Brian McMahon, Communications Specialist at Scope Impact, outlines how their innovative project aimed to revolutionise maternity services and improve mortality outcomes.
While maternal and infant mortality rates have dropped significantly in the last 20 years, complications during pregnancy and childbirth still claim the lives of hundreds of thousands of mothers and newborns each year. As the number of births taking place in health facilities around the world continues to rise, a higher proportion of avoidable maternal deaths occur within maternity wards. In this context, poor quality of care at many health facilities becomes a significant roadblock to further reducing maternal mortality and morbidity. Overcrowding, lack of sanitation, and poor infrastructure at facilities are major factors that contribute to low quality of care, making the experience of birth neither safe nor comfortable for new mothers.
Approaching a woman’s experience of childbirth holistically, including the infrastructure, products, and services available to her at health facilities, can greatly improve her and her baby’s health outcomes. At the same time, improving these elements of health facilities is also likely to boost staff motivation and quality of care they provide.
Launched in 2015, our project Lab.Our Ward has worked in six countries to take a holistic view of the patient experience, rethinking the infrastructure, products, and services of maternity wards. Most recently, we partnered with CARE India and the state of Odisha, India to adopt the Lab.Our model at the Basta Community Health Center, applying lessons learned and innovations from our previous pilot projects. Architects, product and service designers, and health experts came together as part of the project, using human-centered design methods to better understand the needs of new mothers and healthcare providers and innovate new solutions.
As a key part of the human-centered design process, the team began its work by interviewing and observing different actors involved in maternity care, including expecting mothers and their families, nurses, doctors, community health workers, facility management, and ancillary staff. They also examined the role of infrastructure, interiors, and furniture in the patient experience. At the time, women reported a number of issues such as an uncomfortable waiting room environment, a lack of information for patients on what to expect during labour and delivery, poor sanitation conditions, and overcrowding due to inefficient patient flow. Expecting mothers and their family members were also easily disoriented in the facility as they moved along the labour and delivery process. The combination of these difficulties led many new mothers to leave the Basta Health Centre within hours of delivery, even though they were encouraged to stay longer in order to monitor for life-threatening complications.
The Lab.Our Ward team used insights from this research to collaborate with mothers and health centre staff in co-designing new solutions to improve the patient experience.
Co-designed Lab.Our Ward innovations included:
- Baby Bed – A small newborn bed attached to the postnatal bed enables mothers and newborns to be in continuous contact, facilitating breastfeeding and supporting important bonding routines.
- Family Pass – Expecting mothers and their companions receive a wearable pass that communicates care preferences and key information, providing staff with a quick overview of patients and enabling them to respond to unique needs or cultural preferences.
- Delivery Bed – Co-designed by product designers, women, and medical staff, the new delivery bed enables women to adjust the position to reduce pain during delivery and to rest in a comfortable position while bonding with their newborn.
- Colour Coding & Wayfinding – To help women and families better navigate the facility, colour coding was applied to floors, doorways, signs, and furniture to designate areas for each of the five steps of the labour journey, creating easy-to-follow guides.
- Colour-coded Armbands – Colour-coded armbands are now assigned to women during triage based on level of urgency or risk of complications, allowing nurses to easily identify priority patients in crowded waiting rooms.
- Active Labour – As walking or standing upright can help ease pain during early labour, a courtyard was renovated to give mother’s space to walk and handrails were attached in corridors to facilitate mobility.
- Natural ventilation – For future facility expansion, architects recommended semi out-door corridors and open-air courtyards to provide cross-ventilation and continuous airflow, cooling the building naturally and reducing the risk of bacteria remaining inside the facility.
- Rainwater harvesting – Recommendation for future facilities to include roofs designed to maximize the collection of rainwater, channelling it to a filtered reservoir for use in sanitation, cleaning, and laundry.
Following the implementation of several Lab.Our Ward innovations at the Basta facility, a three-month pilot evaluation showed noticeable improvements in women’s experiences. Previously, 40 per cent of patients in the maternity ward had reported challenges with the care they received, which dropped to 18 per cent after the co-designed innovations were adopted. Meanwhile, new mothers’ perception of the birth-giving experience at Basta increased by 25 per cent.
Most importantly, these mother-centred changes to the services, space, and products can do more than just improve the patient experience—they also have the potential to contribute to better health outcomes. After Lab.Our Ward’s new solutions were implemented, 35 per cent more new mothers chose to stay at Basta’s maternity ward for at least 24 hours following birth. Having this extra time at a facility is associated with better health outcomes for new mothers and their babies, as it helps staff to identify and treat complications that arise after birth.
Scope is currently exploring opportunities to scale up innovations developed by Lab.Our Ward and adapt and co-design new solutions in other geographies. Our hope is that this interdisciplinary, human-centered design approach to innovating maternity care can serve as a model for healthcare facilities around the world, helping to ensure a safer start to motherhood for more women and a better start to life for their newborns.
Learn more about Lab.Our Ward.