Selected Work
Case Studies
Bachat Mitra
Designing a digital savings experience for underserved rural women in India
↗ Informed product strategy for 50K+ potential users across 3 Indian states
Overview
Bachat Mitra — 'Savings Friend' in Hindi — was a digital savings app designed for 10 million+ rural women participating in India's National Rural Livelihood Mission (NRLM) self-help groups. The central research challenge was measuring and building user trust in a digital financial product among semi-literate populations with zero prior internet exposure.
The Challenge
How do you validate a financial product for users who have never used a smartphone, don't trust digital transactions, and operate in areas with minimal internet connectivity? Traditional UX research methods — remote usability tests, web-based surveys, analytics dashboards — were fundamentally inapplicable.
Research Approach
Designed a multi-phase Qualtrics research framework with offline-capable survey instruments using advanced branching logic, Loop & Merge, and embedded data for contextual targeting across three Indian states.
Developed a novel 'Hot Spot' behavioral proxy methodology — rather than asking users if they trusted the app, we observed behavioral micro-signals (screen hesitations, repeated taps, help-seeking patterns) and correlated these with self-reported trust measures.
Built a Trust Composite Index combining four validated scales adapted for low-literacy contexts, validated through multilevel modeling (lme4) that accounted for clustering by village, self-help group, and facilitator.
Ran A/B tests comparing two onboarding flows — one emphasizing government branding (institutional trust) vs. peer endorsement (interpersonal trust) — with 400+ participants across Bihar, Jharkhand, and Uttar Pradesh.
Key Findings
Peer-endorsed onboarding increased task completion by 34% and trust scores by 0.8 SD compared to the government-branded variant.
The behavioral 'Hot Spot' proxy predicted self-reported trust with r = 0.74, validating it as a scalable alternative to lengthy survey batteries.
Village-level clustering explained 28% of variance in trust — the social context of first exposure mattered more than individual digital literacy.
MaxDiff analysis revealed 'knowing someone who uses it' was 3.2x more influential than 'government backing' in driving adoption intent.
Impact & Reflection
The research directly shaped the product's go-to-market strategy: peer-led onboarding was adopted as the default, saving an estimated $2.1M in planned institutional marketing spend. The Trust Composite framework was subsequently adopted by the program's monitoring team for ongoing product validation.
Cultural Ecology of Health
How community health workers navigate biomedical & traditional healing systems in Bihar
↗ Published in Frontiers in Health Services · Advanced WHO guidelines
Overview
This three-manuscript dissertation investigated a central paradox in global health: despite significant national progress, stark subnational disparities in maternal and child health persist. Bihar, India served as the research site. The work developed and applied the Cultural Ecology of Health framework to understand how frontline health workers function as adaptive agents navigating between biomedical and traditional knowledge systems.
The Research Question
How do Accredited Social Health Activists (ASHAs) navigate their dual identity as cultural insiders and biomedical promoters? And how does this navigation influence perinatal health behaviors in communities where traditional birth attendants (Dais) have served for generations?
Methodology
Conducted 12+ months of embedded ethnographic fieldwork across rural Bihar, including in-home observations, contextual interviews, and participant observation in health facilities and traditional healing contexts.
Paper 1 examined how ASHAs' personal maternal health experiences predicted their clients' behaviors through multilevel modeling — revealing 'embodied authority' where personal practice was more persuasive than formal training.
Paper 2 mapped perinatal dietary practices as ecological adaptations rather than 'harmful traditions,' showing how education gradients interacted with cultural beliefs to shape nutritional behaviors.
Paper 3 compared ASHA and Dai roles as complementary adaptive strategies within the same health ecology, using comparative analysis to reveal how communities strategically integrate both systems.
Key Findings
ASHAs who personally adhered to biomedical practices were significantly more likely to have clients adopt those behaviors — authenticity outweighed formal credentials.
Dietary 'restrictions' during pregnancy often reflected sophisticated ecological reasoning about seasonal disease patterns and managing food scarcity.
Communities didn't choose between traditional and biomedical systems — they strategically integrated both based on need and perceived risk.
Health behaviors are emergent properties of dynamic, multilevel interactions between cultural beliefs, social structures, environmental conditions, and lived experience.
Impact & Reflection
Three peer-reviewed publications (two in Frontiers journals). Findings contributed to WHO guideline discussions on community health worker integration and influenced USAID programming on traditional provider engagement. The Cultural Ecology of Health framework is being applied by researchers studying health system pluralism in Sub-Saharan Africa and Southeast Asia.
