ICT Intervention for Empowerment of Maternal Healthcare in Assam

in collaboration with IBM Research, New Delhi
& Embedded Interactions Lab, IIT Guwahati
DD 312 Systems Approach to Design
Mannu Amrit / 523
Minal Jain / 526
Project guide: Keyur Sorathia
Course Instructor: Abinash Kumar Swain

* Project started as Design Project 1 (DD 301) in
August ‘12
* Project Collaboration with IBM Research in
October ‘12
* Carried forwad as Design Project 2 (DD312) in
January ’13
1

MMR (Assam) - highest in country
Research analysis done using afﬁnity & 6 use cases prepared.
2 publications in international conferences.
480
MMR - ratio of number of maternal deaths
per 100,000 live births (India)254 1
2 sub-centres (SC), 1 Anganwadi centre,1 primary health centre
(PHC),1 civil hospital & 1 community health centre (CHC) visited &
observed.
12 one-to-one on-ﬁeld interviews conducted with ASHA members,
ANMs, PW & doctors at PHC.
PROJECT HISTORY dd 312 / end semester presentation / wednesday / 17th april 2013

Why are we doing this? Will gesture based systems help those
who can’t read / write? How will user accept and perceive gestural
user interfaces as a communication modality?
2

2Explore use of gesture based interaction using Kinect
combined with Spoken Web technology of IBM in the context
of maternal healthcare in rural Assam.
Propose methodology to determine appropriate gestures for the
proposed system
Conduct an experiment based on gestural interaction with low
literate users. Analyze and take inferences.
Finalize content for proposed system / installation and functions of
system. Validate content with certiﬁed doctors.
PROJECT OBJECTIVES dd 312 / end semester presentation / wednesday / 17th april 2013

The process - the steps involved. Problem Solving techniques. User Centred Design.
3

3
Deﬁne
Process
Literature
Research
Gesture
Documentation
Research
Experiment
Observation
&Analysis
Results&
Conclusion
PROJECT METHODOLOGY dd 312 / end semester presentation / wednesday / 17th april 2013

What’s been done. Learning the terminology. Exploration
of possibilities. Paper presentations.
4

4
12+ papers analyzed, studied & presented to team in form of
powerpoint presentations. Each session followed by brainstorming
with respect to our project.
Topics included Social acceptance of Gestural Interfaces, teaching
natural user interaction, Free-Hand Gestures for Music Playback,
Deriving Gestures with a User-Centred Process etc
LITERATURE RESEARCH dd 312 / end semester presentation / wednesday / 17th april 2013
Biweekly research paper presentations to discuss existing
techniques and methods.

4A critical appriasal of literature study suggest that gesture user
interfaces have not been proposed and explored in developing
regions with low literate, low socio-economic rural audience.
Based on literature review, a design process is proposed for
identiﬁcation of gestures.
Gesture documentation identiﬁed through literature study.
a
b
c

Deﬁne sequence of identifying gestures for a low literate
target audience
5

4Identify right functions (e.g. stop, play, pause etc.)
Explain each functionality in detail to have a clear understanding
of the function.
e.g. skip: it will be used to skip contents on sub modules
Find the gestures that represent functions found in step a.
Preparation: Pre Study, During Study, Post Study
Prepare space, video camera, projector & a scenario video (to be presented to
the users, e.g. a small video & stop function is tested)
Complete task must be recorded - voice recording of the researcher explaining
the tasks, users performing the tasks and post performance questions
Explain user a scenario and ask them to perform gestures for a speciﬁc function
Use video recording and written notes for documentation of performed gestures
DEFINE PROCESS dd 312 / end semester presentation / wednesday / 17th april 2013
a
b

4
c Analysis of user testing - deﬁne gesture vocabulory
Extract commonly used gestures and note how consistently users
use them. Understand whether those are static or dynamic gestures
Evaluate possible and potential gestures with team of doctors
This study will help us identify gestures that can be potentially performed by
PW from different trimesters.

4
d Test the gesture vocabulary
Guess the function
Give users a list of functions.
Prepare a set of videos explaining each function through a gesture
Present the gestures and ask the person to guess the functions
Score = errors divided by number of gestures
Stress
Identify right sequence of gestures*
Identify how many times this sequence has to be performed*
The user must perform the sequence X times, where X times the size of gesture
vocabulary equals 200. Note down other observations during the study.
E.g. User was stressed due to a speciﬁc gesture

4
d Test the gesture vocabulary
Social acceptance
10 sec. video of each gesture will be showcased to participants.
They will be asked two questions: an open question (Q1) and a six-point scale
data question (Q2)
Q1- What would you think if you saw someone else performing this gesture
(for example, when walking down the street)? Participants will be asked to
give 2-3 keyword answer for every gesture and then ﬁll Q2
Q2- How would you feel performing this gesture in public space? The Likert
scale ranged from 1 (Embarrassed) to 6 (Comfortable) will be given to them.
This scale will give us insights on the social acceptance of the gestures

