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System thinking for large scale impact
ROBERTA TASSI
WIAD 2014 15 febbraio
DESIGN FOR
EVERYDAY LIFE
sys·tem
a set of connected things or parts
forming a complex whole.
For example a set of things working together as parts ...
understanding
#empathy #data #patterns
modeling
#synthesis #structure #visualization
translating
#guide #shape #link
the vast majority of the seven
million children who die every year
never see a doctor
community health workers
are the “last mile” in healthcare and
one of the the biggest untapped
resources in global health.
how to design a comprehensive
and systemic solution to
empower Community Health
Workers at a global scale?
design research
understanding CHW aspirations,
workflow and needs
We relied on a Human-Centered Design process to shape sol...
UGANDA
Before CHWs, having medicines
to treat malaria available right in
the village was a daydream.
CHW SUPERVISOR
4 DIST...
Backpack Plus Design Research
The main challenge is sensitizing
people to look for health services
to timely treat their illnesses.
CHW (ASC) SENEGAL
3 ...
Backpack Plus Design Research
system thinking
mapping and modeling
CHW programs
The Backpack PLUS framework is a CHW-centric model that identifies
all t...
CARE
COMMUNITY HEALTH SYSTEM
SERVICES
TOOLS
CHW
TRUST
CARE
SUPPORT
REPORT
CARE
Backpack Plus Framework
INDIVIDUALCOMMUNITY
ASSESS
& TREAT
EDUCATE
RESPECT
TRUST
SUPERVISOR HEALTH CENTER DISTRICT
SUPPLIES
REPORT
COACH
SUPPORT
R...
Backpack Plus Framework
ADVANCED MODULES
BASIC SET
DIAGNOSTICSCOMMODITIES TOOLS ENABLERS
ACT AMOXICILLIN
CHLORHEXIDINE
PARACETAMOL
RDT
RESPIRATORY...
ACTORS INVOLVED
DESIGN PRINCIPLES
SERVICE ELEMENTS
ON DEMAND
RESUPPLY (supervisor)
Ensure continuity by
selecting people w...
TRAINING SERVICE DELIVERY REVIEWING RESUPPLY REWARDINGRECRUITING UPGRADING
INDIVIDUALCOMMUNITY
CHP
SUPERVISOR SUPPLIERHEAL...
product and service design
from research insights to
holistic solutions
Starting from core CHW needs highlighted during fi...
Current tools and process meant to support
CHWs are fragmented, often affecting
effectiveness and undermining motivation.
...
Backpack Plus Toolkit
From a disconnected
set of diagnostic tools
and medical
commodities to a
well-orchestrated
experience that
improves CHW
ef...
Storage and carrying solutions for tools and
commodities aren’t flexible enough and do not
support CHW workflows.
“The bag I...
Backpack Plus Toolkit
From generic
storage and
carrying solutions
to a system
designed to easily
adapt to
evolving CHW
needs.
Backpack Plus Tool...
Data that is currently generated by CHWs and
other actors in the system is not consistent and
seldom turned into useful in...
From one-way data
flows to closed
and effective
feedback loops
that provide real-
time access to
essential
information.
Bac...
CHWs are asked to cover an ever-increasing
variety of health domains, not always properly
supported by training and adequa...
Backpack Plus Toolkit
From irregular
training sessions
to a continuous
learning model
that targets CHWs
but also accounts
...
Current incentive programs -monetary or
otherwise- often fall short of being perceived as
making the difference in the liv...
Backpack Plus Toolkit
From fragmented
incentive programs
to a clear
hierarchy of roles,
responsibilities,
benefits and
oppo...
Fragmented or inefficient supply chains can result
in perceived lack of CHW support, and undermine
the level of trust they...
Backpack Plus Toolkit
From closed
ecosystems to
integrated public
and private
sector initiatives
aimed at better
supportin...
Backpack Plus Toolkit
Backpack Plus Toolkit
Backpack Plus Toolkit
Backpack Plus Toolkit
Pneumonia
FROM 2 TO 11 MONTHS
Diarrhoea
FROM 2 MONTHS TO 5 YEARS
ACT
Lorem ipsum dolor sit amet, con...
Backpack Plus Emblem
Backpack Plus Emblem
Backpack Plus System
Framework
A reference framework to
gather best practices,
assess gaps and align
partners to scale up ...
Backpack Plus What’s next
T h a n k s
WIAD: Design For Everyday Life
WIAD: Design For Everyday Life
WIAD: Design For Everyday Life
WIAD: Design For Everyday Life
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WIAD: Design For Everyday Life

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Roberta Tassi, frog's Senior Design Researcher in Milan, shares her thoughts on system thinking for large scale impact.

