Printr: Exploring the potential of paper-based tools in low-resource settings

Despite the recent push toward using information and communication technologies (ICTs) to replace paper-based workflows, there remain many barriers to designing appropriate and deployable ICT solutions that replace paper. As a result, paper tools such as forms, charts, and graphs continue to be widely used, especially in developing regions. While paper is not without its drawbacks, its advantages are especially relevant to low-resource settings as paper tools require only a fraction of the development, deployment, and operational costs of software apps. In this paper, we investigate how paper tools can be improved and combined with ICTs so that lowresource organizations working in developing regions can benefit from the advantages of both types of tools. We perform an exploration of existing tools to design, printr, a system that integrates into existing paper-based workflows by allowing an organization to rapidly generate paper tools that can perform some functions typically associated with computation-addition, subtraction, lookup, visual feedback, and visualization - without requiring the introduction of an ICT at the point of use. We compare two paper tools that printr produces with two mobile phone apps developed by a large NGO in Ghana and find comparable user performance between apps and generated paper tools.