Dakter Bari: Introducing Intermediary to Ensure Healthcare Services to Extremely Impoverished People

Bangladesh (a low-income country) has a significant number of people dependent on alms for daily survival. These people, who we address as extremely impoverished people (EIP) are deprived of even basic healthcare. Their extreme levels of poverty, coupled with low literacy skills, and complete lack of access to technology means that they are unaware of existing low-cost/free healthcare services (as arranged by local hospitals) available for EIPs. In this paper, we address this gap by means of a carefully-crafted solution, Dakter Bari (a term in Bengali that translates to "Doctor's Home'' in English), that is contextually tailored to enable healthcare access to impoverished people. Extracting critical insights from our field study with (N=70) EIPs, we create a pathway for availing lower-cost healthcare solutions using intermediaries for information dissemination. These intermediaries are small businesses that impoverished people visit often. We also conduct field studies with (N=71) intermediary partners and (N=10) hospitals to identify challenges and realities of such intermediary-based solutions. Based on our findings, we design, iteratively develop, deploy, and user-test our system in real cases and collect feedback from related stakeholders. Preliminary analysis on usage of our system (deployed at intermediaries) revealed 255 healthcare requests made by EIPs via our system in six months. We connect our finding to the broader interests of CSCW around contextualized intermediation, inclusive healthcare, and sustainability of deployed systems.