Published in: Technology

Transcript of "WIAD: Design For Everyday Life"

  1. 1. System thinking for large scale impact ROBERTA TASSI WIAD 2014 15 febbraio DESIGN FOR EVERYDAY LIFE
  2. 2. sys·tem a set of connected things or parts forming a complex whole. For example a set of things working together as parts of a mechanism or an interconnecting network.
  3. 3. understanding #empathy #data #patterns
  4. 4. modeling #synthesis #structure #visualization
  5. 5. translating #guide #shape #link
  6. 6. the vast majority of the seven million children who die every year never see a doctor
  7. 7. community health workers are the “last mile” in healthcare and one of the the biggest untapped resources in global health.
  8. 8. how to design a comprehensive and systemic solution to empower Community Health Workers at a global scale?
  9. 9. design research understanding CHW aspirations, workflow and needs We relied on a Human-Centered Design process to shape solutions for CHWs that are based on a deep understanding of their real-world needs. 01
  10. 10. UGANDA Before CHWs, having medicines to treat malaria available right in the village was a daydream. CHW SUPERVISOR 4 DISTRICTS, 37 INTERVIEWS Backpack Plus Design Research
  11. 11. Backpack Plus Design Research
  12. 12. The main challenge is sensitizing people to look for health services to timely treat their illnesses. CHW (ASC) SENEGAL 3 DISTRICTS, 26 INTERVIEWS Backpack Plus Design Research
  13. 13. Backpack Plus Design Research
  14. 14. system thinking mapping and modeling CHW programs The Backpack PLUS framework is a CHW-centric model that identifies all the essential physical, digital and service-level components required to empower and activate CHWs along their journey. 02
  15. 15. CARE COMMUNITY HEALTH SYSTEM SERVICES TOOLS CHW TRUST CARE SUPPORT REPORT CARE Backpack Plus Framework
  16. 16. INDIVIDUALCOMMUNITY ASSESS & TREAT EDUCATE RESPECT TRUST SUPERVISOR HEALTH CENTER DISTRICT SUPPLIES REPORT COACH SUPPORT REPORT REPORT INSTRUCT SUPPLIER TRAINING SERVICE DELIVERY REVIEWING RESUPPLY REWARDINGRECRUITING UPGRADING CHW DIAGNOSTICS TOOLS ENABLERSCOMMODITIES ASSESS TREAT EDUCATE REPORT Backpack Plus Framework
  17. 17. Backpack Plus Framework
  18. 18. ADVANCED MODULES BASIC SET DIAGNOSTICSCOMMODITIES TOOLS ENABLERS ACT AMOXICILLIN CHLORHEXIDINE PARACETAMOL RDT RESPIRATORY TIMER MUAC ORS & ZINC GLOVES ALCOHOL PADS ALCOHOL SCISSORS SOAP BANDAGES SYRINGE TRASH BIN NOTEBOOKTHERMOMETER TRANSPORTATION (bike, motorbike,...) UNIFORM HOUSE SIGNAGE ADVANCED ED. MATERIALS FEEEDBACK SCORECARD HOUSEHOLD REGISTER HEALTH PROMOTION MESSAGES MISOPROSTOL IPT JOB AIDS ED. MATERIALS VISIT REGISTERREFERRAL FORMS STOCK REGISTER RAIN BOOTS RAIN COAT TORCH, LIGHTPENCILS, PENS SOLAR CHARGER MOBILE PHONE VITAMIN A mother VITAMIN A children PILLS CONDOMS PREGNANCY TEST INJECTABLE RUTF SCALE HIV TEST DEWORMING (Albendazole) MAMA KIT 1|PREGNANCY&NEWBORNCARE2|FAMILYPLANNING3|MALNUTRITION4|HIV5,6,7|ADVANCEDSETS8|MAMAKITBASICSET TOOLS JOB AIDS ED. MATERIALS VISIT REGISTERREFERRAL FORMS STOCK REGISTER Backpack Plus Framework
  19. 19. ACTORS INVOLVED DESIGN PRINCIPLES SERVICE ELEMENTS ON DEMAND RESUPPLY (supervisor) Ensure continuity by selecting people who are long-term members of the community (resident, married). Leverage existing influential roles that are already present in the community. Manage age limits (min but also max age). Embrace flexibility to adapt the criteria to specific regions (i.e. nomadic areas, low-literacy,...). SELECTION CRITERIA PUBLIC ANNOUNCEMENTS REGULAR REFRESHER CHW LIST Define reference recruiting criteria RECRUITING TRAINING SERVICE DELIVERY REVIEWING RESUPPLY REWARDING UPGRADING Create modular training plans to enable incremental learning and differentiate competences. Teach fundamentals of time/budget management. Provide analog and mHealth services that can be access by CHWs also at the end of the training period. Create a moment at the end of each training session to certify and/or celebrate the new competences aquired by CHWs. Set up routine refresher training sessions to ensure a continuous learning experience. Support a continuous learning process Provide standard protocols with reference materials that guide the assessment through a series of steps. Create strong consistency and cross-references across job aids, diagnostics, commodities and informational materials. Include visuals that help understanding and sharing the process also with the