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https://www.designforsocialchange.org/journal/index.php/DISCERN-J 
 
ISSN 2184-6995 
 
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 
International License. 

 

  

 

 

 
Connecting female migrants to healthcare systems through smartphone 
apps: An asset-based design case study translating social capital  
of community organisations into sociotechnical systems 

Laura Niño Cáceres, Dana Valentina Rodriguez, Diana Alarcón, Daisy Yoo, Caroline Hummels 
 
Published online: May 2023 

 
To cite this article:  
Cáceres, N., Rodriguez, D.V., Alarcón , D., Yoo, D. & Hummels, C. (2023) Discern: International Journal  
of Design for Social Change, Sustainable Innovation and Entrepreneurship, 4(1), 12-26. 

  



 

 

13 

Connecting female migrants to healthcare systems through smartphone 
apps: An asset-based design case study translating social capital  
of community organisations into sociotechnical systems 
 
Laura Niño Cáceresa, Dana Valentina Rodrigueza, Diana Alarcónb, Daisy Yooa, Caroline Hummelsa 

 
aEindhoven Technology University, Eindhoven, 5612 AE, The Netherlands.  
l.nino@tue.nl, valenticr98@gmail.com, d.yoo@tue.nl, c.c.m.hummels@tue.nl  
bMedecins Sans Frontiers (MSF), Stockholm SE 100 74, Sweden. alarcondiana@gmail.com 
 

Abstract 

Workers in community organisations in Amsterdam and Bogota daily use smartphones for personal 

reasons. However, smartphone apps have been outside their organisational reach. Thus, our paper 

explores sociotechnical systems’ opportunities to bridge community organisations and female migrants  

to macrosystems such as healthcare systems. Our selected community organisations, Casa Migrante in 

Amsterdam and Kilombo Yumma in Bogota, were born out of serving peer migrants from Latin American 

and Afro-Colombian backgrounds. Their services provide support to female migrants who suffer abuse and 

poverty. Built on cultural practices and social structures of their own, these organisations live on the 

periphery of macrosystems. They struggle to be appreciated and integrated into macrosystems and digital 

networks. Thus, our paper highlights the core of their services, using asset-based design, and translates 

their social capital into sociotechnical systems such as smartphone apps. This is intended to reveal, 

consolidate and integrate their efforts into wider systems. 

 

Keywords: Community organisations, Female migrants, Smartphone apps, Asset-based design, 

Sociotechnical systems, Sociotechnical capital 

 

Introduction  

Supporting the harsh realities of newly arrived low-income migrants are community organisations. 

Migrants carry a heavy burden, as they tend to be seen as people taking advantage of opportunities offered 

by the host countries or cities or as a threat since their presence downgrades the quality of life in 

neighbourhoods where they settle or brings petty crime to an area (Ryu & Tuvilla, 2018). This creates  

a general unwelcoming narrative around low-income migrants.  

 

Additional burdens include the expectation from hosting systems that these migrants will be able to stand 

on their own feet with some limited support, such as language courses or subsidies (Ryu & Tuvilla, 2018). 

Migrants’ abilities to thrive depend on multiple factors, such as strong ties to local networks, institutional 

entities, labour skills or legal immigration status (Biswas et al., 2012). Due to these internal and external 

barriers, migrants suffer from significant vulnerabilities, isolation and mental health issues (Hou et al, 2020; 

Standing, 2011; Syed, 2016).  

 

In the case of female migrants, they fall into the category of ‘inferior’ workers, involving low-skilled and 

low-wage labour (Phizacklea, 1983). Their labour conditions impede them from looking for health services 

in a timely manner. In the Netherlands, migrants avoid seeking healthcare services due to fear of 

deportation or high financial costs (Van Walsum, 2016). In Colombia, although all citizens are entitled to 

free access to care, the amount of paperwork and complexity of the public healthcare system make women 

withdraw from using it. In both cases, the lack of timely access to healthcare services increases  

health inequity.  



