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Joint work with:
Aakar Gupta, Abhishek Sinha, Aditya Vashistha, Andrew Cross, Anoop Saha, Aparna Hegde, Arjun Venkatraman, Ben Colmery, Deepti Chittamuru, Ed Cutrell,
Elisa Tinsley, Jonathan Donner, Manish Bhardwaj, Michael Paik, Niranjan Pai, Nupur Bhatnagar, Pradnya Supe, Pranav Ramkrishnan, Preeti Mudliar, Sandeep Ahuja,
Satish Sangameswaran, Shailesh Kore, Sharon Moshavi, Shelly Batra, Shubhranshu Choudhary, Smita Choudhary, Sridhar Vedantham, Vidya Natampally, Y.S. Nandanwar
Bill ThiesMicrosoft Research India
Impacting Global Health and Human Development via Mobile Technologies
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Microsoft Research India
Photo: Natalie Linnell (courtesy Kentaro Toyama)
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Microsoft Research India
Photo: Natalie Linnell (courtesy Kentaro Toyama)
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Technology for Emerging Markets
Understand existing and potential technology users in developing communities
Design and evaluate technology that contributes to socio-economic development of poor communities
Collaborate with product groups, development-focused organizations, governments and industry for sustained, scaled impact
Photo: Divya Ramachandran
Research Group Goals
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Communications& Sociology
Social Anthropology
Design
Human-ComputerInteraction
ComputerScience
& Engineering
InterdisciplinaryCollaboration
JonathanDonner
Jacki O’Neill
Indrani Medhi
Bill Thies
People Technology
Ed Cutrell(Group Lead)
Kalika Bali
Linguistics
Nakull Gupta
Andrew Cross
MelissaDensmore
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Part 1: Voice Portals for Citizen Reporting
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Literate in English
Non-Literate
Literate in Other
Language
LanguageKnown
Interactive Voice Response: $1B Industry
Voice Remains Primary Interfacefor Mobile Subscribers in India
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Polly: A Viral Voice-Based Game[ICTD’12, DEV’13, CHI 2013 Best Paper, DEV-4]
• That also advertises job opportunities!
• Over 2.5M calls in Pakistan
Agha Ali Raza Roni Rosenfeld
At Carnegie Mellon:
At LUMS, Pakistan: F. Ul Haq, Z. Tariq, M. Pervaiz, S. Razaq, U. Saif
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Chhattisgarh, India
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CGNet Swara:A Voice Portal for Citizen Reporting
with CGNet, United Nations Democracy Fund, Gates Foundation,Hivos Foundation, MIT and the International Center for Journalists
• Anyone can report news, issues, etc. in local language
• Submissions are reviewed by moderators over the Web
• Appropriate submissions are published:– For playback on audio channel
– For browsing on Web
• Activists follow-up on reports
Server
Callers
Moderator
Web Visitors
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Posts per Day(>4,200 total posts)
Calls per Day(>280,000 total calls)
CGNet Swara:A Voice Portal for Citizen Reporting
with CGNet, United Nations Democracy Fund, Gates Foundation,Hivos Foundation, MIT and the International Center for Journalists
0
100
200
300
400
500
Jan-10 Jan-11 Jan-12 Jan-13 Jan-140
5
10
15
Jan-10 Jan-11 Jan-12 Jan-13 Jan-14
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Malaria Deaths in Chhattisgarh:Official Government Figures
0
20
40
60
80
100
CGNet Swara starts
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Malaria Deaths in Chhattisgarh:Official Government Figures
0
20
40
60
80
100
CGNet Swara starts
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Song from 3 days festival in
Odisha where girls only
enjoy and do no work...
“Shilpi from Odisha is telling us about
Raja festival which is celebrated each
year in the month of June. On these
three days girls do not work and make
merry after wearing good clothes and
eating good food. She is singing a song
in Odiya which girls sing on these days
asking them to enjoy the festival.”
http://cgnetswara.org/index.php?id=22097
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Qualitative Evaluationwith Preeti Mudliar and Jonathan Donner
[ICTD 2012, ITID 2013]
Most cited paper of ICTD 2012
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Research Questions: How to Scale?
1. How to moderate content at scale?
2. How to distribute content at low cost?
3. How to search / index content at scale?
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Sangeet Swara:A Community-Moderated Voice Forum
for Songs, Poems, Jokes, & Cultural Content[In Preparation]
Traffic in 1.5 months
• 20,000 calls
• 4,300 posts (by 450 people)
• 110,000 ratings (by 1,320 people)
Quality of Moderation
• Relative to “experts”:
– 98% agreement on categorizing 50 posts
– 98% agreement on gender of 50 posts
– 90% agreement on quality of 10 posts
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Emergent Ownership and Useby the Visually Impaired
“You are like my father, my god, I want to thank you again and again, this small kid wants to respect you from the bottom of the heart. I want to welcome you again and again.”
