Using a human-centered
design process to drive
healthcare innovation:
THE UNICEF BACKPACK
PLUS PROJECT
Roberta Tassi,
Seni...
frog | Introduction

FROG IS A GLOBAL
PRODUCT STRATEGY
AND DESIGN FIRM
We bring together a unique combination of creativit...
frog | Introduction

BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS?

23/01/2014

3
frog Milan | Introduction

AMSTERDAM
MUNICH
SEATTLE
BOSTON
SAN FRANCISCO

NEW YORK

AUSTIN

SHANGHAI

frog MILAN

BIOCAT H...
frog | Introduction

WE APPLY A HUMANCENTERED DESIGN PROCESS
TO DRIVE HEALTHCARE
INNOVATION
Design Research, Design Framew...
Our Approach | Design Research

WE USE DESIGN RESEARCH
TO ILLUMINATE HUMAN
PROBLEMS -BOTH KNOWN
AND UNKNOWN- BY
COLLECTING...
Our Approach | Design Frameworks

PARTICIPATORY DESIGN SESSION
POPULATION
MANAGEMENT
Aggregated data over time provides ev...
Our Approach | Experience Principles

WE IDENTIFY EXPERIENCE
PRINCIPLES TO GUIDE THE
DESIGN ACTIVITIES,
BRINGING THE DESIR...
Backpack Plus
Empowering Community Health Workers

BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS?

23/01/2014

9
Backpack Plus | Introduction

The vast majority of the seven million children
who die every year never see a doctor.

BIOC...
Backpack Plus | Introduction

Community Health Workers are the “last mile”
in healthcare and one of the the biggest untapp...
Backpack Plus | Introduction

To increase their impact
on child mortality, improve
effectiveness and boost
efficiency, Com...
Backpack PLUS | Putting CHWs at the Center

HOW TO DESIGN A
COMPREHENSIVE AND
SYSTEMIC SOLUTION
TO EMPOWER COMMUNITY
HEALT...
Framework | The Backpack PLUS Model

RESEARCH

Understanding CHW
Workflow and Needs
We relied on a Human-Centered Design pr...
Backpack Plus | Field Research

UGANDA
Before CHWs, having
medicines to treat malaria
available right in the village
was a...
Backpack Plus | Field Research

The main challenge is
sensitizing people to look for
health services to timely treat
their...
Backpack Plus | Field Research

BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS?

23/01/2014

17
Backpack Plus | Field Research

BACKPACK ARCHITECTURE / 02
BACKPACK ARCHITECTURE / 02

CARRYING & LOMG-TERM STORAGE
A bag/...
Framework | The Backpack PLUS Model

FRAMEWORK

Mapping and Modeling
CHW Programs
The Backpack PLUS framework is a CHW-cen...
Framework | The Backpack PLUS Model

TOOLS

SUPPORT

TRU
CAREST

COMMUNITY

HEALTH SYSTEM

CHW

CARE
REPORT

SERVICES

CHW...
Framework | The Backpack PLUS Model
COMMODITIES

DIAGNOSTICS

TOOLS

ENABLERS

INSTRUCT

RESPECT
SUPPORT

SUPPLIES

TRUST
...
Framework | The Backpack PLUS Model

BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS?

23/01/2014

22
8 | MAMA KIT

Framework | Inventory of Hard Components

MAMA KIT

HEALTH PROMOTION
MESSAGES

SCISSORS

HOUSEHOLD
REGISTER
...
Framework | Inventory of Soft Components

RECRUITING

TRAINING

SERVICE DELIVERY
TREAT

EDUCATE

REVIEWING

RESUPPLY

REWA...
Framework | Sample applications: country mapping

COUNTRY ASSESSMENT

BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS?
...
Framework | Sample applications: mapping private
providers or other actors (Supervisors)

MAPPING OTHER PROVIDERS

COMMODI...
Tools | The Backpack PLUS Experience

TOOLS & PRINCIPLES

From Research Insights
to Holistic Solutions
Starting from core ...
Gaye

Tools | CHW Archetypes

Fatima

HIGHER-SKILLED
CHW

LOWER-SKILLED
CHW

The health of my community is the most
import...
Tools | CHW Archetypes

Roles and responsibilities of CHWs vary
greatly across programs and geographies,
but common archet...
Tools | CHW Archetypes

All Archetypes share a common set of needs.
The context they operate in has a strong influence
on t...
Tools | The Backpack PLUS System Overview

BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS?

