Rio
A Hybrid Platform for Midwife Education & Knowledge Exchange
Rio is a hybrid social chat and professional education platform which facilitates and supports continuous midwife education. It is powered by social interaction, knowledge exchange, and democratization of information,and operates on a foundation of evidence based medical guidelines. This platform’s aim is to give form and body to existing midwife continuous education efforts, something that comes in many shapes and sizes, and levels of tangibility. Rio also challenges the ubiquitous nature of WhatsApp in the medical context by addressing and rethinking the generation, use, and storage of patient data. In tandem, Rio maintains successful social platform use behaviors and patterns, utilizing these traits to propel professional education and knowledge exchange.
Information
Umea Institute of Design
Partner: Laerdal Global Health (Norway)
Duration: 17 Weeks
Master Thesis
Design Research, Service, UX
Project Location: Moshi, Tanzania
Background
Childbirth is one of the most significant events of a woman’s life, being impactful, transformative and extraordinary. It can also, however, be a time of great stress, vulnerability, and full of avoidable complications, which themselves can lead to maternal and newborn mortality or morbidity.
Challenge
Midwives encounter many barriers to sustaining continuous education, however. Often, the challenges lay not in the initial training, but in the ability to implement training moments in day to day practice, over a sustained period of time. This is due to a range of barriers from larger systemic issues to facility-based challenges.
Approach
One of the most effective ways to improve maternal birthing experience, respect of the mother, and reduce incidents of maternal mortality and morbidity, is through training and continuous education of the midwife. Throughout history, and into the present day, midwives are often the primary provider of this essential obstetric care for most expecting mothers and their child.
Collaboration
I partnered with Laerdal Global Health (LGH) to support midwives’ continuous education for labor management, in Tanzania, sub Saharan Africa, in the digital space. There are 5000 maternal deaths annually in Tanzania, and with 27.7 million women of child bearing age, with an average number of 4.8 live births per woman. (IHME Maternal Health Atlas, 2017)
Medium: The Digital Space
Flexibility
The digital medium has capabilities to provide a flexible solution which adapts to its users and their diverse set of individual and community-based educational needs across geographic regions.
Democratization & Accessibility
The digital space also serves to democratize learning by increasing access to training and educational content.
Data Use
A digital medium has the ability to provide data to LGH to inform training improvements, and to the local and global community to inform health trends.
Methodology
Humble Design
This thesis is founded on the values of humble designing, a methodology that urges designers’ processes to be guided and shaped by the diverse sets of knowledge and worldviews of the people, especially when engaging with communities external to their own. Inherent in this methodology is the acknowledgement that all participants of the design process enter the equation with partial perspectives of the whole, with an emphasis on bringing self awareness to the designer’s own implicit biases.
Recycle, Repurpose, Reuse
This methodology strives to take existing societal structures, methodologies, behaviors, technologies, etc. that live within a community or environment, and recycle and repurpose them in the design process and proposition. This method is not about reinventing the wheel; rather, it means taking elements of the existing that are successful and advantageous to the user, and giving them life in new form.
Research
How can we improve the quality of care mothers receive during labor and birth through supporting midwives’ efforts to participate in continuous education?
How can operating in a digital space provide opportunity for an adaptable and inclusive continuous education platform to support midwives’ competency development?
The Proposal
Rio is…
founded on Evidence based Guidelines, and connects midwives and their knowledge through networked communication channels & Content
Rio facilitates systemic change through…
Rio’s System: Zones
Rio is composed of two zones.
A secondary, supportive zone, and a primary core zone.
Training Hub: Core
Laerdal Global Health Training Suite & Activities
The training hub is organized by the suite of Laerdal Global Health training programs. Upon selecting a program, the user is directed to specific topics within the program, where they can then choose from a variety of training activities such as simulations and practice assessments, and debriefing guides.
Training Hub: Core
Training Activities, Materials & Public Log
Within each training topic are a series of activities from which the user can choose. Upon selecting an activity, the user will be presented with materials to help guide them through the training session, organized by preparations (Prep), activity instructions (Activity), and public history log of previous sessions (Log) for reference material and peer and or facilitator contact.
Training Hub: Core
Reference Material: Evidence-Based
Guidelines & Recommendations
For every topic of training there is an associated set of Laerdal Global Health training standards, global guidelines, and a space for uploaded, institution specific standard operating procedures (SOPs). This serves as a foundation for training and and elevates the access and presence of evidence based guideline for midwives. Further, all video and photo content that is saved into the Training Hub must be verified by an administrator, and these guidelines can serve as support for this.