“I am a blind person so I couldn't get educated. I want to thank you because you enabled all blind persons to get in touch and share. No matter howmuch I praise, it won't be enough.”
“Swara has influenced the country and the world.”
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IVR Junction:Enabling Replication of Voice Forums
IVR Junction
phonecall
Internet
Winner, USAID / Humanity United Tech Challenge for Atrocity Prevention (2013)
Runner-up, Manthan Award (2013)
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Over 30,000 Voices Heard
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Real-Time Monitoring by theBroadcasting Board of Governors
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A Failed Deployment:Parent/Teacher Discussion Forum
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Lesson: Technology Amplifies Human Intent and Capacity; It Doesn’t Substitute for Them
Kentaro ToyamaBoston Review 2010, iConference 2011
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Part 2: mHealth
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“Mobile technology is changing the landscape of health care delivery across the developing world”
“A decade after the start of mHealth … these expectations are far from being met.”
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Mobile Data Collection toCombat Childhood Malnutrition
NordiCHI 2012
Automated Voice Calls for Healthy Behaviors During Pregnancy
ICTD 2013
Using Biometrics forTuberculosis Medication Adherence
Persuasive 2012
Book by Donner and Mecheal Assistive TechnologiesFor Rural Health Workers
in progress
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Extensive Research to Improve Adherence, with Mixed Results
“The study is a review of 38 systematic reviews”
“Although successful adherence interventions do exist, half of interventions seem to fail”
“Non-adherence rates have remained nearly unchanged in the last decades”
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TB Control Strategy in India:Directly Observed Therapy (DOTS)
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Using Biometrics to Strengthen DOTSMicrosoft Research India and Operation ASHA
SMS
Missed Dose
Alert & Follow-upCloud-Based Analytics
5 Indian States
100+ Clinics
7500+ Patients
Manthan Award (2011) – mBillionth Award (2011) – WSJ Innovation Award (2012)
3 Countries
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Impact Assessment
• Two kinds of impact
1. Showcase programs that work well
2. Make programs work better
• In progress: Randomized Controlled Trial (MIT/JPAL)
[Persuasive 2012]
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Lesson: Participant Response Bias can Reverse the Outcome of a Study
[Nicola Dell, CHI 2012]
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Lesson: DOTS is Rarely Possible to Implement Faithfully
Despite large expenditureon DOTS, many barriersto observing every dose:
– Difficult to come to center
– Patients travel / transfer out
– Private treatment unobserved!
Key unsolved problem: check whether patients take drugs without supervision
0
50
100
150
2007 2009 2011 2013
DOTS 50 MDR-TB
Indian gov’t spending ($M)
Src: WHO
Despite large expenditureon DOTS, many barriersto observing every dose:
– Difficult to come to center
– Patients travel / transfer out
– Private treatment unobserved!
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99DOTS: Monitoring Medication Adherence via Mobile Phone
99DOTS enables:
– Targeted reminders, incentives, and follow-ups
– Engagement of patients with 2-way communication
Hand-made prototype (front) Future integrated solutionHand-made prototype (back)
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Pilot Study: Patient AdherenceM
on
th 1
Mo
nth
2Pa
tien
tsPa
tien
ts
Days
Correct response No response
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Deployment Trajectory
World Health Partners (Bihar)
St. John’s Medical (Bangalore)
Innovators In Health (Bihar)
Operation ASHA (Delhi)
John’s Hopkins (Pune)
Swasth India (Mumbai)
Yale / NIMHANS (Bangalore)
BMGF field sites (Gujarat, Mumbai)
Treatment Partnersearly stage - advanced stage
• Winner of the Gates /USAID Grand Challengein TB Control (2013)
• Long-term pilots planned for 2014
• In conversationswith pharmaceuticalcompanies
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Inputmethod
Output method
Typing
Structuredspeech
Free-formspeech
Text Audio Graphics [+ Audio]
flexible
flexibleinflexible
GraphicalUI
Mobile Tools: Design Space
Multi-modal
Live Operator
IVRInteractive
Voice Response
Spoken Dialog
Text-BasedForms, SMS, etc.
[ICTD 2009]
[TOCHI 2011]
[DEV 2013]
[CHI 2013]
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Lesson: Where There’s a Will, There’s a Way[Thomas Smyth, CHI 2010]
Mobile video sharing network
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Conclusions
• Innovative technologies can have a realimpact on global health and development
– But technology itself is not a silver bullet
– Impact comes via capable, sustained deployments
• Lessons learned
– Technology amplifies human intent and capacity
– Participant response bias can reverse the outcome
– Automated is not necessarily cheaper or better
– Where there’s a will there’s a way