Information poverty cannot be addressed by simply giving away computers and installing internet connections in rural areas. What is really needed is to offer rural users relevant, personalized information that enables them to make positive changes in their daily lives, rather than give them the type of information that is typically available via public internet sites. ICT should be viewed as a tool, and not as the solution to building knowledge-based societies. ICT encompasses the full range of information and communication technologies, including radio, television and print media as well as the ever-expanding array of computer hardware and software, telecom devices, internet and portable digital media. To build a knowledge-based society, many organizations and enterprises have given rise to a range of innovative projects and services. These innovative projects attempt to use ICT to enable rural users to access relevant information services with a view to ultimately reducing information poverty. Where information poverty can be understood as a lack of knowledge to make decisions to improve wellbeing in terms of economic and social development. Information services have been offered in crosscutting sectors such as education, e-governance, agriculture, and healthcare. Reducing information poverty through the use of ICT to improve user wellbeing is a major challenge for governmental and non-governmental organizations alike. Several new media ICT interventions such as Telecenters that offer e-services in domains such as agriculture, healthcare, and education have recently been deployed in India. Despite huge investment in recent efforts to address information poverty via new media ICT interventions, the results still do not make a convincing case for solving the information poverty problem. Consequently, there is still an information gap between rural users and the information offered via ICT interventions. The case study evaluation of ICT interventions deployed in India (Chapter 2) indicated that users have still not adopted the majority of these interventions. The low adoption level of ICT interventions could be attributed to the following key issues: a. The information content offered through the ICT interventions such as, telecenters is often found to be too general to be useful for rural users, and is inadequately disseminated. Existing ICT interventions are focused on introducing new applications and technologies to the rural market rather than on having a concrete understanding of user needs and the social environment. The term social environment of an individual can be understood as the culture that he or she was educated and/or lives in, and the people and institutions with whom the person interacts. The information offered via the ICT interventions on a particular topic, such as healthcare or agriculture, does not often take into consideration the existing information needs, daily practices, and the needs of the social environment of the rural communities. As a consequence, rural users do not see that the information given has any added value in their life. b. The sustainability of ICT interventions in a rural context is dependent on knowledge from several scientific disciplines such as, for example, social science for understanding societal issues at community and individual level; computer science for developing the software and hardware of an interactive device; industrial design for designing the user-interface and for usability testing; marketing for addressing issues of economic sustainability and technology adoption. However, the current development approaches are often dominated by a single discipline, namely - the technology development groups. This approach often leads to technology-centered development. Recent literature on ICT development discusses the need for a developmental framework to achieve sustainable ICT solutions (Chapter 3). As an answer to this call, several frameworks have recently been proposed by researchers and organizations involved in promoting ICT for rural development. These frameworks focus mainly on organizational issues, such as how an organization can improve its efforts regarding the design and implementation of ICT interventions in developing countries. However, none of the ICT development frameworks have taken a bottom-up approach, where it is the users who drive the problems and solutions. In particular, these frameworks fail to incorporate user needs, the socio-cultural context, and technological viability issues in the early development phase. Design can play a critical role towards developing a framework to support ICT development for rural communities. Design can address the developmental issues towards holistically improving information dissemination via ICT interventions, thereby achieving a high rate of adoption. Towards proposing a design framework for developing ICT products and services for rural development, this thesis dealt with finding the answers to the following two research challenges: The first research challenge was to incorporate knowledge from multiple disciplines in the user-centered design approach to develop sustainable ICT interventions. To meet this objective, a case study analysis was first conducted to understand where existing ICT development approaches succeed or fail (see Chapter 2). The findings from the case study analysis provided requirements for the design framework to support ICT development for rural communities. Based on the requirement for the framework, this thesis put forward a design framework that amalgamates theories from multiple disciplines such as social sciences, computer science, industrial design and marketing management, and involves different stakeholders to support the main stages in the user-centered development process (see Chapter 3). The design framework consists of two main components: Component A includes the user-centered phases of the design cycle. The three stages of the usercentered development process in the proposed design framework have been termed: Exploratory Research, Creative Design Research, and