Profile & Learning Log: Supportive & Core
Reference Material: Evidence-Based
The profile bridges both the core of Rio, and the secondary, supportive zone of the platform. The public profile (left) gives accessibility of the midwife’s generated content per their own organization, contact information, and quick link to direct messaging. The private profile (right) contains the Learning Log which is a log of all mandatory or optional trainings, and their status, belonging to the midwife. The private profile also shows all Community Hub memberships they are part of, as well as their personal folders of generated content.
Chat: Supportive
Synchronous Messaging System
The chat function serves as a traditional synchronous messaging system, allowing for quick and seamless communication between midwives in and outside of their networks. Training activities can be shared within chats, directly linking users to the Training Hub. All chats deleted after 30 days for security and data accumulation purposes, unless specifically saved by user.
Community Hub: Supportive
Broadcast Communication
The community hub is a broadcast channel for communication. The hub is comprised of user-created groups, both inside a users own facility’s network, and outside. This allows for networking and knowledge sharing capabilities around the globe, between midwife communities. Due to this extended networking, there is a range of privacy settings to accommodate security needs.
Home: Supportive
Hybrid Home Landing Page
The home function is a hybrid feed of the Chat, Community Hub, and Training Hub activity, as well as user status video updates. The feed’s activity visibility settings can be customized per user.
Engagement Prompts: Supportive
Nudge Notifications
Engagement prompts serve to initiate and spark training, social interaction, recognition of peer’s professional efforts. These prompts also function as reminders to take breaks throughout the day to maintain a healthy mentality in a potentially stressful and work-loaded environment.
Data Use & Security
User Journey
Research
Research Methodologies
Ethnographic Research
The research conducted during this thesis used ethnographic principles to drive its methodology and approach. This entailed research based around engagement in various forms, with presence and immersion in the users’ environment central to the process and proposal.
Remote Engagement
The need to utilize remote engagement methodologies for the latter half of the process became a reality due to both geographic, and Covid-19 constraints. Although it reduced innate learnings and observations that can arise from in- person contact, the nature of remote engagement ironically contributed unique, unexpected insights pertaining to the digital space within which the thesis is situated.
Research Phases
Phase One
This phase was focused on gathering foundational obstetric knowledge; preliminary insights from practicing midwives about their work environment, their role as a midwife, and continuing education barriers and facilitators; and training knowledge from Laerdal Global Health.
Locations
Stavanger University Hospital, Norway
Laerdal Global Health, Norway
Umea Hospital, Sweden
Remote: USA, Germany, Austria
Activities
Laerdal Global Health Expert Interviews, Safer Center Simulation Training assist and Expert Interviews- Midwives, Doulas, Doctors, Nurses
Phase Two
This phase both challenged and validated insights from the first phase of research to help further define the brief. This phase also identified the needs of midwives in Tanzania specifically, helped to shape my understanding of their work environment, and gave a glimpse into the local culture, norms, and value systems. Many of the novel insights in this phase revealed key challenges and facilitators of training and competency development.
Locations
Kilimanjaro Christian Medical Center, Moshi, Tanzania
Mawenzi Hospital, Moshi, Tanzania
Activities
Kilimanjaro Christian Medical Center, Moshi, Tanzania
Mawenzi Hospital, Moshi, Tanzania
Primary Insights
Social & Community-Based Learning
Preferred Group Learning Methodologies
Learning With & From One Another
Strong Social Digital Presence
Ubiquitous Smartphone Use
Fluency in Whats App
Successful integration of Social App in Professional Context
User Generated Content as Informal Knowledge Creation and Sharing Method & Security Threat
Diverse Educational Needs & Preferences
Range of Education Methodologies, Formalities
Need for Standardization
Multi-Generational Learning
Cross-Department Learning
Staffing and Organizational Challenges
Mentor Work Burden
Lack of Structure & Organization
High Turnover
Process
Ideation Workshops
Preliminary Sketching
Low Fi, iterative wire-framing & logic testing
Remote Testing
User tests in Tanzania and Europe were conducted remotely through Whatsapp, email, Digital Collaborative boards, video narratives, workbooks,and guided prototypes. Due to gDPR documentation of user testing not shown.