 

 

14 

 

Allowing migrants to navigate unfamiliar places occurs with smartphones. These are a lifeline to low-

income migrants in the Netherlands, as they help them to stay connected to their loved ones and find their 

way in new cities. They also allow safety and connectivity, plus sending money to their loved ones in other 

countries (Alencar et al., 2019; Mazzucato et al., 2008).  

 

The pervasiveness of smartphones, even in low-income populations, has enabled apps such as Tarjimly 

(https://www.tarjimly.org/) and Shifra (https://shifra.app/en) to provide healthcare information to 

migrants and translation services. However, limited smartphone apps exist that connect community 

organisations, migrants and healthcare systems. This phenomenon can be partially explained as small  

and underfunded organisations suffering from the “organisational digital divide” (McNutt, 2008). This 

phenomenon refers to the lack of limited organisational information communication tools, which hampers 

their ability to connect to wider systems and to prove their effectiveness in working with migrants in 

macrosystems (Riza et al., 2020).  

 

Thus, we ask, how are the services and related challenges of our selected community organisations in 

Bogota and Amsterdam? How do they establish connections to macrosystems such as the healthcare 

system? How can smartphones support community organisations in connecting female migrants and 

healthcare systems? What are the distilled principles for guiding the development of smartphone apps  

for these community organisations?  

 

Our main contribution is to characterise the services of our selected community organisations. Next, we 

explore the role of smartphone apps in enhancing those services towards healthcare systems, by distilling 

principles that respect the sensitivity of female migrants’ situations and the social capital and possibilities 

of community organisations.  

 

Theoretical lenses 

We selected sociotechnical systems, sociotechnical capital and collaborative services theories to support 

our study.    

Sociotechnical systems  

The term sociotechnical system alludes to the human–machine intricate components found in small-scale 

devices such as smartphones or large objects and infrastructure such as public transport, the internet or 

any other technology-based product. The socio part involves people and users, and the technical part  

is the machine or technologically based aspects (Ropohl, 1999). 

 Sociotechnical systems are highly embedded in modern life, and society cannot function any longer 

without them (Edwards, 2003; Ropohl, 1999). Digital sociotechnical systems have achieved high 

pervasiveness; thus their absence or failure in functioning creates a significant disruption in work and 

personal life (Amir & Kant, 2018).  

Although sociotechnical systems are modelled out of human activities, they impact human relations and 

interactions permanently. This is because, at the core of sociotechnical systems, the premise is to socialise 

technology, as well as technical social interactions (Ropohl, 1999). Thus, the human and societal aspects  

of sociotechnical systems are to be closely considered. 

Taking sociotechnical systems’ implications into consideration is sociotechnical capital. This concept takes 

the social capital of communities, understood as social interactions, relations, and motivation to connect 

https://www.tarjimly.org/
https://shifra.app/en


 

 

15 

and act together, as the base to transform them into sociotechnical relations. Therefore, sociotechnical 

systems substitute social structures and interactions of users, intending to enhance their social fabric 

through technology/machine possibilities (Robison & Siles, 2002).  

Furthermore, sociotechnical capital explicitly challenges the assumption that sociotechnical systems such  

as information communication technologies (ICT) increase people’s abilities to act together by simply 

having them. Instead, sociotechnical capital proposes to use social capital to promote adoption and 

expected benefits (Resnick, 2001).  

Building further on social capital are collaborative services (Baek, et al., 2018). Where services are built out 

of the capital of human relations. They address social issues and build on social capital by increasing trust 

among communities, support and care. This capital contributes not only to the resilience of societies but 

also to social innovations (Manzini, 2007; Meroni & Sangiorgi, 2011).  

Collaborative services create not only services but collaborative networks (Baek & Manzini, 2012). These 

collaborative networks can be explained since capital is something usually implied for high-income 

segments and yields. However, capital within social capital is the ability of groups to cooperate in horizontal 

ways within their networks, without hierarchical structures to stop them while creating improved outcomes 

for them, despite scarce resources (Robison & Siles, 2002).  

These collaborative services are usually circumscribed in the culture and social institutions of communities, 

which makes them invisible to outsiders (Blomberg & Darrah, 2015). Thus, the role of service designers is to 

carve out those imperceptible services that are ingrained in community discourses and translate them into 

something new, yet highly recognisable to the community studied, respecting the central human condition, 

social capital and organicity of their interactions (Sangiorgi & Prendiville, 2014).  