23/01/2014

31
Tools | Issues Highlighted During Field Research

01

“The job aid is
our Bible”
CHW (UGANDA)

Current tools and process m...
Tools | Opportunities: The Backpack PLUS Experience

From a disconnected set of diagnostic tools and
medical commodities t...
Tools | Issues Highlighted During Field Research

02

“The bag I was given
is big and bulky,
I never need to carry
that mu...
Tools | Opportunities: The Backpack PLUS Experience

From generic storage and carrying
solutions to a system designed to e...
Tools | Issues Highlighted During Field Research

03

“The data collected
here is always
incomplete.”
DISTRICT MANAGER (SE...
Tools | Opportunities: The Backpack PLUS Experience

From one-way data flows to closed
and effective feedback loops that pr...
Tools | Issues Highlighted During Field Research

04

“New training means
that they are investing
in us!”
CHW (SENEGAL)

C...
Tools | Opportunities: The Backpack PLUS Experience

From irregular training sessions to a continuous
learning model that ...
Tools | Issues Highlighted During Field Research

05

“These people put in
their own money to do
their job!”
CLINICAL OFFI...
Tools | Opportunities: The Backpack PLUS Experience

From fragmented incentive programs to a clear
hierarchy of roles, res...
Tools | Issues Highlighted During Field Research

06

“Why should I walk to
the clinic if then they
don’t have medicines?”...
Tools | Opportunities: The Backpack PLUS Experience

From closed ecosystems to integrated
public and private sector initia...
Tools | The Backpack PLUS System Overview

BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS?

23/01/2014

44
Tools | The Backpack PLUS System Overview

BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS?

23/01/2014

45
Tools | The Backpack PLUS System Overview

TYPOGRAPHY

MAIN TEXT

Noto Sans Bold
SECONDARY TEXT

Pneumonia

Noto Sans Bold...
Tools | The Backpack PLUS System Overview

BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS?

23/01/2014

48
47
Backpack Plus | Impact

Backpack Plus
Projected Impact
More cases treated

Better quality of care

Higher efficiency thank...
49
Thanks
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Roberta Tassi / Using a human-centered design process to drive healthcare innovation: THE UNICEF BACKPACK PLUS PROJECT

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Biocat organized a workshop ((January 24, 2014, dHUB Building, Barcelona) about the application of Design Thinking in Health, a strategic topic with strong growth potential. The goals of the event are to provide a general overview of the methodology - considered by some as a true “work philosophy” for problem solving - as well as to explain its origins, fields of application, main benefits and to identify opportunities to innovate in health.

Roberta Tassi / Using a human-centered design process to drive healthcare innovation: THE UNICEF BACKPACK PLUS PROJECT

