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Community Health Worker Design Sprint
Supporting Remote Supervision for CHWs in Liberia
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IRC supports Community Health Workers in countries around the world and wishes to strengthen the community health networks in adapting to the changes posed by the Covid-19 pandemic.
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The objective of the CHW Program Adaptation Design Sprint was to develop an early-stage concept (prototype) that has the potential to leverage community networks to expand essential services in low-tech and hard-to-reach areas.
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Liberia was identified as the focal country to design and test possible solution areas.
Led at: International Rescue Committee
Airball innovation lab NYC
Duration: June 2020 - Jul 2020
Mentor: Shirley Rodriguez
Role: User research, Rapid prototyping, Visual design.
Methods: User Experience Research & Design, Rapid Prototyping & Pilot testing.
Wireframes
CHA and Supervisor user flows made rapidly to test user flow, the cognitive load on per page, and navigation that aligns with the tasks required by the health workers—additionally automating, prompting, and reducing the work for them wherever possible.
Quick informative onboarding process with tutorial screens to assist them at each section of the app feature.
Hierarchy is based on the relevance and importance of the tasks.
Audio and video-based messaging.
Context CHA's
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In Liberia, through the USAID-funded PACS project, IRC fields 650 CHA (Community Health Assistants the local name for CHW), and 56 CHSS who supervise the CHA.
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The CHA operates in remote villages in areas at least 5km from a health facility.
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All CHA in Liberia is issued a smartphone to use as a resource for program information.
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The device is pre-loaded with content related to CHA basic training.
Research context
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Through a rapid evidence review, interviews with our country colleagues, Community Health Service Supervisors (CHSSs), and Community Health Advisors (CHAs), the team identified a wide array of challenges present for IRC’s CHWs operating in Liberia.
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These have been documented extensively for Liberia and the broader context in the literature, including this USAID report and this report created by our own Health TU.
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Supporting remote supervision between CHSSs and their CHAs was prioritized for this exercise.* Enabling small leadership will lead to improved quality care for our clients.
How might we adopt methods CHA's feel drawn to, and how are they reflecting on the tools they use?
How might we introduce the remote monitoring tools for supervisors during COVID 19 and beyond to ensure the quality of care is provided despite changing norms during and post-pandemic.
CHA Supervisor
“Irregular or inadequate supervision is almost universally cited as a key problem in CHW programmes. Regular supervision has been associated with better project outcomes and more accurate classification and treatment of childhood illness by CHWs.”
— Management of sick children by community health workers: Intervention models and programme examples. The United Nations Children’s Fund (UNICEF)/ World Health Organization (WHO), 2006
A clear distinction between Supervision, Resources to share and profile made to distribute tasks without adding more workload for
the user.
Audio and video-based feedback for remote monitoring and mentorship.Audio and video-based feedback for remote monitoring and mentorship.
Meet Prototype
How might we improve service delivery quality
by supporting remote supervision of CHAs, with limited access to network connectivity?
IRC Airble Innovation team Credit: Elena Matsui
User cases from the field
Learning
Amongst the many learnings at IRC Airbel impact lab with the beautiful team were ways in which teams can engage in moments on a design project. This project was introduced to me in the prototype phase, picking up from the insights and building a testable prototype while iterating and researching with the team on building with intentionality, care, and play. Moments that stood out were around:
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Balance of Standardisation vs localization
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Relooking at prior humanitarian aid experience
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Fluid teams and teams structures
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Training and certifications
Featured use cases
IRC Airble Innovation team Credit: Elena Matsui
How I stepped in an
on-going project.
me
The idea is to reduce the burden and make field checkups as comfortable as possible given the pandemic and the responsibility added to the health worker.
By easing and digitizing narrative-based app, we are opening the way for remote monitoring.
Prototype
CHA
Dela a cute bird introduced as a character taking through different features of the app and how it functions making it more conversational and human.
Digitization brings efficiency
Insights based on user interviews
Video-based feedback
preferred
Digital literacy is key for change
Use cases
Journey map
CHA and
CHS supervisor
Fig: Sprint to map the journey of CHAs and CHA supervisors on operations and tasks on the ground and identifying points of intervening.
Fig: The methodology developed and identified by the team working on this project at IRC Airble Innovation team Credit: Elena Matsui