To summarise:  

• Opportunities are created by digital sociotechnical systems such as smartphones and apps, 

which are widely used by migrants and community organisations.  

• The imperative human and social capital requirements in designing sociotechnical systems, 

referred to as sociotechnical capital, enhance the capabilities of users such as migrants and 

community organisations.  

• The potential of smartphone apps is to increase integration into macrosystems such as 

healthcare systems.  

• Our role as service designers and design researchers is to carve out those invisible services, coined 

as collaborative services and next to translate them into smartphone apps to increase appreciation 

and clarity concerning their contributions to macrosystems and society at large.  

Method 

We selected three complementary methods for our study. The first is a literature review, which we used  

to introduce the selected community organisations and frame the problems around them (Creswell, 

2014). The second is asset-based design (ABD), which is used for community design and builds on the 

cultural and social capital of communities (Pei et al., 2022). It differs in particular from human-centred 

design (HCD), which focuses on mitigating negative aspects of interactions with a focus on momentary 

functional requirements. HCD is argued to overlook social structures, leading to social and cultural 

exclusion (Vink & Oertzen, 2018; Wong-Villacres et al., 2020).  

https://www.sciencedirect.com/science/article/pii/S0142694X17300017?casa_token=kzgE2VECjA4AAAAA:6AHCkpJ1f7Yq4Zk9sQeyzq1URaBdfdRkNVZSAD-Yh_HTIlrSIj8pQh8GU4Q9zV9i4jARXlFVzQ#bib39
https://www.sciencedirect.com/science/article/pii/S0142694X17300017?casa_token=kzgE2VECjA4AAAAA:6AHCkpJ1f7Yq4Zk9sQeyzq1URaBdfdRkNVZSAD-Yh_HTIlrSIj8pQh8GU4Q9zV9i4jARXlFVzQ#bib41
https://www.sciencedirect.com/science/article/pii/S0142694X17300017?casa_token=kzgE2VECjA4AAAAA:6AHCkpJ1f7Yq4Zk9sQeyzq1URaBdfdRkNVZSAD-Yh_HTIlrSIj8pQh8GU4Q9zV9i4jARXlFVzQ#bib2


 

 

16 

Particularly in designing digital sociotechnical systems, the focus should be on leveraging existing assets 

such as social capital and cultural practices, which are crucial assets for effective community digital 

interventions (Pei et al., 2022). Thus, ABD aligns well with the concept of sociotechnical capital proposed by 

Resnick (2001). Moreover, ABD seeks the identification of robust practices already developed by 

communities to be translated into interventions such as digital sociotechnical systems that fully represent 

those communities (Cho et al., 2019).  

ABD proposes focusing on assets such as care, solidarity, social networks and local expertise (Wong-

Villacres et al., 2020), variables selected for answering through our study. The approach is intrinsically 

participatory, as it intends to work with communities in co-creating their futures and mitigating social and 

technological inequalities (Wong-Villacres et al., 2021).  

In the co-creation of those asset-based futures, we selected paper prototyping techniques as means to 

represent a service, where its usage and technical aspects become more apparent. Paper prototypes are 

seen as a means to illustrate smartphone app services and to crystallise the capital from community 

organisations (Sanders & Stappers, 2014). Thus, paper prototypes are a means of inquiry to shape the social 

technical capital of such community organisations (Koskinen et al., 2011).  

For our data analysis, we selected inductive content analysis (ICA). This method abstracts data into groups 

to answer the research questions using concepts, categories or themes. ICA is used when the data 

collection process is open and follows loosely defined themes (Kyngäs 2020). For our inductive analysis,  

we used the asset variables introduced earlier by ABD of care, trust, solidarity and sharing resources  

to guide us.   