  1. 1. Using a human-centered design process to drive healthcare innovation: THE UNICEF BACKPACK PLUS PROJECT Roberta Tassi, Senior Design Researcher, frog
  2. 2. frog | Introduction FROG IS A GLOBAL PRODUCT STRATEGY AND DESIGN FIRM We bring together a unique combination of creativity, collaboration and business planning to deliver breakthrough products and services to the market. We are more than 600 strategists, researchers, designers, and technologists who consult and partner with clients across industries and geographies. We help organizations increase their value and expand their offerings through a human-centered design process. BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 2
  3. 3. frog | Introduction BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 3
  4. 4. frog Milan | Introduction AMSTERDAM MUNICH SEATTLE BOSTON SAN FRANCISCO NEW YORK AUSTIN SHANGHAI frog MILAN BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 4
  5. 5. frog | Introduction WE APPLY A HUMANCENTERED DESIGN PROCESS TO DRIVE HEALTHCARE INNOVATION Design Research, Design Frameworks, Design Principles BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 5
  6. 6. Our Approach | Design Research WE USE DESIGN RESEARCH TO ILLUMINATE HUMAN PROBLEMS -BOTH KNOWN AND UNKNOWN- BY COLLECTING INSIGHTS THROUGH OBSERVING AND UNDERSTANDING USER BEHAVIORS. CENTERED ON USERS DRIVEN BY CREATIVITY UNDERSTANDING HUMANS Observing action Understanding behavior Finding underlying motivations Building empathy BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? Immerse in the context What people say, do, think. 23/01/2014 DESIGNED TO BE INCLUSIVE 6
  7. 7. Our Approach | Design Frameworks PARTICIPATORY DESIGN SESSION POPULATION MANAGEMENT Aggregated data over time provides evidence of patient outcomes to help drive best practices and reimbursement. YEARS 360 STANDARD OF CARE MONEY PAYER /PROVIDER HCP-PWD COLLABORATION MONTHS WE BUILD DESIGN FRAMEWORKS: ABSTRACT REPRESENTATIONS OF MODELS AND FLOWS THAT TRANSLATE OUR THINKING AND FACILITATE CONVERSATIONS AROUND COMPLEX SOLUTIONS. In essence 360 is a tool for HCP-PwD collaboration in which the PwD provides the data (in their devices) and the HCP interprets the data, makes therapy decisions, and instructs the patient. 360 EDUCATION / ADVICE / ENCOURAGEMENT THERAPY DECISIONS DEVICE CONFIGURATION WEEKS HCP 360 CAREGIVER 360 CAREGIVER CAREGIVER the caregiver often plays an intermediate role between the HCP and the PwD SELF REFLECTION Reviewing progress, goals, and patterns to: - understand relationships between activity, diet, medication, symptoms, and glucose levels; - make choices about therapy and lifestyle. MOTIVATION 360 THERAPY DECISION DAYS 360 DEVICE CONFIGURATION USER EXPERIENCE MAP PHARMACY SOCIAL MEDIA Automate consumable reorder? TIME FRAME ROCHE Utilization and outcomes data can help Roche develop better products and services BG RESULT BG TREATMENT DOSAGE DAILY LIFE TREATMENT MANAGING COMPLEXITY REAL TIME SELF-MANGEMENT Putting the user at the center - The daily rituals of self-management are the core: essential both for outcomes and to generate the data upon which the 360 system rests Giving tangibility to the intangible BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? Defining a language to facilitate communication processes - All feedback loops ultimately aim to influence outcomes by influencing this sphere SYSTEM & VALUE HOURS PWD 23/01/2014 MODEL 7 - Non-insulin-using patients lack a real-time 'closed loop' and therefore can lack intrinsic motivation to engage - MDI patients miss the automatic data collection of pump users, although the potential richness and value of data is equivalent. - Many key parameters remain untracked: diet, exercise, mood, stress, co-morbidities, etc.
