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Using a human-centered
design process to drive
healthcare innovation:
THE UNICEF BACKPACK
PLUS PROJECT
Roberta Tassi,
Senior Design Researcher, frog
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.

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frog | Introduction

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frog Milan | Introduction

AMSTERDAM
MUNICH
SEATTLE
BOSTON
SAN FRANCISCO

NEW YORK

AUSTIN

SHANGHAI

frog MILAN

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frog | Introduction

WE APPLY A HUMANCENTERED DESIGN PROCESS
TO DRIVE HEALTHCARE
INNOVATION
Design Research, Design Frameworks, Design Principles

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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

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Immerse in the context
What people say, do, think.

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DESIGNED TO BE INCLUSIVE

6
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
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Defining a language to facilitate communication processes

- All feedback loops ultimately aim to influence outcomes by influencing
this sphere

SYSTEM & VALUE

HOURS

PWD

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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.
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.

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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

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FUTURE SCENARIOS

8
Backpack Plus
Empowering Community Health Workers

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Backpack Plus | Introduction

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

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Backpack Plus | Introduction

Community Health Workers are the “last mile”
in healthcare and one of the the biggest untapped
resources in global health.

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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.

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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

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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.

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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

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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

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7
Backpack Plus | Field Research

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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

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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.

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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.
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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

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EDUCATE

REVIEWING

RESUPPLY

REWARDING

UPGRADING

REPORT

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Framework | The Backpack PLUS Model

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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

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VISIT REGISTER

PENCILS, PENS

TORCH, LIGHT

JOB AIDS

ED. MATERIALS

RAIN BOOTS

RAIN COAT

TOOLS

ENABLERS

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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

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FAMILY/COMMUNITY
ENGAGEMENT

HEALTH
CAMPAIGNS

RESUPPLY BY
CONSUMPTION

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Framework | Sample applications: country mapping

COUNTRY ASSESSMENT

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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

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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.

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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
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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.

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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.

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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
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

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CLINIC

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Tools | The Backpack PLUS System Overview

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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.

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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.
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Mobile-enabled assessment tools

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Consistent packaging design

33

Referral tools are also integrated
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

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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.
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A modular home storage system

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Integrated home and on the go solutions

35

Flexible loading capacity
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.

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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
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
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
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
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
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
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
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 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
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 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
49
Thanks

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

  • 1. Using a human-centered design process to drive healthcare innovation: THE UNICEF BACKPACK PLUS PROJECT Roberta Tassi, Senior Design Researcher, frog
  • 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. frog | Introduction BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 3
  • 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. 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. 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. 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. 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. Backpack Plus Empowering Community Health Workers BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 9
  • 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. 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. 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. 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. 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. 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. 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. Backpack Plus | Field Research BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 17
  • 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. 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. 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. 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. Framework | The Backpack PLUS Model BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 22
  • 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. 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. Framework | Sample applications: country mapping COUNTRY ASSESSMENT BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 25
  • 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. 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. 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. 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. 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. Tools | The Backpack PLUS System Overview BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 31
  • 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. Tools | The Backpack PLUS System Overview BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 44
  • 45. Tools | The Backpack PLUS System Overview BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 45
  • 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. Tools | The Backpack PLUS System Overview BIOCAT HOW DESIGN THINKING CAN IMPROVE MY BUSINESS? 23/01/2014 48 47
  • 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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