Results  

Responding to the vulnerabilities of female migrants are Casa Migrante in Amsterdam and Kilombos in 

Bogota. Kilombos were founded by Afro-Colombian women trained in African ancestral medicine. Their 

midwifery roles came along with leadership traits, which made them community leaders. After being 

displaced from their territory of origin, they founded ethnomedical organisations called Kilombos in 

Bogota. These provide safe health spaces for Afro-Colombian women and children. Reclaiming their bodily 

traditions through ancestral midwifery became a form of reclaiming their dignity  

(Gutiérrez Páez et al., 2017). 

 

Casa Migrante was created by a Christian pastor aiming to support Spanish-speaking migrants mostly of 

Latin American heritage in Amsterdam, who were affected by language and cultural barriers. In brief, 

women working in prostitution suffered from significant abuse, and societal stigma knocked on their doors. 

Regrettably, female migrants working in prostitution are mostly unaccounted for in migration and diaspora 

studies (Agustín, 2006).  

 

The Christian tradition encourages people to treat neighbours and foreigners with kindness and generosity, 

to look after the sick, feed the hungry, etc and devote oneself to the service of people in need (Kirillova et 

al., 2014; Laba, 1991) 

 

Afro-Colombian beliefs have two roots: Catholic Christian tradition, imposed by the Spanish colonisers and 

sub-Saharan western African heritage. The latter has as its central premise the “ubuntu spirit”, which 

means “I am because we are” (Hamedani et al., 2012) and is expressed through the ideals of compassion, 

reciprocity and dignity to build and maintain a community with justice and mutual caring relations. This 



 

 

17 

strong level of collectivism is also perceived in their identity, which mostly comes from kinship and family 

ties such as “who I know”, and “what family and community I belong to” (Nussbaum, 2003).  

 

These beliefs are in opposition to Protestant ones embedded in Dutch society and capitalist systems, in 

which the sooner a person is removed from the support of a mother, a community and religion, the more 

independent and self-reliant this person will become (Laba, 1991).  

 

These beliefs have transcended religion and become part of neoliberal economic and political models in 

Colombia and the Netherlands, creating significant contrasts with our selected community organisations, 

whose beliefs and culture of collective support, care and sacrifice guide their existence, as our next 

method’s findings illustrate.  

  

Asset-based design findings  

In the next paragraphs, we present our findings per organisation, following the selected ABD variables  

of care, trust, solidarity and sharing resources. First, we present in Table 1 the summary of the description 

of co-creation sessions and include two photo collages.  

 
Table 1:  Description of the co-creation sessions.  

 

 

 

Casa Migrante  Kilombo Yumma  

Number of co-creation 

sessions  

1 1 

Attendants  7 6  

Profile  Female migrants, volunteers and 

personnel  

Personnel: nurse, community health 

worker, healer, ancestral midwife, 

environmental technician and Matrona 

Duration  120 minutes  90 minutes  

Consent forms  Signed by all attendees  Signed by all attendees  

Raw data  Post-its, notes, audio recordings, 

paper prototypes and 

photographs. All data stored in a 

secure server of Eindhoven 

University of Technology.   

  

Notes, audio recordings, paper 

prototypes and photographs. All data 

stored in a secure server of Eindhoven 

University of Technology.   

Attendees’ recruitment Carried out by community 

organisation via social media and 

WhatsApp.  

Carried out by community organisation 

face-to-face and via WhatsApp.  

  

Casa Migrante 
Care: Care happens at various levels:  

1. Pragmatic  

2. Personal  



 

 

18 

3. Emotional  

4. Healing 

 

1. Pragmatic care: Language, cultural and process translation   

Personnel and volunteers help female migrants access the healthcare system by making 

appointments for them, accompanying them to their appointments, translating from Spanish to 

Dutch and mediating during the appointment to ensure that the female migrant’s articulation of 

her health needs is clearly understood by the physician and vice versa.  

 

The nurse volunteer mentioned that the translating services that Casa Migrante provides go 

beyond language and involve cultural aspects as well. When she joins someone at a healthcare 

appointment, she supports the migrant to define and voice her needs to the physician in question. 

Physicians in the Netherlands tend to ask people “What can I do for you?” which is a foreign 

concept to Latin American communities, who are not used to articulating their health needs 

assertively. Thus, for a female migrant having to do this on the spot with a stranger such as  

a physician is a difficult task where cultural guidance is required.    