patients. Improve guidance through integrated tools Provide standard instructions for dosages with supporting reference materials. Create strong consistency and cross-references across job aids, diagnostics, commodities and information. Support referral at a system level (i.e. referred patients are given priority at the clinic). Strenghten follow-up visits through protocols and reminders. Provide clear instructions & follow-up Facilitate education processes through rich media (visuals, audio, video). Optimize content and materials to address different situations (1:1, households, group sessions). Stimulate an active engagement of the community. Provide tools to facilitate education Facilitate consistent data tracking through clear recording standards and protocols. Enable data sharing across different stakeholders by armonizing tools and optimizing transmission of information. Enable data mining by facilitating aggregation of information across tools. Give value to the collected information by giving it back to CHWs and their communities. Improve data collection and mining Establish clear roles of a supervisor and relationship to the CHW (e.g. how often they see each other). Ensure a continuous support and supervision through meetings at defined intervals (e.g. weekly meeting). Include role-modeling through joint visits with supervisors. Include spot checks of the supervisor with the community. Enable the collection of a clear basic set of data that supports the supervisor with performance management. Enable the supervisor to set real incentives in case of good performance. Set clear roles and responsabil- ities Address restocking by using data to make effective forecasts. Maximize resupply efficiency by communicating availability of stocks. Bring the supplies as close as possible to CHWs by leveraging existing resources (shops, private supply chains, etc.). Facilitate transportation (either by reimbursement or by providing logistical support). Optimize access and system efficiency Enhance the community perception of the role of CHWs through branded materials. Give visibility to the CHW-enabled outcomes inside the community. Celebrate & reward the work of CHWs Establish a clear career path based on personal inclinations and impact. Provide incremental training to enrich and evolve competences. Establish a clear career path SUPERVISOR STANDARD PROTOCOLS REFERENCE MATERIALS VISIT TRACKING STOCK TRACKING HOUSEHOLD TRACKING BASIC MODULE ON EDUCATION SPECIAL MODULES (e.g. RDT) CHW CERTIFICATION BASIC MODULE ON ICCM REFERENCE MATERIALS MOBILIZATION FOR SPECIAL EVENTS BEHAVIOR CHANGE DEMONSTRATIONS STANDARD PROTOCOLS REFERRAL PROTOCOLS REFERRAL TRACKING REFERENCE MATERIALS ONE-TO-ONE REVIEWS SPORT PERFORMANCE CHECK GROUP REVIEWS ‘LEAVE-BEHIND’ INSTRUCTIONS EDUCATIONAL GAMES RESUPPLY BY CONSUMPTION ADDITIONAL TRAINING MODULES GRATIFICATION BY BRANDED KIT REIMBURSEMENTS (e.g. TRANPORT) INCENTIVES THROUGH GADGETS FACILITATION BY BASIC ENABLERS CARRIER PATH PERFORMANCE BASED REPORT ASSESS TREAT EDUCATE REPORT BASICCOMPONENTSNENTSINDIVIDUALCOMMUNITYSUPERVISORCLINICDISTRICTSUPPLIERDESIGNPRINCIPLES Establish clear roles of a relationship to the CHW (e.g. how often they see Ensure a continuous support and supervision through meetings at defined intervals (e.g. Set clear roles and responsabil- Address restocking by using data to make effective forecasts. Maximize resupply efficiency by communicating availability of stocks. Bring the supplies as close as possible to CHWs by leveraging Optimize access and system efficiency Enhance the community perception of the role of CHWs through branded materials. Give visibility to the CHW-enabled outcomes inside the community. Celebrate & reward the work of CHWs Establish a clear career path based on personal inclinations and impact. Provide incremental training to enrich and evolve competences. Establish a clear career path Backpack Plus Framework
  20. 20. TRAINING SERVICE DELIVERY REVIEWING RESUPPLY REWARDINGRECRUITING UPGRADING INDIVIDUALCOMMUNITY CHP SUPERVISOR SUPPLIERHEALTH CENTER SUPPLIES ASSESS & TREAT TRUST REPORT COACH REPORT DIAGNOSTICS TOOLS ENABLERSCOMMODITIES SUPPORT ASSESS TREAT EDUCATE REPORT HEALTH RELATED GOODS SERVICES LG BRANCH INDIVIDUAL CHWCOMMUNITY SUPERVISOR SUPPLIES ENGAGE INFORM COACH REPORT SUPPORT REPORT REPORT SUPPORT SUPPLIERHEALTH CENTER DISTRICT MAPPING OTHER PROVIDERS MAPPING OTHER USERS MAPPING PRIVATE OPPORTUNITIES Backpack Plus Framework
