BACKGROUND
Generally motherhood is mostly a positive and fulfilling experience in developed countries. However, the situation is not the same in many developing countries where motherhood is associated with suffering, ill-health and even death.
In Indian context the milieu of maternal health has always been a great public health concern. A great degree of variation is observed in maternal health indicators in India among different states, rural-urban distribution pattern, rich and poor socio-economic status and level of education and availability of health services.
Implemented by the government in collaboration with UNICEF, MCP card is a folding pictorial tool designed to assist mothers’ understanding and monitor individual progress of maternal and child health and psycho social development. Our team was approached to redesign this card by researching the current needs and challenges and how can it can be made better to stick with young mothers.
Implemented by the government in collaboration with UNICEF, MCP card is a folding pictorial tool designed to assist mothers’ understanding and monitor individual progress of maternal and child health and psycho social development. Our team was approached to redesign this card by researching the current needs and challenges and how can it can be made better to stick with young mothers.
What is a Mother and Child Protection Card?
The Mother and Child Protection Card has been developed as a tool for families to learn, understand and follow positive practices for achieving good health of pregnant women, young mothers and children. This helps families to know about various types of services which they need to access for the health and well being of women and children. It empowers families to make decisions for improved health and nutritional status and development of young children on a continual basis.
Challenge
Through our primary and secondary research we were able to unearth a number of challenges with the MCP card;
- Lack of proper care resulting in torn or damaged MCP cards
- Heavy reliance on health workers for all services revolving around 1000 day pregnancy window
- Large beneficiary crowds and lengthy immunization process forcing health workers to skip the health counseling sessions which are vital for pregnant women and first time mothers
- Lack of motivation leading to low awareness around crucial health information
- Too much information on the current card creates confusion
- Due to unavailability of cards in remote areas, caregivers still following the old format (Poor supply management)
- Lack of proper care resulting in torn or damaged MCP cards
- Heavy reliance on health workers for all services revolving around 1000 day pregnancy window
- Large beneficiary crowds and lengthy immunization process forcing health workers to skip the health counseling sessions which are vital for pregnant women and first time mothers
- Lack of motivation leading to low awareness around crucial health information
- Too much information on the current card creates confusion
- Due to unavailability of cards in remote areas, caregivers still following the old format (Poor supply management)
New Design Brief
After analyzing the challenges the team started preparing a new design brief for the card and made sure that the key objectives are met in the new prototype of the card and is ready to be tested with the target groups.
MCP is primarily used by the following groups:
MCP is primarily used by the following groups:
Caregivers: Mothers, fathers, aunts, mothers-in-law, grandparents, or any other primary care providers who are responsible for the child’s health.
Health Workers: Nurses, community health workers, midwives or other individuals directly involved in delivering immunization services.
Redefined Key Objectives
- It must follow the 1000 days (Pregnancy + First 3 Years of Child growth) narrative in terms of information flow
- Must trigger demand for key products and services (family planning, immunization, child growth information)
- Must provide beneficiaries with complete health information on existing touch points over the 1000 day window
- Trigger beneficiary compliance with respect to visit schedules and facilitate interaction with health workers
- Must be designed keeping in mind first time mothers, who may not have prior access to health information
Health Workers: Nurses, community health workers, midwives or other individuals directly involved in delivering immunization services.
Redefined Key Objectives
- It must follow the 1000 days (Pregnancy + First 3 Years of Child growth) narrative in terms of information flow
- Must trigger demand for key products and services (family planning, immunization, child growth information)
- Must provide beneficiaries with complete health information on existing touch points over the 1000 day window
- Trigger beneficiary compliance with respect to visit schedules and facilitate interaction with health workers
- Must be designed keeping in mind first time mothers, who may not have prior access to health information
It was important to understand knowledge level of both groups (mothers and nurses), cultural associations and discover any nuances that might help deliver the intent and purpose of the artifact
Field Validation and Findings
In alignment with the design brief, team proceeded to conduct field research in Muzaffarpur district of Bihar to test the efficacy of the new MCP card. The team made considerable efforts to get participants to compare the new design of the MCP card with the existing MCP card. This was done through exhaustive focused group discussions as well as in depth interviews with health workers and beneficiaries.
Comparison Parameters:
- Ease of Data Recording - With the current accordion artifact there was very less space for midwives/nurses to note the vitals or any other medical symptom that needs to be recorded.
- Information flow - The current card has a dense display which has often confused midwives who are responsible for filling out the card and mothers who are supposed to understand and follow the instructions for their health.
- Visual Language - We had to create a series of more vernacular and culturally aligned illustrations for every important piece of information in the card that were tested against user's knowledge and comprehension level.
Comparison Parameters:
- Ease of Data Recording - With the current accordion artifact there was very less space for midwives/nurses to note the vitals or any other medical symptom that needs to be recorded.
- Information flow - The current card has a dense display which has often confused midwives who are responsible for filling out the card and mothers who are supposed to understand and follow the instructions for their health.
- Visual Language - We had to create a series of more vernacular and culturally aligned illustrations for every important piece of information in the card that were tested against user's knowledge and comprehension level.
- Ability to Impact the protocol - Our team decided to go ahead with a booklet format instead of an accordion fold for multiple reasons that were validated with the users.
Books are worshiped in the the Indian culture and we noticed that users would generally keep a booklet in a safe space.
Making the booklet more visual helped the midwives to explain certain pregnancy processes using illustration as a reference.
My Responsibilities
Project responsibilities included undertaking field research, conducting interviews and focus group discussions and literature review, designing research tools, Prototype testing, designing the Prototype.