 

2. Personal care: Own health last 

Latin American female migrants tend to neglect their health. This is because they put the needs  

of others above theirs or because they lack health education and information or enabling 

conditions to seek healthcare services, such as flexibility at work or fear of deportation.  

 

Furthermore, some suffer from emotional and/or physical abuse, which diminishes their self-

esteem and agency to act. In supporting these women to understand that they need to put 

themselves first, look after themselves and seek care, this self-awareness is a significant task of 

Casa Migrante. Workshops throughout the year take place to provide spaces to speak and discuss 

these abuse topics. Women are usually recruited via a WhatsApp message, and announcements are 

made via Facebook.  

One participant argued that she did not know that she had health issues. She went to the doctor 

since her boyfriend told her that she was gaining too much weight. It turned out she had thyroid 

issues. Now she takes medicine and supplements to manage it. Despite not being with that partner 

anymore, she has learned to look after herself, especially now that she is by herself in the 

Netherlands.  

3. Emotional care: Overcoming barriers to find own strength  

Psychological, social services and doulas are offered to migrants at Casa Migrante. These services 

are provided during weekends and evenings to accommodate the working life of female migrants. 

However, the notion of mental health is also diluted for these women. It takes time and pondering 

for them to engage in therapy. Domestic violence and general abuse are prevalent subjects 

addressed by these services. The vulnerability of these women makes it hard for them to act on it.  

 

The doula volunteer at Casa Migrante argued that Latin American women that she sees at Casa 

Migrante have a lot of trauma and that pregnancy brings significant cultural clashes between Dutch 

and Latin American healthcare approaches, which ultimately make women not trust their bodies 

and themselves. In addition, the baby may not be intentionally conceived, creating greater anxiety 

in women. Thus, a large part of her work is to help these women trust themselves and their bodies.  

 



 

 

19 

4. Healing care: Cohabiting together as a repairing act  

Some of these migrants do not have stable homes to live in. This can be due to eviction, because 

women decide to leave their abusive partners or simply because they cannot find a home. Casa 

Migrante provides an open living room six days a week. After their opening time, 2 pm, people and 

women flock to the living room and lounge of Casa Migrante. Here they find peers in the same 

situation, they feel safe, and they have a warm place to be and food to eat. The open living room  

is the place where all the above care forms connect and cement and where warmth is experienced 

at an emotional repair level.  

 

Care, therefore, is defined as a journey on which the personnel and volunteers of Casa Migrante embark 

with female migrants to teach them self-care. This means identifying their health needs, finding a voice 

within the healthcare system and larger systems, understanding their rights, meeting peers and acting upon 

their inner strengths. One female migrant argued that she has learned about the benefits of being part of  

a macrosystem. Currently, she pays for her healthcare insurance, which makes her feel good about herself 

and secure. 

  

Trust: Next to language support and cultural translation, there is indefinite time and availability to 

accompany and listen to female migrants. Indefinite time is necessary to understand what they need and  

to build trust.  

 

Solidarity, sharing resources  

Sharing resources is a natural and embedded activity of Casa Migrante. These can be information, time, 

guidance, food, a living room, etc. In the open living room, people can easily connect and extend their 

network, acquaintances and peers, which leads to more emotional support and living opportunities  

for them.    

 

 
 
Image 1:  Photo collage from Casa Migrante co-creation session.  

 
Kilombo Yumma  

Care: Care at Kilombo Yumma happens at  

1. Pragmatic  

2. Physiological and emotional and 

3. Spiritual levels  

 

1. Pragmatic care: Accessing health insurance, removing bureaucratic obstacles  

Kilombo Yumma helps female migrants realise the services of the national healthcare system for this 

population. The nurse and community health workers are trained to know how to manoeuvre the 

bureaucracy to issue health insurance for their population.  



 

 

20 

Pragmatic care involves removing the bureaucratic barriers to accessing the national healthcare services  

in Bogota. The personnel also create referrals, book appointments with health units and hospitals and,  

if necessary, join them in these appointments.  

