Infrastructural artefacts in community health: a case study of pregnancy care infrastructures in south India

The work of frontline health workers providing access to pregnancy care services to women in South India is highly distributed and often overlooked in the design of healthcare infrastructures. Unlike clinical and nonclinical personnel who engage in different care practices within and across hospital departments with clearly established work roles, the work of frontline workers is performed across different geographical areas beyond the boundaries of the hospital and with loosely defined roles and resources making the coordination of work more complex. Based on a case study investigating the work of frontline health workers, we report a number of material infrastructural arrangements (the Thayi Card, physical and digital registers, and mobile phones) that played a major role supporting community health practices. We conclude by discussing the opportunities that these artefacts offer for the design of healthcare infrastructures.