This post is long overdue. Ive been caught up with the madness that trails behind deadlines, mundane activities like getting my driving license, visas etc. In the midst of all this thankfully, I managed to have a chat with Aditya Dev Sood,  Founder and CEO of the Center for Knowledge Societies (CKS). CKS is an innovation consulting firm based in Bangalore, India.

How CKS began – Aditya Sood came to back to India from the States, after studying Architecture, Critical Theory, Sanskrit and Anthropology, amongst other things in 1999, when the Dot Com revolution in India was just about turning into a raging bull, much like the Silicon Valley in the West. As most of these things go, it got Aditya thinking about Information, Communication and Technology and most importantly how these resources can fuel the local ecology and economies. One thing lead to another, and CKS was born. Aditya, while travelling through the country, had collected photographs of village information kiosks, showing how people were clustering around computers. These pictures were noticed, and he was invited to talk about how to use technology more effectively in a non profit world, at The Doors of Perception conference in Amsterdam in 2002. The next couple of years, from 2003 to 2007, were spent in the realm of mobile services and telecommunications. A lot of time was spent researching and studying street technologies and how they were used here in India. All this, while still thinking about the deep and large question of how to design for our economy and ecology. Interrogating and understanding these principles have made up the core DNA of the company.

In 2009, CKS diversified its portfolio and made a bold foray into the world of financial, medical and health services. With a grant from the Bill & Melinda Gates Foundation (that is in the forefront of applying innovation to the social sectors) and in partnership with the Government of Bihar, CKS took on the Innovation for Improved Maternal and Child Healthcare (IIMCH) study, the outcome of which are the 34 ways to save a life that provides solutions as identified by its antecedent,the Vaccine Delivery Innovation Initiative (VDII)

From the report - (Context of the study) – The northern Indian state of Bihar is witnessing rapid change today. It is the fastest growing state in India with an astonishing 10.5% growth rate (CSO, 2010-11), in comparison to the national average of 8.6% (CSO, 2010-11). This is a major leap from 6.3% recorded in 2009 (Economic Survey 2008-09). Bihar has, thus, come a long way from the morass state it was in about a decade back, with growing promises for the future, but not without its own set of challenges.

One of the most critical challenges that the state encounters today is in its health scenario. Being the second most challenging state as far as health care service delivery is concerned, Bihar today, cannot afford to tread the traditional developmental path of continuous roll out and upgrade. Set back by at least a decade of no active development, Bihar now needs to look at innovative ways of leapfrogging a decade of little development.

Keeping with the research and innovation that CKS’s work surround, the  34 Ways to save a life special report focused on studing and developing and detailing out potential design solutions to address key challenges identified through its antecedent, the Vaccine Delivery Innovation Initiative (VDII). The main objective was to facilitate innovation in the delivery of maternal and child healthcare services in Bihar and other rural parts of India through design solutions that not only address challenges in the vaccine delivery mechanism, but also cater to related services within the broader ecology of maternal and child healthcare.

A broad array of design solutions have emerged in this report, which are presented against five metacategories:

• Managing Health Information

• Enhancing Service Delivery Infrastructure

• Improving Medical Equipment

• Strengthening the Healthcare System

• Transforming Community Perceptions

One of the solutions that has emerged from this extensive study has been the redesigning of the Vaccine Delivery Service Kit.While its currently still at its early stages of development, the kit used by the frontline health workers, to delivers vaccines to children in remote parts of the district.

The challenges address by this concept are -

• Immunization session execution and logistics
• Tracking children and work activities
• Accountability and training

Types of problems addressed-

• Unwieldy structure- Very large and heavy vaccine carrier box, making its transportation and handling difficult.
• Space and function- Carries only vaccine vials irrespective of its large size, and has no provision for incorporating other components (e.g. syringes, needles, hub cutter) that need to be transported to the immunization session site.
• Safety issues- Difficulty in cleaning and maintenance of pockets provided for ice packs lead to formation of molds. No provision to carry cotton, disposable needles and syringes, leading to unhygienic practices and disposal methods.
• Temperature control- Melting of ice packs owing to improper freezing, large distances of transportation from the cold storage and lack of provision for refilling poses potential threat of spoiling the vaccines. Handling of the vaccine vials using sweaty hands also poses a challenge.
• Potential for institutional branding to build recognition, credibility and empowerment remains unexploited.