  8. 8. Our Approach | Experience Principles WE IDENTIFY EXPERIENCE PRINCIPLES TO GUIDE THE DESIGN ACTIVITIES, BRINGING THE DESIRED QUALITIES, BEHAVIORS AND INTERACTIONS TO LIFE THROUGH PRODUCTS AND SERVICES. ENVISIONING THE SOLUTION Identifying the signature moments Creating principles and user stories Socializing inside the company/team USER STORIES Nurture our relationship E.g. contact users after the first month to ask them if they are satisfied with the service. Make me count E.g. ask movement participants to help create a coverage map that shows how good the network is in different parts of the city. Make me smile E.g. provide additional functionality and companion content on the phone when the user watches TV. WHY WHAT HOW People want network providers and their annoying ads or badly executed software out of the way. R4G wants to make your life feel good, to make you remember that small thing which makes a big difference and makes people smile True delight is in the tiny details of the execution, but has a huge impact on the overall experience, especially when it's unexpected. Surprise people by giving that one extra touch of love that makes them smile, because they understand you care. BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? TOOLS FOR SOCIALIZATION WHY WHAT HOW WHY WHAT HOW Most people are indifferent to telcos and network companies, or are annoyed by having unfit offers pushed on them. Putting people first is a core value of R4G, promising to always help out and provide great A harmonic relationship with a brand is built over time, and based on getting what is best for oneself, while being heard and supported as needed. The more personal/human the relationship is, the Act on what's "best for the user" and actively foster, maintain, and strengthen the personal relationship with them. Make the user feel cared for by offering personalized customer service and transparency Today people often feel helpless and at the mercy of companies and institutions. However, there is a new generation in India that wants to leap up and change the future. The R4G movement supports this new mood A movement has to be about people, and people have to feel like a valuable part of the movement. They have to see that they are participating in creating a better future for themselves and for India. Foster a sense of co-creation. This is a network by Indians for India from the ground up. Lower the barriers for entry, make communication tools ubiquitous, and create stronger ties to the online 23/01/2014 FUTURE SCENARIOS 8
  9. 9. Backpack Plus Empowering Community Health Workers BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 9
  10. 10. Backpack Plus | Introduction The vast majority of the seven million children who die every year never see a doctor. BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 10
  11. 11. Backpack Plus | Introduction Community Health Workers are the “last mile” in healthcare and one of the the biggest untapped resources in global health. BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 11
  12. 12. Backpack Plus | Introduction To increase their impact on child mortality, improve effectiveness and boost efficiency, Community Health Workers need holistic solutions that address their daily and long-term needs. Backpack PLUS offers an approach towards a comprehensive and systemic solution to achieve these ambitious goals. BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 12
  13. 13. Backpack PLUS | Putting CHWs at the Center HOW TO DESIGN A COMPREHENSIVE AND SYSTEMIC SOLUTION TO EMPOWER COMMUNITY HEALTH WORKERS AT A GLOBAL SCALE? 1 Design Research | 2 Design Framework | 3 Design Principles BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 13
  14. 14. Framework | The Backpack PLUS Model RESEARCH Understanding CHW 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. BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 14
  15. 15. Backpack Plus | Field Research UGANDA Before CHWs, having medicines to treat malaria available right in the village was a daydream. 4 DISTRICTS, 37 INTERVIEWS CHW SUPERVISOR BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014
  16. 16. Backpack Plus | Field Research The main challenge is sensitizing people to look for health services to timely treat their illnesses. CHW (ASC) SENEGAL 3 DISTRICTS, 26 INTERVIEWS BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 16 7
  17. 17. Backpack Plus | Field Research BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 17