2. Physiological and emotional care: Complementing western medicine with ancestral midwifery 

To Kilombos Yumma’s personnel, western medicine is limited in supporting health since it is only 

approached from the physiological aspects. In their communities, when a woman gets pregnant, her role 

within the community varies. Having a baby is following an important milestone in the personal and 

emotional development of a woman, such as getting their period. These milestones also involve an 

emotional and communal transition that needs to be addressed, which is ignored by western healthcare 

systems. When women suspect they are pregnant, they consult matrons, midwives or healers to guide 

them in their process. This process is a journey where chants, massages, and tailor-made pregnancy advice 

are provided. All of it is aimed at making the woman feel safe, prepared and supported by her community 

in her transition.  

However, ancestral midwifery also involves physiological aspects carried out by midwives. They ask 

questions and examine the pregnant woman. To be sure, they go through a list of risky conditions in 

pregnancy such as palpitations, beeping ears, headaches etc. Through their hands, the size of the belly and 

the position of the baby are checked. If they notice the baby is breech, they have different techniques to 

reposition him/her. All these practices provide comfort and safety to the population.  

As midwives know their limitations, they are very comfortable leaning on nurses’ expertise to complement 

their examination and to refer women with high-risk conditions in pregnancy to the national healthcare 

system. Women referred by Kilombos to the healthcare systems are closely followed up to ensure they are 

seen and understand the necessary treatment to be followed. They insist that their work goes beyond the 

symptoms. It is to guide and accompany women at a deeper level.  

3. Spiritual care: Piercing through the soul of everyone in need   

The Matrona from Yumma is very explicit about the spiritual care they provide to their population. She 

describes Kilombo’s service as seeing through the eyes of people into their soul to fully understand the 

person in front of them to best support him/her. 

Spiritual care is understood as taking the time to assess the family situation of that person by asking “Who 

do you live with, who works in the house or earns money, who do you look after, who looks after you and 

who is your support network?” 

In this process sometimes, the female migrant is given a plant to look after. Kilombo’s personnel intend to 

assess the well-being and ability of that person to look after herself and others. Thus, spiritual care is 

defined as picking through the soul of the person, revealing and assessing her emotional needs.  

Solidarity: Connected to spiritual care is solidarity. A core part of their tradition is to heal through group 

rituals called “sanación”, which translates as healing. Many female migrants who visit Kilombo Yumma are 

victims of war, which means they have been displaced by force and terror from their homes. They may 

have been raped by armed men. They have witnessed and lost relatives in the war. Thus, Kilombo Yumma is 

a place where literal and figurative healing takes place. Kilombo Yumma personnel get together around the 

woman who has been through a very difficult experience. They encircle her and through chants and calling 

out the inner strength of the person and collective support, they aim to help her to move on. This is 

accompanied also by active listening, which is a daily activity they carry out at Kilombo Yumma.  



 

 

21 

 

The Matrona expressed offence at the fact that the Secretary of Health does not understand nor distinguish 

between their ritual practices. Some are aimed at healing the person and others are aimed at getting the 

community in sync by holding hands and sharing their collective good intentions, good health and support. 

 

Sharing of resources: Donations or other goods are something found at Yumma. This is because they are  

a central resources hub for the community for information, guidance, medicine and support. Many people 

tend to arrive by lunchtime since they know that the food will be shared. They say: “Where one eats, many 

can eat also”.  

 

Paper prototype findings   

Casa Migrante 

The participants recognise their daily use of smartphones and selected apps such as Uber, maps, WhatsApp 

and calendars. However, they dislike apps with extensive data and complex navigation formats.  

 

The main challenge Casa Migrante identified was the lack of digital tools to connect and coordinate female 

migrants to volunteers who want to support them. Currently, there is much back and forth between the 

personnel of Casa Migrante and female migrants before the volunteers get involved.  

 

Thus, the idea of having an Uber service-type app for volunteers and female migrants was defined as 

essential to increase coordination and the number of female migrants being helped by Casa Migrante.  