The existing vaccine carrier box can be judiciously redesigned to incorporate multiple functions such as storage of RI paraphernalia, easy transportation and collapsible work surface.

The RI kit here is designed in the form of a briefcase, with adjustable straps to provide flexibility to the ANMs to carry it either on their shoulder or back. Alternatively, the RI kit can also be designed in the form of a roller bag, provided with wheels and telescopic handle to allow easy mobility. It also has shoulder straps for the ANMs to carry it on their backs on rough terrains.

Multifunctionality is the highlight of the concept, with storage provision for registers, disposable syringes and needles, cotton, Vitamin A bottle, and medicines, in addition to vaccine vials. The extensible tray acts as a work surface for holding vials and other paraphernalia while in use and as a writing surface support. Incorporating technological features such as an information display screen and smart card reader could help in improved session execution.

Characteristics creating potential value

• The compact form with its smooth rounded edges adhering to the shape of the body, enhances its ergonomics. It would also help in easy stacking, enabling courier men to carry more than one box at a time.
• Accommodating all required paraphernalia for vaccine administration and record keeping, as well as providing work surface in the same box would improve its functionality. Color-coded vials would allow easier identification of vaccine types. This would help in resolving the challenges around equipment management, enabling smoother work flow.
• Replacing ice packs with materials such as PCM would reduce space wastage as well as help in easy cleaning and maintenance.
• Integrating the hub cutter and compartments for safe and easier disposal of needles, syringes and vials ensure effective waste
management.
• Use of innovative materials such as Phase Change Material (PCM) provides insulation to the vials and constantly maintain them at the desired temperature range of 2 to 8 degree Celsius. Provision of an outer case to hold the vials prevents direct contact with
person holding the vials, and contributes towards maintaining the temperature intact.
• Additional features such as information screen displaying the names of due recipients and vaccines due could aid in easier tracking of children, and faster vaccine administration. Incorporating smart card reader would make data entry faster and error proof, and also provide an in-built feedback mechanism by tallying due recipients with recipients administered vaccines at the end of every session. This would generate better accountability.
• Branding the RI kit (e.g. NRHM logo) would create improved recognition of the services provided, impart a professional identity to the ANMs and make them feel more empowered.

One can read the full 34 Ways to save a life report here.

All images from the 34 ways to save a life and the Vaccine Delivery Innovation Reports by CKS.

As design minds in the US try to figure out whether effective problem solving can still be called design-thinking or needs to be replaced by another buzz word called creative intelligence (refer to Bruce Nussbaums recent article on the subject, and Robert Fabricant’s take on creative intelligence) a conclave in India tries to figure out how to incorporate design-thinking in the process of governance to create effective citizen government interfaces.

Design!publiC conclave was held in India on 18th March. The event was organized by a number of partners including Center for Internet and Society, Center for Knowledge Societies and sponsored by the Bill and Melinda Gates foundation. The conclave tried to elaborate upon design-thinking and the challenge of governance innovation.

India is not the sole government that lacks empathy when it comes to delivering services. However, the government of India does happen to be the largest service provider in the country. Other than the blatant corruption and bureaucracy that plagues the various systems and services that the government provides, there is little effort amongst the heads of the states to simplify the tediousness that goes with anything government related.

Visiting India this time and speaking with my brother who lives in Singapore about the salaries the government employees in Singapore made, made me think that maybe there needs to a simpler system to bribe the government employees in India. Wherein a bribe can be considered a service fee and can be paid easily through legal channels. More along the lines of tipping the wait staff in certain countries. My ideas did not make it to the round tables of this conclave but other better ideas did. A bunch of case studies on government innovation formulated a part of this conclave like a new design for a vaccine services delivery kit in Bihar by Center for Knowledge Societies; Design for public transportation in the sparsely populated Oppland County in Norway by Live|Work; Reduction of red tapism in private industry and government interaction by Mindlab; Redressing Gender imbalances with Bicycle gifts by Government of Bihar to name a few noteworthy projects.

