Reimagining Wearable-Based Digital Contact Tracing: Insights from Kenya and Côte d’Ivoire

Research Background and Issues

• Identified Problems or Challenges: Studies have shown that digital contact tracing tools (DCT) have been extensively researched and applied as a means to control the spread of infectious diseases in Western contexts. However, their applicability and related applications in Africa remain underexplored. Major barriers to deploying these technologies in Africa, particularly in low- and middle-income countries (LMICs), include low smartphone penetration rates, socio-economic and cultural differences, and distrust of privacy and technology.
• Importance of the Issue: The African region urgently requires effective disease surveillance technologies to prevent and control the spread of epidemics due to its fragile healthcare systems, high population growth, and significant health threats posed by infectious diseases such as tuberculosis, Ebola, and cholera.
• Research Motivation and Related Work: Most existing DCT designs are based on Western contexts, referred to as "WEIRD" (Western, Educated, Industrialized, Rich, Democratic) samples, which overlook the unique cultural and economic contexts of Africa and LMICs. The research motivation stems from this background, aiming to develop wearable DCT solutions tailored to Africa's actual needs through technological exploration and participatory design.

Solution

• Proposed Method or Solution: The research team developed an ultra-wideband long-range sensing system called the "Wearable Proximity Platform (WPP)" and conducted field tests in Kenya and Côte d'Ivoire as a technological probe. They combined semi-structured interviews and participatory design workshops to gather local users' needs and suggestions for wearable DCT.
• Innovative Aspects of the Solution:
  • Combining technological probes with participatory design methods to collect authentic user needs.
  • Focusing on cultural and social acceptance by designing wearable devices resembling traditional African jewelry.
  • Optimizing the design to prioritize reliability and functionality, recognizing users' low sensitivity to privacy concerns.
• Implementation Steps and Key Technologies:
  1. Technology Development: Developing precise sensing devices based on ultra-wideband (UWB) technology.
  2. Field Testing: Conducting user trials in healthcare and rural communities in Kenya and Côte d'Ivoire.
  3. User Feedback Collection: Gathering insights on device form, functionality, and acceptance through interviews and design workshops.
  4. Iterative Design: Developing portable, durable, affordable, and culturally sensitive DCT devices based on user suggestions.

Research Outcomes

• Specific Findings:
  • Users preferred wearable DCT devices that are portable, easy to use, and do not interfere with daily activities.
  • Design recommendations included concealed wearable devices, traditional jewelry-style devices, and enhanced durability and battery life to suit rural environments.
  • Identified major social barriers, such as misunderstandings about technology and diseases, cultural and religious beliefs, and economic constraints.
  • Proposed educational outreach strategies (leveraging community health workers and volunteers to build trust) were found to be more effective in promoting technology adoption than government mandates or financial incentives.
• Advantages Compared to Existing Solutions:
  • Compared to smartphone-based applications designed for Western contexts, this solution is better suited to the realities of African regions, particularly addressing low smartphone ownership and network connectivity limitations.
  • Device design emphasizes cultural and social acceptability, such as using traditional styles and concealed designs to avoid social stigma associated with wearing the device.
• Experimental or Evaluation Results:
  • Most users expressed willingness to adopt the device but emphasized the need for further education and awareness campaigns, as well as more reliable technical support for rural areas.
  • Users clearly prioritized the reliability, durability, and affordability of DCT devices over privacy concerns.
• Limitations and Future Directions:
  • Limitations: The study was conducted only in Kenya and Côte d'Ivoire, and the results may not represent other African regions; network connectivity issues in rural areas remain unresolved; using technological probes may limit users' imagination of other technologies.
  • Future Directions:
    • Conduct similar studies across broader African regions to validate the generalizability of the findings.
    • Further optimize device design, such as introducing solar charging or long-range wireless connectivity technologies (e.g., LoRa) to address power and connectivity issues in rural areas.
    • Integrate policy-making and public education to promote DCT technology while strengthening collaboration with local communities to avoid "helicopter research."

The study provides important insights for designing DCT solutions suitable for Africa and sets a model for developing similar technologies in other low- and middle-income countries.