M4ID (now Scope Impact): Strategy for a knowledge platform for the Lab.Our Ward Project with M4ID

Scope Impact and the Lab.Our Ward Project

Scope Impact (previously M4ID) is a design and implementation agency headquartered in Helsinki, Finland with offices and collaborators across the global south. Aa few years ago, they collaborated with the Bill‌ &‌ Melinda Gates Foundation on a project to do a deep analysis of maternal wards in Africa and India. The objective was to understand how the human centered design lens could be applied to improve wards and experiences of women and families that use facilities in low income contexts.

While maternal and infant mortality rates have dropped significantly in the last twenty years, complications during pregnancy and childbirth claim the lives of thousands of mothers and newborns each year. Every two minutes, a woman dies from causes related to pregnancy or childbirth, and each year more than one million children die on the day they are born. Overcrowding, uncleanliness and the lack of essential health infrastructure mean that for many women, the experience of birth is neither safe nor comfortable. As the number of births taking place in health facilities around the world continues to rise, maternity wards must be adequately prepared to deliver high quality care to women and newborns everywhere (M4ID‌, 2018).

The Lab.our Ward Innovation Project brings together expertise from the fields of product, service and architectural design, in collaboration with maternal and newborn health experts, to improve the birth experience in low-resource settings. Through innovations and tools applied to new and existing health facilities, the Lab.our Ward project aims to improve quality of care from the perspectives of both women and care providers. Ultimately, the Lab.our Ward innovation project seeks to have a positive impact on health outcomes for mothers and newborns worldwide (M4ID‌, 2018).

The Problem/Brief and Objective

The Lab.our Ward Program got an extension grant in 2017, and the primary objective of the grant was to partner with the district administration in Balasore, Odisha to run a pilot at two facilities, the district hospital in Balasore town and the community health centre in the block of Basta.

The pilot would be used to learn about what it took to translate the Lab.our Ward service and system design concept to actual maternal wards. The Scope Impact team took the opportunity then to also explore how a solid strategy could be built around a ‘toolkit approach’ to enable other organisations, government departments and the like to take their designs and translate these to their needs.

My main brief was to work with the Scope Impact program team to think through, define and aid the building out of this strategy. Along with that, I ended up playing a small role in helping operations get going for the pilot in Basta, and helping to hire a program officer to manage the project on ground.

What I did

The project played out over about 10 months starting in November 2017 with my involvement culminating in August 2018. The process was iterative since we were responding in part to the realities of trying to implement a pilot, as well as figuring out the strategy for the Scope Impact team as the program evolved in parallel to my process.

Phase 1: Discovery and Disposable Concepts

Initial Immersion
To begin with, I spent the first few weeks getting to know the team through calls, understanding their perspective on where M4ID (at the time) was and how they were thinking about scale in the longterm for the LW project, and the challenges they had faced with previous attempts at documentation. Additionally, I was starting to build an understanding about the issues related to maternal health, since it was a new sector for me at the time, through M4ID's own project documentation, as well as my own research. Finally, this was backed up by a trip to Balasore and Basta, where the M4ID team had been in conversation with various administrators for the past few months (having done certain ideation and prototyping sessions with stakeholders as well).

Strawman Concept
Based on the work I'd done with the INREM Foundation in Jhabua, previous thinking about toolkits, and the initial discovery process with M4ID's program and leadership, I built out a strawman concept. The idea was to put out a strategy note with potential directions within a few weeks of getting involved. The attempt was to provoke discussion, input, questions and ideas through a concept note. The tool of choice was a google doc, which received a lot of input from the program team, leading to a lot more clarity on how they were actually seeing the future of the program. Just as importantly, it highlighted gaps that we needed to better understand what would be needed to build a truly effective method to support the replication of the LW system across various geographies.

Phase 2: Sensemaking and Driving Forward

Personas, Canvases and Workshopping
Based on this initial understanding we set up a workshop in Helsinki with the larger M4ID team to build a foundation to help drive the thinking forward. Unlike other firms that focus on using HCD tools in the social sector, M4ID has an issue focus with looking at the lives of women from adolescence through reproduction to their lives as mothers and family planning. This has led to projects such as the Lab.Our Ward amongst others. At the time of the project, from my perspective, the organisation was taking a few key projects like LW and turning them into programs, changing fundamentally the nature of the org with a greater focus on implementation, monitoring and evaluation, and operations. This is one reason that it was important for us to look at the long term strategy of LW through the lens of this evolution of the org. The workshop in Helsinki focussed on mapping the various modalities of engagement with potential partners and funders. Based on this thinking, we then used the 'Open Canvas' (from Mozilla's Open Leaders Training Series, Editable Tool), to begin thinking of the LW toolkit as an open and collaborative digital platform project.

Based on the outcomes of the workshop, we began mapping out the various personas who we might target through a platform of this sort. The focus was to drive towards a deeper understanding of how the content that we share might be accessed, and most importantly lead to application. This led to a clearer defined platform concept with a focus on pathways through the content and how LW and M4ID could support the implementing agency through the process of building a new maternity ward, or improving an existing one.

Driving the pilot forward
In parallel, we were working through the changes that the district hospital was going through, to understand the most appropriate way in which to get the pilot going. Through conversations with enthusiastic block and district officers we collectively realised that it would be most beneficial (and with the least friction) to run a pilot in the CHC at Basta as opposed to the District hospital which was transitioning to becoming a full fledged teaching hospital. At that time I helped to liase with the block officials, and to hire a program officer based in Balasore to be able to take over operations and get the pilot going.

Phase 3: Strategy, Roadmap and Deliverables

Zooming in
The idea was to think about the documentation through the lens of a dynamic knowledge platform that would act as a space to build a community around the idea of driving towards more and better maternal wards across the world. Taking the lens of the stakeholders, and the experiences of translating the original service design tools for Basta, we dived into the content that would be available on the platform.

The outcome of this process was a clearly defined framework, that could be applied to each tool to aid a stakeholder looking to implement the tool as part of a larger process. The key was to ensure that even without the LW team's intervention, how might we support each individual or organisation with the information, digital files and such for them to be able to actually implement the solutions as opposed to simply aspiring to do so.

Zooming Out
While a larger concept note around the platform had been articulated, along with a sense of who the stakeholders were, it was important to think about how one might get to a well functioning platform. This led to a comprehensive three year roadmap that M4ID could use to raise additional funding to be able to anchor the work on the platform and scale up the LW concept to more locations.

Outcome

Since the project, the evolving path that M4ID was already on has played out with a larger team and rebranding to Scope Impact. The LW concept is being applied in various locations, though it's important to note that perhaps the platform idea is still on the back burner at Scope Impact.

Since 2018 though, I have co-founded Ooloi Labs, which builds on the learnings from this project to begin to build a product and system that would help an organisation like Scope Impact easily bring their idea of a platform to fruition. To know more, email me at akshay@ooloilabs.in.