As previously stated, the conclave was centered around design-thinking and governance. There were representatives from design practices, social awareness groups, the government of India as well as Denmark and many more interesting places. Anand Dev Sood, one of the organizers is quoted as saying, ” the application of design in the public arena can create systems and services that are more efficient, more cost effective and more useful for the people whom they service’.

The conclave included a few panel discussions that discussed questions like – What do Designers do? How can Physical, Informational and Interaction Design Impact the Everyday Life of Citizens? How Can Governments Best Use Designers and Design Thinking? How Can Social / Media Promote Design and Governance Innovation? What Institutional and Organizational Models can best Foster Governance Innovation? On the other hand, there were brainstorming and concepting sessions around ‘Conducting Ethnography to Inform the Innovation Process’ and ‘Approaches to Institutionalizing Innovation in Government’.

Public sector innovation is the next new thing in India and it won’t be long before it gains momentum through such conclaves and efforts. There is growing interest in the approach of user centered service design. This involves ethnographic research where design researchers go out into the field to understand the needs of the user who is the center of this initiative. The tools employed to conduct this research may be many and could include workshops with the users, use of technology to record experiences and living patters, interviews etc. The second phase involves collecting all this data into a digestible format where common themes can be grouped together to understand patterns, the patterns are later developed into insights and the insights are synthesized by designers in actual products. This may seem like a whole lot of design jargon but is an effective way to capture the needs and necessities of the users who are often ignored and left out of services that are being created for their benefit.

In countries like India, this road is full of skepticism and challenges. Governance is often conservative and traditional. Very few countries have the luxury of having truly innovative leadership. India is certainly not one of them, not because there aren’t any talented and progressive thinkers in the government, but because a big part of governance in India is leftover from the British Raj. It is archaic, hierarchical, complex and old. Government systems are also very different from private sector. In this case, key partnerships need to be formed with government departments so that they can benefit from more progressive and innovative thought leadership. An effective citizen government interface will be formulated if there is adequate interest from both the sides to make this relationship work. Citizens need to ask for effective governance and the government needs to listen. The presence of representatives from the National Planning Commission and the Ministry of Housing in this conclave is an optimistic sign that things are moving in the right direction and we hope they continue to do so.

For more details on the conclave:
Using Design Principles for Good Governance for Livemint by Aparna Piramal Raje (also has a video in the post which is informational)
Design!publiC: design for governance in India by Putting people first
The Designpublic blog

JustDial maintains a large and updated database of all local businesses and services not only for metro cities but also for all small towns in India.

Just Dial’s service came into existence in early 1990s when VSS Mani, founder and CEO, identified a user need . In a news channel interview he mentioned, “Things never used to get done. People would wait forever because they didn’t have a piece of information to act upon.”

Local businesses in India did not invest much in advertising. Their strategic location in a market place and word-of-mouth usually worked as ways of attracting customers. As for the customers, they relied on local printed directories, newspapers and word-of-mouth to look for a business or service. However, these listings were not updated enough. JustDial successfully bridged this gap and has been able to build a sustainable business model. Local businesses pay to JustDial to be on their listings.

JustDial predates the internet era in India; it laid its foundation in the telecom boom in the mid 90s. The more popularly used interface for looking up businesses is the phone service available by dialing 69999999 nationwide than looking it up justdial.com on the Internet . The other end of the call is a JustDial representative who responds to the queries. They respond with the list of the top matches of the business in the required location and also send the listing in an sms. The low call rates and ever-increasing mobile users support this user behavior.

What is significant is that their claim to have “an excellent user experience” holds true. No matter how efficient an automated search engine may be, no other experience can match that of a conversation with a live, friendly human voice.

[This article contains information available in public domain.]

Jinal Shah is a digital strategist and works for Electric Artists in NYC. She describes herself as a thinker, writer and storyteller and jots down her thoughts in her blog - Constant Beta. She also started a blog called Dsplaced that aggregates stories from people and talks about their sense of displacement from home and country. She spoke to Designwala about innovation in India through incremental change. She also talks about examples where storytelling has been used in education, women’s empowerment and social change.