  18. 18. Backpack Plus | Field Research BACKPACK ARCHITECTURE / 02 BACKPACK ARCHITECTURE / 02 CARRYING & LOMG-TERM STORAGE A bag/backpack to store /carry CARRYING & LOMG-TERM STORAGE the register and most supplies A bag/backpack to store /carry the register and most supplies RESUPPLY A chest/container RESUPPLY to hold a minimum amount A chest/container of supplies (2-3 days) to hold a minimum amount of supplies (2-3 days) CARD SORTING STORAGE STORAGE VISIT AT HOME VISIT AT HOME HOUSE-TO-HOUSE VISITS HOUSE-TO-HOUSE VISITS RESUPPLY RESUPPLY BP+ frogTHINK / KAMPALA, JUNE 4th / 5th BP+ frogTHINK / KAMPALA, JUNE 4th / 5th CONCEPT EVALUATION & REFINEMENT REAL TIME PROTOTYPING BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 18
  19. 19. Framework | The Backpack PLUS Model FRAMEWORK 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. BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 19
  20. 20. Framework | The Backpack PLUS Model TOOLS SUPPORT TRU CAREST COMMUNITY HEALTH SYSTEM CHW CARE REPORT SERVICES CHWs are crucial links connecting the communities they serve and the health system. BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 20
  21. 21. Framework | The Backpack PLUS Model COMMODITIES DIAGNOSTICS TOOLS ENABLERS INSTRUCT RESPECT SUPPORT SUPPLIES TRUST COACH COMMUNITY SUPERVISOR INDIVIDUAL CHW ASSESS & TREAT HEALTH CENTER DISTRICT SUPPLIER REPORT REPORT EDUCATE REPORT RECRUITING TRAINING SERVICE DELIVERY ASSESS TREAT BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? EDUCATE REVIEWING RESUPPLY REWARDING UPGRADING REPORT 23/01/2014 21
  22. 22. Framework | The Backpack PLUS Model BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 22
  23. 23. 8 | MAMA KIT Framework | Inventory of Hard Components MAMA KIT HEALTH PROMOTION MESSAGES SCISSORS HOUSEHOLD REGISTER FEEEDBACK SCORECARD UNIFORM TRANSPORTATION (bike, motorbike,...) ALCOHOL PADS ALCOHOL HOUSE SIGNAGE ADVANCED ED. MATERIALS TRASH BIN NOTEBOOK 3 | MALNUTRITION 4 | HIV SOAP BANDAGES 5,6,7 | ADVANCED SETS SYRINGE THERMOMETER HIV TEST DEWORMING (Albendazole) RUTF SCALE STOCK REGISTER 2 | FAMILY PLANNING INJECTABLE PILLS CONDOMS PREGNANCY TEST VITAMIN A mother ED. MATERIALS VITAMIN A children MISOPROSTOL VISIT REGISTER JOB AIDS ADVANCED MODULES 1 | PREGNANCY & NEWBORN CARE REFERRAL FORMS IPT GLOVES PARACETAMOL STOCK REGISTER SOLAR CHARGER MOBILE PHONE TOOLS BASIC SET BASIC SET ORS & ZINC CHLORHEXIDINE RESPIRATORY TIMER ACT AMOXICILLIN RDT COMMODITIES REFERRAL FORMS MUAC DIAGNOSTICS BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? VISIT REGISTER PENCILS, PENS TORCH, LIGHT JOB AIDS ED. MATERIALS RAIN BOOTS RAIN COAT TOOLS ENABLERS 23/01/2014 23
  24. 24. Framework | Inventory of Soft Components RECRUITING TRAINING SERVICE DELIVERY TREAT EDUCATE REVIEWING RESUPPLY REWARDING UPGRADING REPORT Establish clear roles of a relationship to the CHW (e.g. how often they see SUPERVISOR COMMUNITY CLINIC DISTRICT ACTORS INVOLVED Set clear Optimize roles and access and responsabil- system efficiency SUPPLIER INDIVIDUAL ASSESS SUPERVISOR Ensure continuity by selecting people who are long-term members of the community (resident, married). DESIGN PRINCIPLES Support a continuous learning process Create modular training plans to enable incremental learning and differentiate competences. Leverage existing influential roles that are already present in the community. DESIGN PRINCIPLES Define reference recruiting criteria Teach fundamentals of time/budget management. Manage age limits (min but also max age). Embrace flexibility to adapt the criteria to specific regions (i.e. nomadic areas, low-literacy,...). 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. Improve guidance through integrated tools 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. Provide clear instructions & follow-up 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). Address restocking by using data to make effective forecasts. Maximize resupply Provide tools to facilitate education Improve Set clear Optimize Celebrate Establish efficiency by data Ensure a continuous access and & reward roles and communicating a clear collection the work career supportresponsabil- system availability of stocks. and supervision and mining ities of CHWs path through meetings at efficiency Facilitate education processes through rich media (visuals, audio, video). Celebrate & reward the work of CHWs Establish a clear career path Enhance the community perception of the role of CHWs through branded materials. Establish a clear career path based on personal inclinations and impact. Provide incremental training to enrich and evolve