Male Engagement in Maternal Health
Human-centered design research reshaping how men participate in reproductive health decisions
↗ Core77 Design Award — Social Impact 2023 · Male participation 10% → 65%
Overview
A two-year Gates Foundation-funded design research initiative with Dalberg Design and Project Concern International India. The project challenged a fundamental assumption in global maternal health: that men in rural India are disengaged from reproductive and maternal health decisions. Our ethnographic work revealed the opposite — men were deeply involved, just in ways the health system didn't recognize or leverage.
The Challenge
Maternal health programs treated men as barriers to overcome. But maternal mortality doesn't happen in a vacuum — men control household resources, accompany wives to health touchpoints, and make decisions that directly affect health outcomes. How do you design for a user who refuses to be in the room?
Design Process
Spent months in ethnographic immersion — tea shops, cricket clubs, agricultural meetings — to understand male social dynamics and identify where health conversations could organically happen.
Strategically reframed the conversation: instead of 'reproductive health,' we discussed 'family prosperity.' This linguistic shift made culturally sensitive topics discussable by connecting to men's provider identity.
Moved engagement to male spaces: trained male champions to lead conversations during cricket matches and evening tea gatherings, meeting men where they already were.
Co-designed two intervention prototypes through participatory workshops with couples, health workers, and community leaders. Rapid iteration cycles tested messaging and delivery channels across multiple villages.
Key Outcomes
Male participation in maternal health activities jumped from 10% to 65% across intervention sites.
Joint health decision-making between couples increased by 40%, with measurable improvements in care-seeking behavior.
The reframing strategy proved 2.8x more effective than health-based messaging in engagement metrics.
Two innovative programs are now being explored for digital delivery pathways and scale-up through India's public health system.
Impact & Recognition
Runner-up in the Core77 Design Awards 2023 (Social Impact category). Programs reached 200K+ beneficiaries and contributed to shifts in how India's National Health Mission conceptualizes male engagement. The key design insight: solving problems with culturally sensitive topics requires deep community immersion, strategic reframing, and meeting stakeholders where they are.
ASHA & Dai Navigation
How frontline health workers make critical decisions when two knowledge systems collide
↗ Published in Frontiers in Health Services · Cited in USAID programming
Overview
This study examined what happens at the interface between India's biomedical community health workers (ASHAs) and traditional birth attendants (Dais). Rather than treating this as a conflict to resolve, the research revealed a sophisticated ecosystem of complementary expertise.
The Research Question
India's health system invested $3.6 billion deploying 1 million ASHAs while simultaneously marginalizing Dais — traditional birth attendants who hold deep community trust and centuries of accumulated ecological knowledge about childbirth. How do health workers navigate this dual landscape, and what can their strategies teach us about designing for pluralistic user ecosystems?
Research Approach
Conducted in-depth semi-structured interviews with 45 ASHAs and 30 Dais across rural Bihar, using grounded theory to build an empirical model of how each group conceptualizes their role and expertise boundaries.
Developed a comparative framework mapping the 'ecological logics' each provider system operates within — ASHAs embedded in biomedical institutional logic, Dais in traditional ecological knowledge passed through apprenticeship.
Analyzed community-level decision-making patterns: when families chose ASHAs, when they chose Dais, and critically, when and how they integrated both simultaneously during the same pregnancy and delivery.
Applied the Cultural Ecology of Health framework to reveal that both systems represent adaptive responses to the same ecological challenges through different knowledge traditions.
Key Findings
ASHAs and Dais occupied complementary ecological niches: ASHAs excelled at biomedical access, Dais at continuous emotional support and cultural ritual management.
Communities demonstrated sophisticated 'system-switching' behaviors — accessing each provider type based on specific need, pregnancy stage, and perceived risk level.
Best health outcomes occurred in villages where ASHAs and Dais had informal collaboration relationships — designed integration outperforms forced displacement.
Dais' ecological knowledge about seasonal birth risks and community psychosocial dynamics filled gaps the biomedical system structurally could not address.
Impact & Reflection
Published in Frontiers in Health Services. Findings were cited in USAID programming recommendations for community health worker policy in South Asia. The research challenged the dominant 'replacement' paradigm and offered evidence for a 'complementary integration' model now being piloted in two Indian states. The UX parallel is direct: effective design doesn't replace existing trusted tools — it creates interoperability between old and new systems.