The app would allow the Casa Migrante personnel to do less coordination and provide more social, legal, 

emotional and practical guidance to other female migrants. Furthermore, this app would fill upa gap in  

the Dutch healthcare system:  

 

The nurse volunteer argued that in the past there were translators in hospitals to support people, which 

today do not exist anymore. Thus, the work of the volunteers becomes even more important to culturally 

and personally support the female migrant be understood and helped properly.  

 

Introducing the app would be done by the Casa Migrante personnel, since the coordinator argued that once 

the relationship is established with Casa Migrante, female migrants feel comfortable being helped by any 

volunteer female to go to the doctor, as long as this person can speak Spanish.    

Last but not least, the number of meetups between volunteers and female migrants is captured by the app 

and can be accessed by Casa Migrante. In this way, evidencing their effectiveness in connecting female 

migrants to Dutch healthcare would be possible.   

Kilombo Yumma 

All personnel from Yumma use smartphones daily. However, few of them are literate in using computers. 

They find the paper forms that they need to fill in from the Secretary of Health cumbersome and an 

extension of racial subordination from macrosystems to them. Thus, they want to have an app on their 

smartphones.   

 

The purpose of the app is to support Yumma to collect data in easier and more empowering ways. The  

data variables to be collected need to be defined since they currently see that the paper forms do not 

represent their ancestral practices in culturally appropriate ways, which subsequently means their lack  

of representation within the national healthcare system and national data systems.  

 



 

 

22 

Thus, to Yumma any sociotechnical app aims to streamline data collection while acknowledging and 

increasing the representation of their ancestral practices.  

 

Thus, the opportunities identified are:  

A. Swift data collection instead of cumbersome forms  

B. Representation of medicine and combined approach  

C. “Ubuntu” of health 

D. Impact through referral data  

 

A. Swift data collection instead of cumbersome forms  

Currently, they use several forms to collect data from the population to characterise them, their 

living situation and their health issues. These tasks are done by the Secretary of Health; thus 

Yumma is the data clerks Moreover, the forms take a long time to fill in, interrupt their flow of 

practices and affect the human connection, which aims to establish a “spiritual” connection.  

 

B. Representation of medicine and combined approach   

Kilombo Yumma has a western and ancestral medicine approach, provided by their 

multidisciplinary team including a senior nurse. Regrettably, the Secretary of Health and its forms 

undermine their ancestral medicine practices. Instead, there are general questions in the forms 

such as ancestral medicine next to acupuncture. In the eyes of Kilombo Yumma, this 

underrepresents them at the local and macrosystem levels. Thus, the smartphone app aims to 

collect their combined ancestral and western medicine practice as presented in Table 2 below.  

A limited selection of data fields was selected for this paper to illustrate the sociotechnical system 

opportunity.  

 

Table 2:  Selection of data fields to be included in their sociotechnical system. 

 

Ancestral medicine data  Western medicine data  

Is the baby well positioned in the belly?  Has the pregnant mother experienced any unusual 

symptoms?   

Is the baby “boxed” in the belly?  Does the pregnant mother have pain down under 

the belly?  

Has the pregnant female received ancestral 

advice?  

Does the pregnant female have a headache?  

Did the healer advise the pregnant female?  Does the pregnant female have to bleed?  

Does the pregnant female have beeping sounds in 

her ears?   

What is the pregnant female’s foetocardia?   

Does the pregnant female have blurry vision?  What is the pregnant female's blood pressure?  

Are the ankles of the pregnant female swollen?  What is the pregnant female heart rate?  

 

 

 



 

 

23 

A. ‘Ubuntu’ of health 
To Yumma, the support network and living situation of female migrants is essential to understand and 

capture. In their view, when these aspects are not in place and the woman is pregnant, the outcome of the 

pregnancy will not be good. Lack of good nutrition leads to problems with the baby, to mention one thing. 

Thus, the questions to be included in the app are:  

 

• Who do you live with?  

• Who is your support health network?  

• How many people earn an income in your family?  

• Who takes care of you (financially and emotionally)?  

• Who do you look after?  