competences. Facilitate consistent data tracking through clear recording standards and protocols. Optimize content and materials to address different situations (1:1, households, group sessions). Stimulate an active engagement of the community. defined Establish clear roles (e.g.Address restockingBring thethe community Establish a clear career intervals of a by Enhance supplies as using data to make perception of the role of path based on personal supervisor and effective forecasts.close as possible to CHWs through branded inclinations and impact. relationship to the CHW materials. (e.g. how often they see Maximize resupplyCHWs by leveraging Provide incremental each other). efficiency by Give visibility to the training to enrich and 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. Strenghten follow-up visits through protocols and reminders. Give visibility to the CHW-enabled outcomes inside the community. Set up routine refresher training sessions to ensure a continuous learning experience. 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. communicating availability of stocks. CHW-enabled outcomes inside the community. evolve competences. GRATIFICATION BY BRANDED KIT ADDITIONAL TRAINING MODULES 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). Enable the supervisor to set real incentives in case of good performance. BASIC COMPONENTS ADVANCED COMPONENTS BASIC MODULE ON EDUCATION STANDARD PROTOCOLS STANDARD PROTOCOLS REFERENCE MATERIALS VISIT TRACKING ONE-TO-ONE REVIEWS CHW LIST BASIC MODULE ON ICCM REFERENCE MATERIALS REFERENCE MATERIALS BEHAVIOR CHANGE DEMONSTRATIONS STOCK TRACKING GROUP REVIEWS INCENTIVES THROUGH GADGETS SPECIAL MODULES (e.g. RDT) REFERRAL PROTOCOLS MOBILIZATION FOR SPECIAL EVENTS SPORT PERFORMANCE CHECK REIMBURSEMENTS (e.g. TRANPORT) CHW CERTIFICATION SERVICE ELEMENTS SELECTION CRITERIA REFERRAL TRACKING PUBLIC ANNOUNCEMENTS REGULAR REFRESHER ‘LEAVE-BEHIND’ INSTRUCTIONS EDUCATIONAL GAMES HOUSEHOLD TRACKING PERFORMANCE BASED REPORT ON DEMAND RESUPPLY (supervisor) FACILITATION BY BASIC ENABLERS CARRIER PATH SELECTION TEST FINAL TEST REMINDER SYSTEM COMMUNITY REWARDING PLANS COUNSELING TRACKING SUPERVISION GRID SPECIAL SUPPLY BY INITIATIVES CELEBRATION OF SUCCESS BADGING SYSTEM HOUSEHOLD GOALS RECOGNITION PATIENT TRACKING ABILITY CHECK STOCK-MGM FACILITATORS PERFORMANCE BOARD BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? FAMILY/COMMUNITY ENGAGEMENT HEALTH CAMPAIGNS RESUPPLY BY CONSUMPTION 23/01/2014 24
  25. 25. Framework | Sample applications: country mapping COUNTRY ASSESSMENT BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 25
  26. 26. Framework | Sample applications: mapping private providers or other actors (Supervisors) MAPPING OTHER PROVIDERS COMMODITIES DIAGNOSTICS TOOLS ENABLERS MAPPING PRIVATE OPPORTUNITIES HEALTH RELATED GOODS SUPPORT SUPPLIES TRUST COMMUNITY COACH INDIVIDUAL SUPERVISOR CHP ASSESS & TREAT HEALTH CENTER SUPPLIER LG BRANCH REPORT REPORT SERVICES RECRUITING TRAINING SERVICE DELIVERY ASSESS TREAT REVIEWING EDUCATE RESUPPLY REWARDING UPGRADING REPORT MAPPING OTHER USERS INFORM SUPPORT SUPPLIES REPORT COMMUNITY INDIVIDUAL SUPPORT CHW HEALTH CENTER COACH SUPERVISOR DISTRICT SUPPLIER REPORT REPORT ENGAGE BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 26
  27. 27. Tools | The Backpack PLUS Experience TOOLS & PRINCIPLES 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. BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 27
  28. 28. Gaye Tools | CHW Archetypes Fatima HIGHER-SKILLED CHW LOWER-SKILLED CHW The health of my community is the most important thing for me Maliki CLINIC-BASED People call me ‘village doctor’ Jassim CHW SUPERVISOR CHW Without sensitization, people wouldn’t come to the BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? health post I try to visit my CHWs once a month but often I don’t really have time 23/01/2014 28
