Sammendrag
Digital solutions play an increasingly central role in promoting and delivering healthcare in low- and middle income countries (LMICs), but such digital interventions have a high failure rate. Parts of the reason, many argue, is related to limited user involvement during design of eHealth solutions. Although user involvement is claimed by many to be important in securing usable and relevant software solutions, the practitioners who design and implement these systems in LMICs, referred to as eHealth designers, face a range of multi-layered and complex challenges to involve the users. Existing literature identifies some main challenges of involving users in LMICs; lack of resources, limited IT literacy, significantly skewed power relationships and lack of cultural appropriateness of conventional means to involve users. However opportunities to better involve users in LMICs have most often been explored from the perspective of foreign researchers than from the local eHealth designers that work in these contexts on a daily basis. The thesis explores the question: Which opportunities do eHealth designers in LMICs see for better involvement of healthcare workers during design of eHealth solutions? Based on a qualitative study probing experiences and future speculations from the perspective of 37 eHealth designers in 7 African countries, the following opportunities for better user involvement are identified: role play, instant messaging group, visual means, design thinking, prototyping with generic software, peer-driven user involvement, effective stakeholder feedback mechanisms and improved organizing of projects. The identified opportunities have in common that they have a combination of cost efficiency, appropriateness to context and focus on attaining quality. In addition to the perspectives of eHealth designers in LMICs on opportunities for better user involvement, this master thesis contributes to existing knowledge about user involvement in LMICs, by presenting a definition of frugal user involvement which can guide both eHealth designers and researchers to cope with multiple layers of complex challenges to involve users and identifying viable means for affordable quality user involvement in LMICs.
Keywords: user involvement, design methods, ICT for development, eHealth design, healthcare workers