Designing for Amplifying Voices-Supporting Bangladesh's Low-Income Ready-Made Garment Workers Through Technology Amid COVID-19 Pandemic: Interview Study Among Workers.

Background: The ready-made garments (RMG) industry is a crucial component of Bangladesh's economy, using over 4 million workers from low-income backgrounds who often neglect their health care needs. Historically, this sector has faced criticism for labor exploitation, unsafe working conditions, and rights violations, as highlighted by tragic accidents resulting in loss of life. Compliant factories may uphold higher labor standards, but many noncompliant factories expose workers to poor conditions, increasing health risks. The COVID-19 pandemic intensified vulnerabilities, leading to widespread factory closures and job losses, increased health risks, and left millions of workers without wages. Although the government attempted to provide some relief, it fell short in offering job security, social protection, health services, and emergency assistance. Limited access to technology due to digital literacy gaps further hinders these workers, who primarily use basic mobile phones for communication rather than accessing health or emergency services. Thus, there is a pressing need to develop a sustainable system that capitalizes on their existing technological familiarity. Objective: Our goal was to gain a deep understanding of RMG workers' experiences, focusing on their work environments, technological interactions related to health care management, and the impacts of COVID-19 on their circumstances. This understanding aims to inform the design of a technology-based framework that is both sustainable and contextual. Methods: In phase 1, we conducted in-person interviews with 55 RMG workers, comprising 32 female and 23 male participants from urban and suburban areas of Dhaka and Gazipur, before the pandemic. Participants were aged between 18 and 40 years. In phase 2, we reconnect with 12 phase 1 participants during the pandemic and also consulted 3 stakeholders from RMG factories via phone. Each interview, conducted in Bengali, was recorded with consent, totaling 846 minutes of discussion that were translated and transcribed. Thematic analysis was used to analyze the results. Results: Insights gathered revealed variations in working conditions, personal experiences, perceptions of health care, lifestyle choices, and technology use tied to factory compliance. Workers at compliant factories had better health care support and used technology more effectively than those in noncompliant settings. The pandemic drastically altered the landscape for all workers, heightening health and safety concerns and shortages of emergency assistance. The RMG sector faces significant challenges, highlighting the urgent need for targeted emergency relief and health services. Conclusions: This research examined the challenges and technology use among RMG workers during the pandemic, with a focus on health care perspectives. Based on our findings, we proposed a technology-based framework called VOICE (Virtual Outlet for Integrated Community Engagement) that connects workers with service providers through a simplified interface. This aims to assist marginalized communities during emergencies and enhance their overall well-being.