  29. 29. Tools | CHW Archetypes Roles and responsibilities of CHWs vary greatly across programs and geographies, but common archetypes exist. LOWER-SKILLED CHW HIGHER-SKILLED CHW CLINIC-BASED CHW CHW SUPERVISOR HEALTH EDUCATION TREATMENT (iCCM) SUPERVISION Lower-skilled CHWs provide Health Education to their communities, and are highly mobile, operating most of the time on the go, and focusing on social gatherings. Higher-skilled CHWs are trained to cover iCCM duties. They tend to operate out of their homes, hence needing to also store large quantities of commodities and tools. BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? Clinic-based CHWs operate out of rural Health Posts, where they support medical professionals. They usually have their set of supplies, but can easily restock at the Clinic. 23/01/2014 Supervisors monitor and mentor groups of CHWs. They are or have been CHWs themselves. They are usually based out of a clinic, but have to regularly visit their CHWs. 29
  30. 30. Tools | CHW Archetypes All Archetypes share a common set of needs. The context they operate in has a strong influence on the set of tools they tend to use. LOWER-SKILLED CHW HIGHER-SKILLED CHW CLINIC-BASED CHW CHW SUPERVISOR HEALTH EDUCATION TREATMENT (iCCM) SUPERVISION ON THE GO HOME BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? CLINIC 23/01/2014 30
  31. 31. Tools | The Backpack PLUS System Overview BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 31
  32. 32. Tools | Issues Highlighted During Field Research 01 “The job aid is our Bible” CHW (UGANDA) Current tools and process meant to support CHWs are fragmented, often affecting effectiveness and undermining motivation. BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 32
  33. 33. Tools | Opportunities: The Backpack PLUS Experience From a disconnected set of diagnostic tools and medical commodities to a well-orchestrated experience that improves CHW effectiveness. An integrated approach to information-gathering tools, diagnostic devices, mobile-enabled services and medical commodities will guide service delivery during a visit, streamlining workflows and increasing patient and community trust in the indications provided by CHWs. BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? Mobile-enabled assessment tools 23/01/2014 Consistent packaging design 33 Referral tools are also integrated
  34. 34. Tools | Issues Highlighted During Field Research 02 “The bag I was given is big and bulky, I never need to carry that much.” CHW (UGANDA) Storage and carrying solutions for tools and commodities aren’t flexible enough and do not support CHW workflows BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 34
  35. 35. Tools | Opportunities: The Backpack PLUS Experience From generic storage and carrying solutions to a system designed to easily adapt to evolving CHW needs. A long-term storage solution for supplies and commodities at home that’s fully integrated with a carrying solution for visits on the go will improve CHW efficiency. Flexible compartments will support varying loads, while dedicated areas for “assessment” and “treatment” will better support CHW workflows. BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? A modular home storage system 23/01/2014 Integrated home and on the go solutions 35 Flexible loading capacity
  36. 36. Tools | Issues Highlighted During Field Research 03 “The data collected here is always incomplete.” DISTRICT MANAGER (SENEGAL) Data that is currently generated by CHWs and other actors in the system is not consistent and seldom turned into useful information. BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 36
  37. 37. Tools | Opportunities: The Backpack PLUS Experience From one-way data flows to closed and effective feedback loops that provide realtime access to essential information. BIOCAT Community performance boards An integrated information management approach that flexibly accounts for analog and mobile-enabled workflows will provide timely feedback loops to all relevant actors in the system. Real-time stock tracking and access to patient information will improve CHW effectiveness while addressing current stock HOW DESIGNmanagementIMPROVE MY BUSINESS? THINKING CAN issues. 23/01/2014 Integrated analog and digital reporting tools 37
  38. 38. Tools | Issues Highlighted During Field Research 04 “New training means that they are investing in us!” CHW (SENEGAL) CHWs are asked to cover an everincreasing variety of health domains, from iCCM to family planning and HIV prevention, not always properly supported by training and adequate tools. BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 38