Evaluative Research. Component B, the theoretical framework, explains the theories from multiple disciplines that have been adapted to guide the development process followed in component A. Both these components were interlinked with each other where component B provided the theoretical foundation to the various stages in the user-centered process as defined in component A (see Chapter 3). The second research challenge was to design and develop ICT interventions for socially complex environments in order to improve information dissemination and increase user-adoption of ICT intervention. As a development case, an ICT intervention focusing on disseminating primary health information to rural women was developed by following the proposed design framework. Following the exploratory phase of the design framework, field studies were then conducted in Gujarat, India. The purpose of the field studies was to obtain baseline data on user needs and to understand the socio-cultural norms of rural women surrounding their health practices, and to investigate the knowledge level of rural women relating to menses and maternal health (see Chapter 4). Chapter 4 describes the exploratory research phase of the proposed design framework. This phase included two studies (1 and 2) conducted with the baseline group (rural women) and potential stakeholders in the pilot villages of Gujarat, India. The studies were conducted to identify the existing knowledge level (baseline survey) and the social beliefs and practices of rural women relating to menses and maternal health. The theory of planned behavior was adopted in the exploratory stage as a means to understand the social norms and user needs for developing an ICT intervention. The questionnaire used was based on the three factors of the theory of planned behavior that affect human action: Attitude toward the Behavior, Subjective Norm, and Perceived Behavioral Control. The results from studies 1 and 2 indicated that the knowledge level of rural women on matters relating to menses and maternal health was low. The results illustrate that there exist social beliefs and health practices that inhibit the acceptance of good health practices relating to menses and maternal health. We concluded from the exploratory stage that, in order to improve the knowledge level of rural women, the social beliefs and practices as identified need to be positively shaped. This implies that in ICT development, besides understanding the social beliefs and attitudes of the target user group, it is critical to incorporate them in the design of nformation content and the physical environment. The PHIS was developed as a part of the creative design phase of the proposed design framework (Chapter 5). The PHIS design integrates theories from multiple disciplines, such as social cues from persuasive technology, and the theory of planned behavior for shaping the social beliefs and health practices of rural women. Concept 1 of the PHIS was developed on the basis of the design requirements obtained in the exploratory phase (Chapter 4). The design and development process employed persuasive technology in designing information communication strategies, the physical environment, and the physical system design of the PHIS. The role of persuasive technology was to shape existing social norms via an interactive system and to motivate the rural women to have a high behavior intention, thereby increasing their perceived behavior control. The PHIS used a computer as a tool, a medium, and a social actor to create a persuasive interactive experience for the rural women to shape their social beliefs. Social cues from persuasive technology such as physical cues, language cues, psychological cues, social dynamics, and social roles were applied in the PHIS for shaping social beliefs and the health attitude of rural women in India. Studies 3 & 4 were conducted to evaluate the first concept of the PHIS. Firstly, an initial impact study (study 3) was conducted to compare user engagement between the PHIS (village B) and the local NGO-health information system (village A). Results from the comparative study reported an increase in user engagement with the PHIS compared with the NGO health system (see Chapter 5). The results showed an increase in the number of revisits and in the number of questions asked by the rural women using the PHIS compared with the NGO system. Secondly, an evaluative study (study 4) was conducted to evaluate the PHIS on the basis of Rogers innovation attributes from diffusion theory. Feedback from rural women was collected against four product innovation attributes: Relative, Advantage, Compatibility, Complexity, and Observability. The women using the PHIS reported high values against the four innovation attributes. For example, the PHIS gave them privacy and the freedom to access health information. Therefore, the rural women ranked it high on the “relative advantage” attribute compared with the NGO system. We concluded from studies 3 & 4 that applying social cues from persuasive technology in designing the form, content and interaction of the PHIS can positively shape the social beliefs of the users. For example, to incorporate psychological cues from persuasive technology in the PowerPoint slides, three animated characters representing local identities were used to convey the relevant messages. These characters represented the main characters found in the village community, and included (a) a teenage girl for discussing menses issues; (b) a married woman for discussing maternal issues; and (c) a doctor for answering the queries. Traditional folk music and puppet shows were used to convey the stories woven around these characters. In all six categories, the three characters presented existing beliefs through cases and discussed their effects rationally. It can be concluded from the results that by offering belief-based content the health information dissemination process can be improved and hence user engagement. The findings from the creative design phase informed the design of Concept 2 of the proposed ICT intervention