Published on March 11, 2014
design thinking for global health gravitytank RECORDS FOR LIFE CONTEST IS AN INITIATIVE OF THE BILL & MELINDA GATES FOUNDATION
7 01: The Problem gravitytank 2
The Bill & Melinda Gates Foundation estimates that 1.5 million children die each year — one every 20 seconds — from vaccine-preventable diseases such as diarrhea and pneumonia. Vaccines Save Lives 3gravitytank
In developing countries, there are numerous challenges to widespread vaccination — expensive ingredients, supply shortages, unreliable logistics, untrained health workers, as well as ineﬀective systems for tracking children’s vaccination histories. Immunization Faces Obstacles 4
gravitytankRECORDS FOR LIFE CONTEST IS AN INITIATIVE OF THE BILL & MELINDA GATES FOUNDATION 5 Records for Life Contest To address that last problem, The Bill & Melinda Gates Foundation sponsored a contest asking designers to rethink the child vaccination record. The objectives were to increase accuracy, make records easier to interpret and use, and create value for health workers and families alike.
gravitytank | PRIVATE & CONFIDENTIAL RECORDS FOR LIFE CONTEST IS AN INITIATIVE OF THE BILL & MELINDA GATES FOUNDATION David O’Donnell Amy Guterman Elena Valentine Nick Maschinski Andrew Bates Tiﬀany Huang Arielle Deane Challenge Accepted A team of designers, researchers and strategists at gravitytank, decided to use the contest as an opportunity to apply design thinking to a major global health issue. 6
RECORDS FOR LIFE CONTEST IS AN INITIATIVE OF THE BILL & MELINDA GATES FOUNDATION gravitytank 7 02: Our Process gravitytank 7
Research on global vaccination records quickly revealed that complexity was a consistent problem. In an eﬀort to provide comprehensive information, they often emphasize quantity of data over quality and relevance. As a result, records are neither meaningful nor intuitive for parents or health workers that must use them. Identifying the Problem 8gravitytank
gravitytank | PRIVATE & CONFIDENTIAL RECORDS FOR LIFE CONTEST IS AN INITIATIVE OF THE BILL & MELINDA GATES FOUNDATION gravitytank 2RECORDS FOR LIFE CONTEST IS AN INITIATIVE OF THE BILL & MELINDA GATES FOUNDATION gravitytank We built prototypes to embody the design principles of durability, information hierarchy, and usefulness — providing data only when and where it’s needed. 9 Prototyping Solutions gravitytank
gravitytank We then tested the prototype concepts with international aid workers currently living in the United States. Their feedback helped us reﬁne the prototypes into a ﬁnal design. Testing with Experts 10
RECORDS FOR LIFE CONTEST IS AN INITIATIVE OF THE BILL & MELINDA GATES FOUNDATION gravitytank 7 03: Our Solution gravitytank 11
Introducing Pasteur ‘Pasteur’ is an integrated system of vaccination records and health education tools that support the needs of both caregivers and health workers while attending to the constraints of developing countries. A method for creating digital records of vaccinations using mobile technology. 1 2 3A simple, legible record that functions diﬀerently in the home and during vaccinations. A separate, primarily illustrative set of health education cards. ! 12
At the Visit: the record as a trigger for dialogue VISIT-BY-VISIT DATA: Organized by the age of the child, each page allows ample room to record treatments. VACCINE SCHEDULE TIMELINE: Progress bar facilitates a 5+ year dialogue between the health worker and caregiver. SCHEDULE NOTATION: Tracking the dose sequence prompts health workers to check vaccination histories and remind caregivers. ! ! Our Solution Challenges A record plays diﬀerent roles during a medical examination and at home. During the examination it should be legible, easy-to-use documentation that oﬀers health workers the latitude to create useful medical narratives through notation. DISTINCT VACCINATION & NOTE PAGES Notes pages keeps documentation in one area and interpretation in another. ONE COLOR PRINTING A single color minimizes cost and allows for easy reproduction. 13
