ADAPTING SERVICE DESIGN FOR SOCIAL IMPACT

October 2, 2015Zack Brisson

http://Reboot.org @theReboot

ABOUT REBOOTReboot is a think and do tank dedicated to inclusive development and accountable governance.

We help governments, foundations, and international organizations achieve their missions.

DESIGN HAS CHANGED THE PRIVATE SECTOR

DESIGN HAS TRANSFORMED THE PRIVATE SECTOR

BUT WE STILL HAVE A WAYS TO GO IN THE PUBLIC SECTOR

SO WHERE DO WE ADAPT?

PRINCIPLE 1

ADDRESS THE PUBLIC SECTOR’S UNIQUE INCENTIVES

PRINCIPLE 2

THINKING & WORKING POLITICALLY

PRINCIPLE 3

DON’T JUST SHIP - BUILD CAPACITY

PRINCIPLE 4

SPEAK THE PUBLIC SECTOR LINGO

RECAP- Address the Public Sector’s Unique Incentives

- Think & Work Politically

- Don’t Just Ship - Build Capacity

- Speak the Public Sector Lingo

PUTTING THESE INTO PRACTICE

CONTEXT

Wamba, Nassarawa State, Nigeria

Visit the clinic. Receive short SMS survey. All responses collected and put into reports.

Reports distributed to national, state, LGA, and hospital staff.

We are all working to make health care better!

Addressing Public Sector’s Unique Incentives

Thinking & Working Politically

Don’t Just Ship - Build Capacity

Speak the Public Sector Lingo

FEEDBACK COLLECTION

DATA MANAGEMENT& DISSEMINATION

INSTITUTIONAL UTILIZATION & RESPONSE

1aDuring the patient intake process at the health facility, staff members register patients by collecting their unique ID number, mobile number, and purpose of visit. Staff send this information in one SMS to the free My Voice shortcode.

Patient receives a mobile survey with a series of up to nine questions about their experience at the health facility. Patients respond by choosing from multiple-choice answers; they also have the option of providing additional, free-form comments.

All received comments are organized and stored in the My Voice database. Authorized users can access a back-end administra-tive viewing panel to sort and download data by clinic, date of report, service delivered, and other relevant categories.

Any person can send open-ended feedback on a health facility experience to the free My Voice shortcode at any time, regardless of whether they are registered with My Voice. To do so, they first send an SMS message with a trigger word. The system then prompts them to select a clinic and provide feedback via subsequent text messages. Select community groups and leaders are also encouraged to send feedback reported to them by local citizens.

3b

3a

2

Program executives and policymakers from the relevant state, national, and World Bank bodies view patient feedback via the My Voice dashboard (www.myvoicenigeria.com) which is updated in real-time.

Reports on each facility are printed and delivered weekly by government health staff to each facility’s management and the director of primary health care for the local area.

4

5

Registered patient responds to questionnaire

Patient feedback is stored in database

IN-CLINIC REPORTING

Patient sends feedback via mobile

Printed reports are delivered weekly to service providers and local level NSHIP management

Facility management and local government health staff discuss the patient feedback from the weekly reports. They reflect on practices contributing to patient satisfaction that should be continued, and identify incidences of patient grievance that require further examination. The same process is repeated with facility staff.

Facilities discuss patient feedback and reflect on own practice

Facility management and staff jointly use a problem-solving framework to discuss possible causes of challenges surfaced by patients. Based on this, they then develop action plans to address identified issues. The plan is shared with the local director of primary health care.

Facilities develop action plans to address identified challenges

Local government uses patient feedback to supplement data from other facility evaluation instruments and develop more holistic analyses of what drives or constrains health service delivery. Analyses inform key management discussions and decisions on program spending and technical support provision in meetings at state and national levels as well.

Patient feedback is used to improve service delivery

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Community leaders—in this case, the local Ward Development Committees—use the My Voice reports to develop recommenda-tions for improvements in health services and advocate for these improvements with local facilities and government.

Community leaders advocate for service delivery improvements

OUT-OF-CLINIC REPORTING

Analyzed patient feedback data is displayed in summary reports on the My Voice web dashboard.

1b

FINAL TAKEAWAYS

THANK YOU!

October 2, 2015Zack Brisson

http://Reboot.org @theReboot