IEEE Technology and Society Magazine - Spring 2013 - 52

system actually works. Our research
team discovered that within the
country of Kenya itself, there is a
significant variation in the CHWs'
roles, responsibilities, and resources
from region to region. Ethnographic
studies of the CHWs that capture
their resources, needs, constraints,
communication mechanisms, and
operating models can help identify
contextual constraints and keep the
technologies user-centered. Such
studies can themselves be facilitated by cellphones and other technologies. CHWs do not always have
access to the equipment and supplies
stipulated by the government. Studying what tools CHWs have access
to and how they are actually being
used can help uncover opportunities
for innovation. CHWs travel long
distances by foot, bicycle, and public
transportation. Lightweight, portable, and multi-functional designs
would be well received by the CHWs.
Electric power is hard to access and
expensive, making electronic gadgetry less attractive. Affordable
computing technologies and the
growing popularity of cellphones, an
extremely multi-functional device in
developing countries, presents many
opportunities for real-time coordination and data sharing.
The CHWs' toolkit does not
include simple tools that would help
connect CHWs to each other, share
medical information with doctors,
or maintain digital records, transmit
information, or provide basic triaging services. These technologies are
crucial to addressing the logistical
challenges posed by resource-constrained environments. While the
CHW programs have been successful, several inefficiencies need to be
addressed to ensure that the CHWs
are working in tandem with the larger
healthcare system. Sustainable business models and incentive structures
are crucial to empowering CHWs in
the longer term. The power of trust
and social capital in developing communities must be harnessed to ensure
that the CHWs are able to work harmoniously in their communities.
52

Conclusion
Community healthcare workers
play a critical role, and have great
potential for increased involvement
in addressing the health inequities
and the evolving global healthcare
crisis in developing countries. The
operating model and responsibilities
of CHWs are well-defined in some
countries, and yet to be understood
in others. CHWs have access to some
basic equipment and supplies such
as educational materials and simple
medicines, but lack communication
and data collection systems that
would greatly enhance their work.
There is a huge need for technology
and policy interventions to enhance
CHWs' efficiency and effectiveness
in order to amplify their impact.
Our team, with students from medicine, engineering, and business is
now applying ethnographic methodologies to understand the operating
model, challenges, and resources for
CHWs in central Kenya. This article is meant to be a call to action,
to challenge engineers and designers to further investigate the needs
of CHWs in specific contexts, partner with this population, and conceptualize appropriate technology
solutions. The goal is user-centered
devices that are designed for the
context, which can be seamlessly
integrated into the country's healthcare system and function in a sustainable manner.

Author Information
The authors are with the Humanitarian Engineering and Social
Entrepreneurship (HESE) program,
The pennsylvania State University,
University park, pA.

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IEEE TECHNOLOGY AND SOCIETY MAGAZINE

SprING 2013

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Table of Contents for the Digital Edition of IEEE Technology and Society Magazine - Spring 2013