In this series of blog posts we will describe how the Lab.our Ward project uses evidence-based practices, especially for non-clinical interventions, to shape the design proposals and explore how guidelines and recommendations can become real and concrete through service interactions, spatial and product design.
The Lab.our Ward design process follows a user centered approach, i.e. framing design solutions around the needs and behaviors of the people using the services and products. Most of these design proposals are non-clinical interventions that can positively influence the interactions between the women and healthcare practitioners involved in facility based delivery.
But designing for the health context requires us to also look at evidence-based practices. In this series of articles, we look at how the design team took into consideration various tools and guidelines to link the design solutions to evidence-based practices for Quality of Care. Two of the guiding frameworks were the WHO Quality of Care Framework (Tuncalp et al., 2015) and the BOLD Negotiated Standards of Care (Bohren et al., 2015).
BOLD Negotiated Standards of Care
“To end preventable maternal and newborn morbidity and mortality, every pregnant woman and newborn need skilled care at birth with evidence-based practices delivered in a humane, supportive environment.” (Tuncalp et al., 2015)
The BOLD Negotiated Standards of Care are a set of guidelines for effective behaviors which deliver high quality of intrapartum care. They have been developed with input from international guidelines and recommendations as well as formative research and negotiation processes with specific health facilities and community members in Uganda and Nigeria to make concrete what is feasible and acceptable within certain contexts.
BOLD Negotiated Standards of Care
- Every woman presenting in labour is welcomed with a smile.
- Every woman presenting in labour is encouraged to express her needs, wants, concerns, and expectations about the birth process; and providers take time to understand, consider, and respond to these views.
- Clear and accurate information exchange between healthcare professionals on the status and condition of the woman is ensured for continuous and coordinated care with the knowledge of the woman.
- There is proper communication and education relating to both normal and abnormal outcomes and interventions, e.g. caesarean section.
- No woman or newborn is subjected to abusive treatment such as physical, sexual or verbal abuse, discrimination, neglect, detainment, extortion or denial of services on any grounds.
- Show empathy to all women and their families.
Our design team aimed to integrate these behaviours into a series of products, services and the spatial concept using design methods like iterations in the field, following a participatory design process that invites different stakeholders, such as health authorities, practitioners and experts, to take part.
In the following blog posts we link different Lab.our Ward design proposals to a specific behavior from the BOLD Negotiated Standards of Care and the designers reflect on their design process.
World Health Organization. Quality of Care: A Process for Making Strategic Choices in Health Systems. Geneva: WHO 2006
BOLD Negotiated Quality of Care standards for Uganda: key themes 8 “C”s– communication, care, comfort, confidentiality, consent, control, confidence, and companion