In the Home: the record as a prompt for sustained care CHILD PHOTO: The health worker uses a low cost instant camera to take a photo of the child (i.e. Fuji Instax Mini 8 Film Camera, $60) and attaches it to the holder. ! Access to photos can be limited in the developing world. The child’s image transforms the record into a keepsake to be proudly displayed at home, ensuring that it (and the follow-up date) stays visible but out of harms way. Our Solution Challenges In the home, the most critical role of the record is to indicate when to return for a follow-up visit. Stored for safe-keeping, it is no longer a reminder for action. Conversely, kept out, the record is subject to wear-and-tear or unintentional misuse. NEXT VISIT PROMPT: After the vaccination , the health worker writes the date of the next visit and folds the record so that this information is visible on the ‘front’ of the record. DURABLE MATERIALS: The record is printed on tear- and water-resistant paper (approx $0.29 / sheet). The record is contained in a durable Tyvek sleeve ($19 / 2000 sleeves). FORM & VISUAL DESIGN: The design emulates a government document, like a passport, to ensure it is kept safe and not discarded. 14
Our Solution In the Home: education cards live separately ! ! SINGLE SET, LARGE AUDIENCE: Rather than disbursed only through families, the cards can also be given to respected community member to broaden the public health impact. SEPARATE CARDS: To ensures that reference materials will be used as frequently as needed, while keeping the vaccination records safe. VISUAL COMMUNICATION: Simple illustration to communicate key health concepts, making it more legible for those with limited reading skills. Our Solution Challenges Many records include general health education along with vaccination histories. While this information may be used frequently by caregivers, the vaccination record itself need only be accessed immediately prior and during visits. Using the record as a reference tool only increases the likelihood that it will become damaged or lost. ! ! 15
Digitally: push reminders and retroactive data entry ! To complement the record, we propose a simple digital platform using available cellular technology. The health worker uses SMS to retrieve the child’s unique ID number, then inputs codes for vaccines administered, the caregiver’s mobile number, and follow-up date. Ideally, data entry would take place during the vaccination, but could also be done retroactively. Using the information collected, a central database would automatically text a reminder to the caregiver one week prior to the next scheduled visit. gravitytank 16
RECORDS FOR LIFE CONTEST IS AN INITIATIVE OF THE BILL & MELINDA GATES FOUNDATION gravitytank gravitytankRECORDS FOR LIFE CONTEST IS AN INITIATIVE OF THE BILL & MELINDA GATES FOUNDATION 18 04: Results gravitytank 17
gravitytank | PRIVATE & CONFIDENTIAL RECORDS FOR LIFE CONTEST IS AN INITIATIVE OF THE BILL & MELINDA GATES FOUNDATION gravitytank IxDA Interaction14 Award Ceremony: Grand Prize Winner! gravitytank’s Pasteur was awarded the grand prize out of 312 entries to The Records for Life contest. ! gravitytank 18RECORDS FOR LIFE CONTEST IS AN INITIATIVE OF THE BILL & MELINDA GATES FOUNDATION
No single design will become the ﬁnal solution. The Bill & Melinda Gates Foundation will present designs from the top 10 ﬁnalists to health oﬃcials in developing nations, who will be able to mix and match features in order to implement a new vaccination record optimized for their local context. RECORDS FOR LIFE CONTEST IS AN INITIATIVE OF THE BILL & MELINDA GATES FOUNDATION Next Steps share with stakeholders ! ! gravitytank 19
thank you about Pasteur and gravitytank’s work: www.gravitytank.com ! about vaccinations in developing countries: www.gatesfoundation.org Learn More PHOTO CREDITS PG 1: PIERRE HOLTZ FOR UNICEF | WWW.HDPTCAR.NET PG 3: PIPPA RANGER, HTTP://FLIC.KR/P/DLXJV5
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