Uma – iXDA Winner

Let’s look into the prevailing conditions that have created this complex ecosystem and the unique barriers in Poonam’s pregnancy:
India is a largely patriarchal society, where gender bias exists in many forms such as distinct gender roles, gender stereotypes, sexual violence, taboos about sex, etc. Women and girls are part of a system that routinely and functionally overlooks their rights, agency, and independence.

These structural barriers don’t work in isolation – they reinforce each other in a compounding effect. For instance, gender norms restrict the involvement of the father which perpetuated gender roles and limits the pregnant person’s agency, and so they lack a solid support system. These gender norms also restrict the education of the pregnant person, which limits their agency, access to information, and ability to communicate the details of their pregnancy to the doctors. Together, these factors hinder the decision-making abilities of the pregnant and perpetuate unsafe health practices.

The Project

Since this was in the middle of the COVID outbreak and we all went home to our native places deep into the Indian hinterland to places like Udupi and Uttarakhand. Our team was perfectly poised to do in-depth research closer to the people we were studying. We started with an immediate audit of the system.

Mapping several layers of support and information sources around the pregnant woman we realised that she exists in a complex ecosystem, her immediate support group formed by family members, then extended family and friends and then the healthcare layer which had ASHA workers and doctors and nurses. This ecosystem was riddled with contrasting messages, with the doctors saying something and the friends and family touting fear around the treatment plan. We set to work using principles which were a mix of service design, systems theory and Enterprise Design Thinking.

We discovered various paradigms that had to be unpacked for the solution to be successful. We processed and analysed the data from a systems perspective and found an interesting feedback loop which existed in the system. Distance from a healthcare centre and the lack of education around health came up as the biggest concerns.

The Solution

This was a very critical and sensitive area of concern for anyone who is working in rural healthcare. Sensitivities, both cultural and personal run high when it comes to having a baby. And yet we needed a solution that was low-tech enough to be adopted, low cost enough to be supported by any actor in the ecosystem, and still saved time for doctors and nurses.

We ideated and evaluated multiple solutions including games which were designed for better conversations and behavioural change, playing cards and so forth. After carefully prioritising each solution against several factors, we focussed on building out a product which did not have entry barriers, data privacy loopholes, accessibility barriers and was sustainable from a materials perspective.

While doing the research, we had noticed an artefact hanging in every house. The humble calendar. The whole family communicated things like payments, special days of pooja and celebration or simply to note how many days to go before they get paid. This provided the fulcrum for our solution.

The solution offered a low-tech alternative which could stand on its own, solving the problem around doctor patient communication. But we had also discovered that doctors and nurses often have more than 40 patients a day in rural India. It was impossible for a doctor to read this! So we brought in the tech. A computer vision based AI solution that would give doctors and nurses an overview of the problems without them having to read complex calendars in multiple languages.

Since we wanted to leverage mobile usage in the family, if it was present, we also used QR codes to connected to a system of knowledge which was curated to address information asymmetry and lack of tools for the pregnant person.

This completed our service, with touchpoints starting from the clinic where the pregnant lady was shown videos introducing her to the product, to the nurse who gave her the sticker sheets, to the family which read the signs and symptoms from a household artefact to the support system around her which could plugin to the wealth of validated knowledge curated into a You Tube channel. This service came together leveraging multiple existing systems in the landscape to mould them towards the healthcare needs of females in rural areas.

From the Road

Our mascot, Uma, the female significant other in the rural pregnant woman’s periphery who helps her through her pregnancy, came about. We used artefacts from the original research to

The awards

We had applied for the IF design awards, the INDIGO awards, iXDA, WDO & for publication in the service design journal and the design research society journal. Uma cleaned the table! Here is the presentation from the World Design Organisation stage. We are second in line, so please forward to our presentation.