evaluation

Paper-based systems for monitoring maternal labor have been shown to reduce life-threatening complications in low-resource environments; however, significant barriers exist to the use of these tools in developing countries. This paper presents the PartoPen - a digital pen system that enhances a common labormonitoring form known as the partograph. The PartoPen system provides real-time data feedback and reinforces birth attendant training, while retaining the paper-and-pen interface currently used by most healthcare workers. In this paper, the results from a preliminary user evaluation of the system in a Kenyan hospital are described. The qualitative results collected in this study indicate that the PartoPen system is easy to use, and addresses many of the current barriers facing effective partograph use in developing countries.

The PartoPen in practice: evaluating the impact of digital pen technology on maternal health in Kenya

This paper critically examines the use of digital pen technology at two key points in the healthcare system in Kenya: nursing student training and patient care in public labor wards. The PartoPen system -- a digital pen software designed to enhance the paper labor monitoring tool known as the partograph -- was evaluated with 95 nursing students at the University of Nairobi (UoN), and with 50 nurses in the labor ward at Kenyatta National Hospital (KNH). Students using the PartoPen had significantly higher scores on partograph worksheets than students using a silent PartoPen, especially on challenging and high-risk labor cases and on difficult sections of the partograph. In the maternity ward study, nurses unanimously reported positive improvements in the number of partographs they were able to complete, but these qualitative responses were not supported by the quantitative data. We discuss the results of both studies, and what these results suggest about the potential value of the PartoPen at different levels of the healthcare delivery and training hierarchy.

A connective massive open online course for K-12 science, technology, engineering, and mathematics teachers in New Mexico Pueblo schools

This note describes preliminary work directed toward developing a teacher-training project that is intended to increase Science, Technology, Engineering, and Mathematics (STEM) proficiency among elementary and high school teachers in Northern New Mexico Pueblo schools. This project builds upon prior work that trained K-8 teachers to use investigative teaching, which in turn had a significant positive impact on the math and science proficiency of Native-American and Hispanic students. The current project seeks to use Massive Open Online Course (MOOC) technology to capture and scale this professional development through the use of video, imagery, and community building in order to integrate Native-American learning processes. The overall objective is to enable Pueblo teachers to more effectively teach STEM subject matter, as measured by an increase in both teacher and student content knowledge scores. If successful, the use of MOOC technology should facilitate rapid expansion of the program across New Mexico and elsewhere.

Designing for trauma: the roles of ICTD in combating violence against women (VAW)

It is a development axiom that womens empowerment is a critical key to successful, sustainable development. While great strides have been made in recognizing womens needs, both as participants and beneficiaries of development efforts, Violence against Women (VAW) continues to rob women of the agency and opportunity that empowerment strategies aim to offer. Information and Communication Technology for Development (ICTD) interventions have been adopted as mechanisms to support VAW prevention, protection at the point of violence, and post-VAW treatment. This short paper explores these efforts from both a survey and critical lens.

Improving Partograph Training and Use in Kenya Using the Partopen Digital Pen System

This paper presents the findings from two studies of the PartoPen system – a digital pen software application that enhances the partograph, a paper-based labor-monitoring tool used in developing regions. Previous studies have shown that correct use of the partograph significantly reduces pregnancy complications; however, partographs are not always correctly completed due to resource and training challenges. The PartoPen addresses these challenges by providing real-time decision support, instructions, and patient-specific reminders. The preliminary studies described in this paper examine how the PartoPen system affects classroom-based partograph training among nursing students at the University of Nairobi, and partograph completion in labor theater use by nurse midwives at Kenyatta National Hospital in Nairobi, Kenya. Initial results indicate that using the PartoPen system enhances student performance on partograph worksheets, and that use of the PartoPen system in labor wards positively affects partograph completion rates and nurses’ level of expertise using the partograph form.

Using Digital Pens for Maternal Labor Monitoring: Evaluating the PartoPen in Kenya

The goal of the PartoPen system is to enhance the partograph, a paper-based labor monitoring tool intended to promote timely delivery of quality care by birth attendants in developing countries. The PartoPen digital system provides audio instructions for measuring and recording labor progress indicators, real-time decision support based on recorded measurements, and time-based patient-specific reminders. Previous studies of the PartoPen system showed improved partograph completion rates among students in nursing classrooms at the University of Nairobi (UoN) in Kenya. This paper presents the results of two continuation studies conducted in the maternity ward of Kenyatta National Hospital (KNH) in Nairobi. In this paper we identify and discuss the interrelated factors impacting PartoPen adoption and use in the labor ward at KNH, and review the challenges and opportunities likely to face digital pen deployments in other healthcare settings.