SERVICE DESIGNBREAKFAST

INNOVATIVESERVICE DESIGN

AND COMMUNICATION FOR DEVELOPMENT

AND HEALTH

A SMALL TEAMWITH BIG AMBITIONS

98%

LONG WAY TO GO

WHO

M4ID

MAKAREREUNIVERSITY

UGANDA

UNIVERSITYOF IBADAN

NIGERIA UNIVERSITYOF SAO PAULO

BRAZIL

LOCALINNOVATION

PARTNERS

THE BILL AND MELINDA GATESFOUNDATIONS

CHANGE THE HISTORY OF OBSTETRIC CARE

A tool that will help health workers to better monitor women

and make decisions about next steps of their care

during childbirth

New tools for women, their families and their communities to support and educate them

during pregnancy and childbirth

SELMASimplified effective labour monitoring to action tool

PSPPassport to Safer Birth

A 50 YEAR OLD TOOL?

CUSTOMER EXPERIENCE?

HOW WE DO IT?

OBSERVE PEOPLE , THEIR RELATIONSHIPS AND

ACTIONS

TALK WITH WOMEN, FAMILY MEMBERS AND

HOSPITAL STAFF ABOUT THEIR PERCEPTIONS

TO IDENTIFY IDEAS AND SOLUTIONS TO IMPROVE

THE QUALITY OF CARE

THEN DESIGN & BUILD TOOLS

TOGETHER

AND TRY THEM OUTIN PRACTICE

COLLECT FEEDBACK AND IMPROVE THEM

DISCOVER & DEFINE

DESIGN & BUILD

Gathering of data:

/ In-depth interviews/ Direct observation/ Shadowing/ Design workshops

Developing prototypes together with target users:

/ In-depth interviews/ Workshops/ Field testing kit

Design of solutions: From rapid prototypes to minimum feasible level prototypes that can

Remote

On-location

Uganda initial visit

Preparationsand desk study

Analysis Analysis

Ugandadesign

research

Nigeriadesign

research

Uganda co-design

Nigeriaco-design

Solutions/research strategy

Iterative process

Research preparation

SynthesisInput Formative

Design

AND WHERE?

COMMUNITY

FACILITY

COMMUNITY

FACILITYrural / low volume urban / high volume

LOOK AT THE EXTREMES

DOCTORS, WOMEN, NURSES, MIDWIVES

MOTHERS

TRADITIONAL BIRTHATTENDANTS &

COMMUNITY HEALTH VOLUNTEERS MEN, FATHERS & FATHERS TO BE

MOTHERS IN LAW, EXTENDED FAMILY

PERCEPTIONS, EXPERIENCESDURING PREGNANCY & BIRTH

KNOWLEDGE AND INFORMATIONSEEKING BEHAVIOR

INTERACTIONS BETWEENSTAFF AND CLIENTSCLINICAL PRACTICES AND ROUTINES

MYTHS AND RELIGIOUSBELIEVES

BARRIERS AND OBSTACLES DECISION MAKING

DESK STUDY

80 papers

15 interviews

50 projects &

innovations

10books

Pregancy, labour and risk signs Referral

process

Transport

Maternity waiting home

Admission/Reception

Waiting room/hall

Delivery room

Recovery room/Overnight stays

Payment/Discharge

PRE-PREGNANCY PREGNANCYWoman’s journey

Key touchpoints

Journey moments

Access to blood/drugs

Return

Post-partumcheck ups

Stories

Education

Family planning

Myths and believes

Stakeholdersand Involvement

Women’s experience and feelings

Identified issues and bottlenecks

Questions to be researched

Opportunities identified/ Value creation

Antenatal check ups

Cultural norms

Superstitious believes & mythsFears in generalAttitudes to and awareness towards pregnancyRole and access to technology and mediaRole and communication habits with the stakeholdersFamily planningFirst touch point pregnancy health careGeneral health-seeking behaviour andhabitsLevel of education & literacyPrevious birth experiencesWOM of birth storiesPerception of facility based care vs. home delivery

ATTENDING ANTENATAL CAREReasons for late attendenceReasons not to attenedProcesses, routines and recommendedprotocolsTouchpoints and rolesAccessibilityInformationExperience & quality of careRole of the other stakeholders, likehusbands, mothers-in-law...

IDENTIFYING LABOUR & RISK SIGNSFirst touchpointBody knowledgeTraditional habits & belifsReasons for delaying the transportationInformation about access to helpBias in risk detection

REFERRAL PROCESSProcess, routines and rolesMotivations, cultural bias

TRANSPORTTransport options & costsReasons for delayCommunity insurances & schemesCommunication between the transportand health facilityExperienceArrangement of the home-responsibili-tiesLiabilities

Identi�cation of the possibilitiesSocial acceptanceDIY optionsRoles, protocols and touchpoints

Forms of neglect, disrespect and abuseRoles, processes and protocols (visibleand background)Delivery statisticsStructural statisticsSupply chain managementLeadership and managerial practices(feedback, rewarding, motivation)Training & educationPriorization & screeningWorking conditions, safetyHygiene standards and habitsAccountabilityDi�erent spaces (Layout of the facility)Laws and regulations vs. innovationpotentialCommunication and recording methodsLevel medical equipmentsKPI's for the hospital & sta�

Map / journey within the hospitalHome vs. facility experienceEmotional needs and fearsPrivacy & embarrassmentAccess to information about process andstatusCompanions and family membersKnowledge about the patient rightsCosts of hospital stayPayment methods.Access to food & waterHygiene habitsAccess to farmacyPeers & other patientsAccess to communicationOptions for decision-making

Postnatal care (PNC) / check-upsFollow-up instructions (breastfeeding etc.)Family planningTake-away packagesPost-facility storiesReception of the new mother/babyReactions to costs

DELIVERY POST-PARTUM

Mother

Husband

Mother in law

Health worker

Friends

IN THE FIELD

“This makes my mind think big”

“This makes me focus on one thing”

“If we need help we just shout and hope someone comes. Having a tool to call for help would really be useful“

“No one has a full overview on what is going on. We just see the bits and pieces and therefore sometimes its challenging to prioritize right“

MIDWIFE PROFILES

THE RESCUER

THE IMPROVERTHE SURVIVOR

THE FOLLOWER

Less skillsLack of support

UncertaintyClinical process

ExperienceIntuitionAuthorityEmpathy

Con

text

of

wor

k

Way of working

Sharing work in teamsComplications are taken care in the facility

Often working aloneComplications lead to referrals

FOCUSAREAS

THE RESCUER

THE IMPROVERTHE SURVIVOR

THE FOLLOWER

Less skillsLack of support

UncertaintyClinical process

ExperienceIntuitionAuthorityEmpathy

Con

text

of

wor

k

Way of working

Sharing work in teamsComplications are taken care in the facility

Often working aloneComplications lead to referrals

TIME & TASK MANAGEMENT

VALIDATION &DOCUMENTATION

DATA &RECOMMENDATION

KNOWLEDGE &DECISION MAKING

Workstation Delivery room

Labour room Manager’s Office

TOUCHPOINT OVERVIEW

”There is no-one to ask so I just need to manage.”

The Survivor

MONITORING LABOUR

“Service Design sounds like a wonder-ful approach. Rarely have I been asked what would really help me. Contribut-ing to designing the solutions I will use makes me feel empowered and valued.”

DESIGNINGHEALTHY SYSTEMS

IN AHEALTHY

WAY

DESIGN THINKING

SERVICE DESIGN