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The Invisible Work of Maintenance in Community Health: Challenges and Opportunities for Digital Health to Support Frontline Health Workers in Karnataka, South India

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journal contribution
posted on 2021-03-12, 16:34 authored by Nervo Verdezoto, Naveen Bagalkot, Syeda Zainab Akbar, Swati Sharma, Nicola Mackintosh, Paula Griffiths, Padmini Ray Murray, Deidre Harrington
Frontline health workers are the first and often the only access point to basic health care services in low-andmiddle
income countries. However, the work and the issues frontline health workers face are often invisible to
the healthcare system, with limited resources to assist them. This study explores the work practices, challenges
and roles of frontline health workers in community health with particular focus on pregnancy care in South
India. Drawing on the notion of maintenance and articulation work, we describe the maintenance work of
frontline health workers maintaining, anticipating, reconciling, and supporting care infrastructures beyond
data collection practices. Our findings highlight how socio-cultural practices, perceptions, status, and existing
systems influence maintenance work practices. Based on our findings, we suggest moving beyond the focus on
training and performance to design CSCW tools to support the maintenance work of frontline health workers
as ‘system-builders’ to make healthcare infrastructures work in community health.



Proc. ACM Hum.-Comput. Interact. 5, CSCW1, Article 91 (April 2021), 30 pages.

Author affiliation

SAPPHIRE Group, Department of Health Sciences


  • AM (Accepted Manuscript)

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Proceedings of the ACM on Human-Computer Interaction, CSCW1


Association for Computing Machinery (ACM)



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