  39. 39. Tools | Opportunities: The Backpack PLUS Experience From irregular training sessions to a continuous learning model that targets CHWs but also accounts for the need to educate their communities. A flexible and scalable training curriculum that combines longer immersions with ad-hoc modules will create opportunities for CHWs to “learn on the go” and constantly improve their skills over time. Mobile-enabled media will allow CHWs to repurpose their training materials to educate their communities in return. BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? Checklists and reminders Real-time support services 23/01/2014 39 Mobile learning services
  40. 40. Tools | Issues Highlighted During Field Research 05 “These people put in their own money to do their job!” CLINICAL OFFICER (UGANDA) Current incentive programs - monetary or otherwise - often fall short of being perceived as making the difference in the lives of CHWs. BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 40
  41. 41. Tools | Opportunities: The Backpack PLUS Experience From fragmented incentive programs to a clear hierarchy of roles, responsibilities, benefits and opportunities for growth over time. BIOCAT Custom home signage A reward and incentives architecture that feels like a career path will help in retaining CHWs, while motivating them to improve their performance. Clearly defined CHW “maturity models” can help mitigate differences across programs and geographies, provide clear expectations for CHW growth and HOW DESIGNimprove Supervisor effectiveness. THINKING CAN IMPROVE MY BUSINESS? SUPERVISOR 23/01/2014 Transportation aids 41 Supervisor pin
  42. 42. Tools | Issues Highlighted During Field Research 06 “Why should I walk to the clinic if then they don’t have medicines?” CHW (SENEGAL) Fragmented or inefficient supply chains can result in perceived lack of CHW support, and undermine the level of trust they need to be effective. BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 42
  43. 43. Tools | Opportunities: The Backpack PLUS Experience From closed ecosystems to integrated public and private sector initiatives aimed at better supporting CHWs and Supervisors. A system where public sector programs work in synergy with private sector initiatives will amongst others - contribute to reduce the risk of stock-outs, create opportunities to offer new incentives to CHWs and offer private Supervisor programs for improved management of CHWs. BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? Guidelines and standards 23/01/2014 Nike backpack production DHL network distributing commodities
  44. 44. Tools | The Backpack PLUS System Overview BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 44
  45. 45. Tools | The Backpack PLUS System Overview BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 45
  46. 46. Tools | The Backpack PLUS System Overview TYPOGRAPHY MAIN TEXT Noto Sans Bold SECONDARY TEXT Pneumonia Noto Sans Bold Italic Noto Sans Regular FROM 2 TO 11 MONTHS Amoxicillin Lorem ipsum dolor sit amet, consectetuer adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. COLOR PALETTE 07712345678 MAIN DISEASES GENERIC DISEASE 07712345678 Lorem ipsum dolor sit amet, consectetuer adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. ICONS MAIN DISEASES Amoxicillin FROM 2 TO 11 MONTHS Pneumonia GENERIC DISEASE BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 46
  47. 47. Tools | The Backpack PLUS System Overview BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 48 47
  48. 48. Backpack Plus | Impact Backpack Plus Projected Impact More cases treated Better quality of care Higher efficiency thanks to a more streamlined workflow Reduced error rates thanks to improved tools and higher guidance Increased effectiveness thanks to easier assessment and treatment tools Better treatment thanks to enhanced guidance and real-time support Increased motivation due to better support and diversified incentives Increased community trust thanks to better communication BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? Higher-skilled CHWs thanks to continuous training and supervision Reduced stock outs thank to improved data management and private sector partnerships 23/01/2014 48
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  50. 50. Thanks

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