 

B. Referrals  

Yumma creates many referrals to the healthcare system and other public instances. Thus, they would like 

to capture the type and number of referrals done monthly, as follows:   

• National health insurance 

• Subsidy claims 

• Food 

• Ambulance 

• Birth at hospital 

 

One of the main takeaways from the prototypes was the significant interest in creating lists of activities or 

symptoms in a smartphone app to which they could answer YES or NO to avoid interrupting their routines 

and rituals. Since they are a large team, their preference is that only one person completes the app, instead 

of all of them having to enter data, as happens today.  

 

 

Image 2:  Photo collage from Kilombo Yumma co-creation session.  

 

Discussion 

Mitigating structural gaps for female migrants to access the healthcare systems in Amsterdam and Bogota 

are Casa Migrante and Kilombo Yumma community organisations. Despite their deep care and significant 

efforts to help female migrants, the lack of appropriate sociotechnical systems impedes them from being 

appreciated beyond their communities.  

Due to their type of work and sociotechnical systems’ literacy, it was found important to introduce 

sociotechnical systems to these organisations and female migrants in smartphone apps. Those apps also 

should follow the features and logic of WhatsApp, Uber, Calendars or Anylist, which are familiar to them.  



 

 

24 

However, to ensure that sociotechnical systems are fully adopted and meet the core values and practices of 

these organisations, they should also follow the sociotechnical capital identified and presented next.  

Sociotechnical capital principles for community organisations  

1. Jointly defining health needs for appointments to happen: The identification of the health need is 

something that requires time and personal interaction with female migrants. Once the health need has 

been identified, a series of administrative activities comes to make the appointments happen. These are 

enabled and registered in the apps.  

 

2. Extending relations: The more effectively the community organisations can do their work using the apps, 

the more relations and support are created for the female migrants. The natural horizontal navigation of 

their own and extended networks is enhanced through the apps.  

 

3. Feeling represented in large networks: Naming and capturing their traditions in sociotechnical apps is 

crucial to create a better understanding and representation of these communities within the society 

they are part of but invisible to.  

 

4. Impact in numbers: Finally, through the apps the select community organisations have immediate access 

to the activities and their total number is summarised. This can be displayed on their social media page, 

shared with macrosystems, etc.  

 

The sociotechnical capital principles distilled through our study are built upon several complementary 

aspects of the social capital and services of the community organisations selected. This capital involves soft 

and hard aspects, such as defining a health need through active listening and having data (total number of 

activities) from their efforts. It is clear that for female migrants and community organisations such soft 

qualities in place enabled the hard ones to happen. Thus, this is replicated and visualised (Image 3). 

Without sociotechnical capital, the leap for these organisations to more digital and robust sociotechnical 

systems is questionable.  

 

 
 
Image 3:  Sociotechnical capital pillars for community organisations. 

 



 

 

25 

Through ABD and paper prototyping, we carved out the imperceptible services of community organisations 

in Amsterdam and Bogota. These methods enabled the service designers and design researchers to 

articulate sociotechnical capital for these organisations. However, these methods have limitations as 

follow-up is required to assess and further these opportunities for these organisations, which is outside the 

scope of this paper. These methods created enthusiasm in the community organisations as they opened an 

invisible door to them. However, without the external support of design and engineering teams, the 

materialisation of these opportunities continues to be far-fetched to them.  

 

Conclusion  
Female migrants from Latin American origin arriving in a new country such as the Netherlands and its 

capital city, Amsterdam or Afro-Colombian migrants from the Pacific coast arriving in Bogota experience 

significant social, cultural and bureaucratic barriers to accessing healthcare services. Helping them in 

navigating this complexity are community organisations. These organisations, however, suffer from a lack 

of sociotechnical organisational systems to support them in connecting female migrants and the healthcare 

systems. These organisations also suffer from a lack of visibility and electronic ways to prove their impact 

on macrosystems. Finally, their social capital and assets of care, solidarity and ability to support female 

migrants have not yet been captured in sociotechnical systems. Thus, through ABD and sociotechnical 

capital, we prototyped two digital apps for smartphones, aimed at cementing their core services of 

community organisations to amplify their services involving deep care for their communities while 

establishing bridges and ways to prove their efforts to macrosystems. To materialise these initial 

opportunities, further efforts within and beyond these community organisations are required.  

 

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