  21. 21. product and service design from research insights to holistic solutions Starting from core CHW needs highlighted during field research we identified opportunities to improve the quality of the solutions they are provided. Integrating physical tools and mobile-enabled services into one cohesive experience will positively impact community health outcomes. 03
  22. 22. Current tools and process meant to support CHWs are fragmented, often affecting effectiveness and undermining motivation. “The job aid is our Bible” CHW (UGANDA) Backpack Plus Research Insight
  23. 23. Backpack Plus Toolkit
  24. 24. From a disconnected set of diagnostic tools and medical commodities to a well-orchestrated experience that improves CHW effectiveness. Backpack Plus Toolkit
  25. 25. Storage and carrying solutions for tools and commodities aren’t flexible enough and do not support CHW workflows. “The bag I was given is big and bulky, I never need to carry that much.” CHW (UGANDA) Backpack Plus Research Insight
  26. 26. Backpack Plus Toolkit
  27. 27. From generic storage and carrying solutions to a system designed to easily adapt to evolving CHW needs. Backpack Plus Toolkit
  28. 28. Data that is currently generated by CHWs and other actors in the system is not consistent and seldom turned into useful information. “The data collected here is always incomplete.” DISTRICT MANAGER (SENEGAL) Backpack Plus Research Insight
  29. 29. From one-way data flows to closed and effective feedback loops that provide real- time access to essential information. Backpack Plus Toolkit
  30. 30. CHWs are asked to cover an ever-increasing variety of health domains, not always properly supported by training and adequate tools. “New training means that they are investing in us!” CHW (SENEGAL) Backpack Plus Research Insight
  31. 31. Backpack Plus Toolkit From irregular training sessions to a continuous learning model that targets CHWs but also accounts for the need to educate their communities.
  32. 32. Current incentive programs -monetary or otherwise- often fall short of being perceived as making the difference in the lives of CHWs. “These people put in their own money to do their job!” CLINICAL OFFICER (UGANDA) Backpack Plus Research Insight
  33. 33. Backpack Plus Toolkit From fragmented incentive programs to a clear hierarchy of roles, responsibilities, benefits and opportunities for growth over time.
  34. 34. Fragmented or inefficient supply chains can result in perceived lack of CHW support, and undermine the level of trust they need to be effective. “Why should I walk to the clinic if then they don’t have medicines?” CHW (SENEGAL) Backpack Plus Research Insight
  35. 35. Backpack Plus Toolkit From closed ecosystems to integrated public and private sector initiatives aimed at better supporting CHWs and Supervisors.
  36. 36. Backpack Plus Toolkit
  37. 37. Backpack Plus Toolkit
  38. 38. Backpack Plus Toolkit
  39. 39. Backpack Plus Toolkit Pneumonia FROM 2 TO 11 MONTHS Diarrhoea FROM 2 MONTHS TO 5 YEARS ACT Lorem ipsum dolor sit amet, consectetuer adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. Malaria FROM 4 MONTHS TO 3 YEARS 07712345678 07712345678 ORS Lorem ipsum dolor sit ame diam nonummy nibh euism magna aliquam erat volutp Amoxicillin Lorem ipsum dolor sit amet, consectetuer adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. 07712345678 Paracetamol Lorem ipsum dolor sit amet, consectetuer adipiscing elit, sed diam nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. 07712345678 Diarrhoea FROM 2 MONTHS TO 5 YEARS Zinc Lorem ipsum dolor sit ame adipiscing elit, sed diam no Chlorhexi Lorem ipsum dolor sit amet, adipiscing elit, sed diam non Neonatal care NEW BORN Fever FROM 0 TO 5 YEARS TYPOGRAPHY COLOR PALETTE ICONS Noto Sans Bold Noto Sans Bold Italic Noto Sans Regular MAIN TEXT SECONDARY TEXT MAIN DISEASES GENERIC DISEASE
  40. 40. Backpack Plus Emblem
  41. 41. Backpack Plus Emblem
  42. 42. Backpack Plus System Framework A reference framework to gather best practices, assess gaps and align partners to scale up existing and future CHW initiatives. Toolkit Emblem A systemic set of physical and digital tools to empower CHWs and improve the quality of the healthcare services they provide. A symbol for Backpack PLUS that could be used by the public health community for advocacy and large scale fundraising.
  43. 43. Backpack Plus What’s next
  44. 44. T h a n k s
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