Find
gestures
Identify
functions
Deﬁne
Vocabulory
Test
Vocabulory
Memory
Stress
SocialAcceptance
4

Documentation of all possible commonly performed / used gestures in the Indian context
Overview of possible 3D gestures, which can be implemented in gestural user interfaces
for variety of purposes
6

63D Gesture Documentation is an attempt to provide an
overview of possible 3D gestures, which can be implemented
in gestural user interfaces for a variety of purposes.
It also highlights the possible functionality associated with it.
GESTURE DOCUMENTATION dd 312 / end semester presentation / wednesday / 17th april 2013
It is gathered from existing literature and initial research activity
(ongoing) on identiﬁcation of appropriate gestures for social
acceptance.

In collaboration with
Speach Based and Pervasive Interaction Group
Tampere Unit for Computer Human Interaction
University of Tampere, Finland
7

1. Female Literate
2. Female Low Literate
3. Female Old Literate
4. Female Old Low Literate
5. Male Literate
6. Male Low Literate
7. Male Old Literate
8. Male Old Low Literate
Literate: 10th + years of schooling
Old: above 35 years of age
Total Users - 25
6
RESEARCH EXPERIMENT dd 312 / end semester presentation / wednesday / 17th april 2013

EXPERIMENT SETUP
User Observational Study

6
RESEARCH EXPERIMENT dd 312 / end semester presentation / wednesday / 17th april 2013
After each task, users were asked to ﬁll in the NASA TLX system
evaluation form.
Parameters - Mental Load , Temporal Load, Physical Load,
Performance, Effort, Frustration
After completing both the tasks and their NASA TLX evaluations,
users were asked to answer three interview questions:
a. Of the two selection methods, which one did they prefer and why?
b. Give one positive feedback and one negative feedback about their
interaction with the system.
c. If they would be open to using such a system in the future.

Qualitative + Quantitative. NASA TLX Evaluation technique.
In depth observations.
7

7
OBSERVATION & ANALYSIS dd 312 / end semester presentation / wednesday / 17th april 2013
The above shows the mean and standard deviation for all the parameters.
It is observed that the values of mean and standard deviation are found
quite close.
Using T-test, p-value for comparison between pointing and touching for all
the users is - 0.27194

7

7
A few low literate users mistook the content / system as being able
to take their x-rays or see inside of them.
Users easily believed that the system is more capable than it actually is and
somewhat trust it blindly.
A few users (literate and low literate) greeted the lady character in
the introductory video with their arms folded saying Namaste after she
greets them similarly.
Users treated the lady persona (ASHA) as a real human.
Personas can thus be used to create characters speciﬁc to information required
from users. For ex, a nurse who asks symptoms
a
b

7
Some users expected the system to understand their speech.
They explained their discomforts verbally like pain in the shoulders.
Possibility to use multimodal systems
A lot of the users would keep touching the relevant body part even after
the video started playing.
Gesture needs to be more accurate, speciﬁc & exact.
Users felt that doing anything would trigger ‘something’ from the system.
For 1 user, it was observed that her dupatta was tracked by the
Kinect if her hand was in front of her body. This caused the system to
take in a skewed skeleton and affect her interaction with the system.
Cultural constraints: duppatas and saris effect the user skeleton the data the
application receives
c
e
d

7
For Touching, users were not able to relate to the Human shadow
on the screen (even after the exercise session), and thus it seems
that users' felt there was immediate feedback only for pointing
(hand cursor on the screen).
This is interesting because for the exercise session they were able to relate
to the shadow. Also, with users so new to such a gesture based system,
it seems that users found this mapping difﬁcult to recall.
f

7
Language translation and explanation of parameters of NASA
TLX method was found very difficult. Researchers had difficulty in
explaining various "demands" in local language Assamese/Hindi, due
to which it was difficult for users to understand and answer difference
between "demands".
Application of NASA TLX for low literate users extremely challenging
specially when moderator is not familiar with local language.
g

What does all this mean? Where are we heading to?
8

8
RESULTS & CONCLUSION dd 312 / end semester presentation / wednesday / 17th april 2013
Although quantitative results show no clear distinction between
pointing and touching, qualititative analysis throws light upon
factors that might have influenced the study.
Process defined for gesture identification revised and improvised
based on findings and results in the study.
Research Paper being written to be submitted for the 17th ACM
Conference on Computer Supported Cooperative Work and Social
Computing (CSCW 2014)

We’d also like to thank
(Denny, Muckti, Fabin) - Project Staff, EI Lab , (Saurabh & Nitendra Sir) - IBM Research, New Delhi
Sumita Mam (University of Tampere, Finland), Poly Mam, Shreya ( B.Tech 1st year) & all participants
who patiently tolerated us as we tried experimenting NASA TLX with them.

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