termed the Mobile Persuasive Health Information System (MPHIS) (see Chapter 6). Concept 2, the MPHIS was designed to make the PHIS mobile and enhance social interaction by using traditional metaphors in the user interface design. The results from the MPHIS evaluative study (Study 5) illustrated increased social interaction as a result of enhanced product engagement, product attachment, and increased community decision-making. As a consequence of increased social interaction, sensitive health information relating to menses and maternal health was easily disseminated to the rural women. The reflection of traditional metaphors on design reduced the technology barrier prevalent among rural women, and therefore increased their engagement when interacting with the MPHIS. Furthermore, because the MPHIS was mobile, rural women from remote villages could also access the system, which was previously not possible with the PHIS. We concluded from Study 5 that by adapting traditional metaphors to design the Tangible User Interface (TUI), a personalized relationship between the interactive system and the user can be developed. This allows even those users with limited exposure to technology to access the relevant information independently. As part of the evaluative research, we measured the impact of the PHIS intervention on the knowledge level and health practices relating to menses and maternal health of rural women. In this thesis, an increase in knowledge level and the positive change in heath practices among rural women has been considered to be an indicator of a high rate of adoption of the PHIS intervention (see Chapter 3). In order to investigate the rate of PHIS adoption, a longitudinal study (Study 6) was conducted for sixteen months (see Chapter 7). The purpose of this study was to investigate the changes in the knowledge level of rural women and in their health practices relating to maternal health and menstruation between the village in which the women received no intervention (baseline group) and the village in which women received the PHIS intervention (intervention group). The results from Study 6 between the baseline group and intervention group indicated the difference in knowledge level of rural women who did and did not receive the intervention. The results from the longitudinal study indicated that the PHIS intervention had a positive impact on improving the knowledge level of rural women and brought about positive changes in their health practices. The data from the control group indicated that the improvement in knowledge level determined from the comparison between the intervention and baseline groups was not influenced by any external factors. The results from the longitudinal study indicate a positive impact of the PHIS intervention in improving the knowledge level of rural women. The follow-up observation conducted by the PHIS operators and community health workers revealed positive changes in the daily health practices of rural women. These changes were mainly observed in the disposal of menstrual cloths, maintaining personal hygiene, nutritional habits and delivery practices. For example, after the PHIS intervention, the women learned that it was possible to burn used cloths in their backyard. It was observed that (n=82/120) rural women adopted this new practice. Previously the used cloth had been stored in an unhygienic place and was not dried in the open in the sun because rural women did not understand that menstruation was simply a normal biological process. After accessing health information from the PHIS, (n=42/120) rural women reported that they changed the cotton cloths every two months, and that they dried them in the sun to sterilize them. These results could be attributed to the fact that the content was dynamically updated by the operators in accordance with the information needs and existing health practices of the rural women. The results from Study 6 lead to the conclusion that the necessary information relating to personal health that is consistently reinforced and is in compliance with existing social beliefs and practices may lead to a change in health-related practices. Disseminating information specifically designed for women, and through an intervention that engages them to interact in groups to discuss their personal health issues, may lead to positive changes in their health practices. Additionally, we conclude that information that directly adds value to the participant’s daily life may have a positive influence on the rate of adoption of ICT intervention. Key findings and implications from the various studies conducted during this research are reported on in Chapter 8 which discusses in particular the relevance of organizing multi-disciplinary collaboration in the design process of ICT development, the need to investigate existing social beliefs and practices, and issues surrounding stakeholder involvement and capacity development in ICT interventions. I have made an attempt with this thesis to demonstrate the strength of industrial design as a discipline to address socially complex problems in the rural context. In order to shape the social beliefs and health practices of rural women, two persuasive health information systems were developed by following the proposed design framework. However, I am aware of the fact that it is too soon to generalize or to judge the reliability of this framework in terms of guiding user-centered ICT development. The design framework still needs to be rigorously tested when designing other ICT projects deployed in a rural context, such as e-governance, distant education, and tele-medicine services. In terms of testing the reliability of the proposed design framework, the spinoff project from this thesis -called “Savera” -will follow the three phase design framework and we expect to draw some general lessons from this experience. This thesis should be considered as an example of how a bottom-up approach that involves users in the content development and the design process could lead to user-centered ICT developments for the rural context.