Public health care [in India] runs on the ASHA worker, not the doctor. We knew we had to design something which she could use.

Ingawale’s remark foregrounds a practical truth about India’s public health system: frontline community health workers—ASHA (Accredited Social Health Activist) workers—often carry the day-to-day burden of outreach, screening, follow-up, and patient navigation, especially in rural areas where doctors are scarce. The quote argues for “designing for the real user,” insisting that health technologies and protocols must match the skills, time constraints, and working conditions of ASHAs rather than assuming physician availability. It also implicitly critiques top-down innovation that overlooks last-mile realities, suggesting that scalable impact comes from empowering the most ubiquitous, trusted interface between the state and patients.