Toolkit for Differentiated Healthcare delivery for Rural Indian families in Bihar: Product Design & Testing
Consultant with Vihara Innovation
Multiple Partners
May 2019- Oct 2019
The Paanch Paar(Over 5 years of age) project is based in Bihar where children face the danger of prolonged and repeated episodes of illness owing to underlying and hitherto undefined states of vulnerability, resulting in poor health, morbidity, and mortality.
Project Paanch Paar is a collaborative project commissioned by the Bill and Melinda Gates Foundation and led by the Vihara Innovation Network, in partnership CARE India and M4ID Finland.
Paanch Paar employs human-centred design to unpack under 5 vulnerability and develop innovative solutions to identify vulnerable children and resolve the repeated cycle of illness towards pathways of resilience.
Above passage is taken from the Vihara Innovation's website.
My role: I joined the organisation to take the insights uncovered from the research during the Panch Paar project and create tools for Health workers who are the final mile distributors of services in India's rural lands. I needed to create product prototypes, conduct product testing, make iterations on the basis of the research and thus validate the products before they could be implemented at a large scale by CARE India.
The Toolkit Design
It was important to consider how the service delivery will take place. ASHA's often travel on foot, walking many miles. They are 25-45 yrs old literate women with formal education until 8th Standard from the community itself. We needed to ensure that instead of theoretical information, ASHA can break barriers about difficult conversations like contraceptive use & family planning. Culturally, Bihar has a culture filled with folk stories and we decided to use the same stories to talk about Healthcare.
Step 1: Identification of the Family Type
Ashas trying out the Identification tool to see if they can place families from their communities within the identified categories using the Tool
Some of the parameters we tested the tool for were flow, efficiency, adaptability, language and function etc. We developed the visual language of this tool with the help of the ASHA workers themselves so that ASHAs with low literacy levels would not struggle with the tool.
The back of the tool had a visual guide for how to use the tool
Cards explaining the factors that defines a particular family type and affect a child's health
Job Aids
After the ASHA would identify different family type, they would deliver the health information to them in the style that family prefers. The JobAid had different animal stories with the aim of creating a better retention for this information. At the same time, the intention of the stories was to take family behaviours and explain the affect of those behaviour on children's growth. I was also responsible for creating the illustrations for the Job Aid prototype.
We tested different forms of the product to check the ergonomics of the product when ASHA would actually hold the tool and use it. ASHA's didn't always have a space to unfold the tool completely therefore, we needed to make it stackable and easy to handle.
Other tools
We tried to come up with contextual solutions that the families could execute at home. From explaining how they could get a balanced nutrition diet from the materials available at home to solutions like Gamla refrigeration that could help them store green leafy vegetables. This knowledge gap was identified by conducting a comparative analysis of the existing Healthcare delivery tools. The tools talked about solutions without looking at the economic capacity of the families.
All the measures in the nutrition book were in the form of cup and spoon to make the metric easy to understand & the recipes were based on the fact that they didn't need to buy cerelac packets for their child nutrition, they could get the correct nutrition from raw ingredients already available in their pantry.
During our testing, we made changes in the product as and when we learned new things about the tool and at the end our user ASHA became adapt at using these tools. They found them easy and fun to use and believed these tools can help bring about behaviour change amongst the community members.
