PATH

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Moulding health seeking behaviour in UP

Ethnography

Co-creation

Culture

CSR

Behaviour

Service Design

Jun, 2018

CHALLENGE

How can we improve the health seeking behaviour of communities affected by AES in villages of eastern Uttar Pradesh districts, and encourage them to reach out to government healthcare facilities in case of a suspected AES risk with their children?

OUTCOME

PATH and TinkerLabs unearthed multiple critical insights about community perceptions, health practices, preferences and reasons behind child death/disability due to AES, which are being leveraged to not only promote better health-seeking behaviour for AES patients and their families, but also improve the complete infrastructural offering of the Uttar Pradesh healthcare system

SERVICES

Program Design

AES (Acute Encephalitis Syndrome)/JE (Japanese Encephalitis) claims numerous lives of little children in Uttar Pradesh, and PATH has been working closely with the UP government for the past few years, to help curb the problem. The main goal of the PATH AES project has been to ensure that patients get the right treatment at the right time by the right person. For delivering this, PATH has helped the government set up and monitor multiple ETCs(Encephalitis Treatment Centres) which are capable of handling AES and suspected AES cases. Despite this, adoption of ETCs amongst the local village community is extremely low, and they still choose to seek help from local quacks and private practitioners.

This is where TinkerLabs was invited to dig deep into the communities’ motivations, aspirations, practices etc. and understand the reasons behind this disconnect despite multiple communication efforts by the PATH team. The aim was to come up with insights and ideas that can improve the usage of specialised government healthcare facilities, primarily for AES cases, by the village community members.

TinkerLabs approach:

In order to bring about a behavioural shift in a community practice, it is first imperative to understand the complete ecosystem and its drivers in detail. In a case where established infrastructure is not being utilised by most members of the community, it becomes all the more important to immerse oneself in the system and identify key pivot points for implementing change. This was accomplished in the first phase of the project, which dealt with deep user immersion by employing multiple research techniques and defining multiple problem zones which can be explored to deliver impact.

Once the problems were defined, the second phase was about creating ideas by keeping into account the many different stakeholder perspectives, challenges, contexts, and constraints. The end results were system level ideas to enable shifts in behaviours, to ensure that no child dies of AES in these regions anymore.

What happened on ground:

For the first phase of the project, the intention was to immerse ourselves in the complete ecosystem of these villages and districts and understand what is the decision making framework of the people here.

We did a mix of semi-structured empathy interviews and ecosystem observations. The interviews had a relaxed and conversational format making the consumer comfortable and gave us a deeper look at their decisions, aspirations, concerns and understanding of self.

Ecosystem observations were done at the:

  • Household level: to understand new influences, gender dynamics, media channels etc.

  • Village level: to understand caste based geographical differences, hygiene, sanitation levels etc.

  • System level: to understand the current state and perceptions around government health services

The team conducted over 50 interactions across 3 districts in a span of 5 days, spanning a mix of stakeholders with varied decision-making levels. The information collected was then synthesised using Empathy Maps, User Journeys, Need Clusters etc. to identify 4 key Impact Zones, and further qualified with multiple Action Statements (How Might We questions) in each zone.

Once these insights were shared with the PATH team, the next phase of co-creation was kicked off. For this, experts from Behaviour Change Communication, Government Medical Officers, CDC and Social Impact evangelists were brought together in one room for a full day workshop, to assess the needs of the stakeholders, utilise selected insights and come up with system level solutions. The workshop concluded with a total of five detailed out system-level solutions for chosen impact zones, with first level prototypes ready for execution. These were then compiled to be pitched to the Uttar Pradesh government for further action


What did we achieve:

Not only was TinkerLabs able to identify previously unrealized reasons for community’s mistrust in the government healthcare offerings, but also mapped secondary insights about the infrastructural flaws in the current system. These detailed insights helped to get the buy-in of government medical officers, who then helped to create tangible solutions for improving the health seeking practices of the community, by working closely with the Path team, multiple behaviour change experts, and TinkerLabs Design Thinkers. We were also able to ignite the interest of these government officials in the Design Thinking tool for creative problem solving, and they invited us to co-create on the remaining insights as well to bring about the needed change in the system.


Highlight of the project:

The 5 days spent on the field for research, engaging with the community, gave the team a highly insightful as well as a highly emotional experience. In talking to families where the syndrome had claimed lives of children as young as 3 years of age, the team learnt how to communicate in the most sensitive scenarios. On the other hand, the faith and dreams of families who tackled AES were unparalleled to anything they had ever seen before. TinkerLabs now can claim to have a newfound understanding of the realities of life in these regions of Uttar Pradesh

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