Technology

Transform Tangerine’s banking experience into a powerful, sophisticated, and friendly digital financial ecosystem to help Canadians make smart decisions with their money and meet their banking goals.

A complete design system and roadmap to reflect Tangerine’s Forward Banking philosophy across a new suite of digital banking features, including a refreshed brand, responsive website and new mobile app.

“I was very impressed by Artefact’s creativity, open-mindedness, and ability to think in abstract ways. Your work was much appreciated and valued in helping us develop the client-centric Forward Banking experience we are pleased to provide today.”

Simplifying everyday
banking

Tangerine sees money differently. The Scotiabank subsidiary is an online-only direct bank with innovation at its core. Tangerine was previously known primarily as a savings and investment institution, but through this work has evolved to become a preferred everyday bank for Canadians. Beyond their mission of simplifying daily banking, Tangerine is dedicated to helping people make better financial decisions that increase their long-term wealth.

We joined forces with Tangerine to help evolve their platforms, elevate and expand their brand, and develop a suite of innovative digital banking features that set Tangerine apart as the bank that empowers you to take charge of your financial future, every day.

Transforming how clients engage with banks

Forward Banking reimagines and personalizes the client’s complete financial journey, from initial onboarding and everyday bill paying, to long-term goal setting and adopting additional banking products.

We turned Tangerine’s vision and strategy for the future of banking into features that their team could ship, develop, and use to rebuild Tangerine’s entire banking experience.

Insights


Insights provides actionable notifications about accounts delivered in a timely and contextual manner. From low balance alerts and task reminders to helpful hints on improving spending habits and achievement milestones, Insights tailors the banking experience to clients’ specific needs.


Left to Spend


Create a personalized budget and stay on track with real-time data. Forward Banking uses a client’s transaction history to generate a bespoke daily, weekly, or monthly budget. Clients can see if they’re on track at a glance, and how much they have left to spend to continue meeting their goals.


Goals + Progress


Easily set financial goals, track progress, and explore impact. We applied principles of behavioral economics to the goal-setting feature, such as a sliding scale that helps clients easily visualize trade-offs and impact, encouraging better financial habits.


Transaction categorization


Transactions are categorized and displayed in clear visualizations to help clients understand their financial habits and behaviors. Whether clients want to dive into spending on a particular day or see an overview of top spending categories, the controls are at their fingertips.

Onboarding + Basket Page


A familiar, e-commerce-style shopping cart experience for signing up for new products and accounts. In contrast to traditional banks, where each new account requires a separate sign-up, Forward Banking offers a streamlined and digestible enrollment experience.

Trust is fundamental to banking. We helped Tangerine communicate their credibility and maturity with a refined design system of brand, visual guidelines and user interface patterns. From icons and typography to navigation, modals, charts and tables, the result was a clean, modern, and radically simplified banking experience.

We then integrated their online banking platforms – the visitor’s site, secure site, and mobile app – into one consistent, seamless experience across all products, platforms and devices.

Setting the stage for future growth

Artefact worked closely with more than 150 members of Tangerine’s team across our three-year partnership, strengthening internal design capabilities to ensure Tangerine has the design processes, methods, and tools to build on their success.

We helped Tangerine cultivate a design team, organize around a cohesive design system, and understand the latest design process innovations. Together, we created guidelines for implementing new features, products, and components within the design system to support more efficient team collaboration and future platform scalability and expansion.

We couldn’t be prouder of what we’ve achieved together and what lies ahead for Tangerine Forward Banking.

What we delivered

+ Generative research

+ Foresight

+ Concept envisioning

+ Strategic assessment

+ Experience design

+ Evaluative research

Learn more about our expertise


Design

Inspiring educators to reimagine how students learn

For classrooms on the cutting edge, gone are the days of rote memorization and time-based instruction. The world of education is evolving. Today’s teachers are looking for student-centered methods that empower young people with the skills to become the next generation of problem solvers.

Global Online Academy (GOA) is a non-profit organization that equips educators with tools to help students face an ever-changing world. Their approach? Competency-based learning (CBL): a teaching method that mirrors how people learn, work, and succeed in the real world. Rather than evaluate students based on seat time or standardized tests, students are challenged to master specific skills, or competencies, in a flexible, personalized way.

GOA came to Artefact with an idea for a collaborative toolkit that teaches educators how to implement CBL in their schools and classrooms. We worked together to concept, research, and prototype a family of resources that articulate what CBL is, why it matters, and how to use it. The result is an engaging, tactile toolkit perfect for teams.

“I felt very taken care of and truly felt that Artefact was my partner in this work. We needed not just a design partner but a thought partner. That’s what you’ve been to us.”

Three educators in a brightly lit window room working with the CBL toolkit.
The CBL toolkit open on a meeting room table, with two educators chatting while using activity cards in the background.

What we delivered

+ Generative research

+ Foresight

+ Concept envisioning

+ Experience design

+ Capacity building

Learn more about our expertise

Two children filling up water bottles.


Design

Wash, rinse, drink: we do it several times a day without a second thought. But for many children living in urban poverty, personal care practices like handwashing are far from routine.

Children who lack access to water and soap are less likely to learn healthy hygiene habits and more at risk of contracting life-threatening illnesses. Unsafe drinking water and a lack of water or soap for washing are responsible for 2.2 million deaths each year, 90 percent of whom are children.

Seattle-based, international development organization Splash designs child-focused water, sanitation, hygiene (WASH) and menstrual health solutions for governments in some of the world’s largest, low-resource cities. With a focus on reaching children at schools, Splash is passionate about changing behaviors and encouraging healthy hygiene habits.

Artefact and Splash turned years of local behavior change research into smart and scalable drinking and handwashing stations that can be mass-manufactured in plastic. Splash plans to roll out the newly designed drinking and handwashing stations to nearly 1,600 schools in India and Ethiopia as part of their major initiative, Project WISE (WASH in Schools for Everyone). This project will reach every government school in Addis Ababa and Kolkata, benefiting one million children by 2023.

“Artefact was the ideal partner to bring our vision for drinking and handwashing stations to scale. The new design will benefit some one million children through Splash projects over the next five years by enabling access to clean water for drinking and water and soap for handwashing.”

Kid tested. Community approved.

Successful drinking and handwashing stations require more than just a child-friendly design. They need to be easy to manufacture, transport, install, and maintain.

We sat down with Splash’s team of behavior change and engineering experts to design stations that fit the community context. We explored not only who uses the stations and the cultural norms around drinking and handwashing, but also where and how the stations are fabricated, installed, and maintained.

After brainstorming, creating, and vetting more than 100 different ideas, we aligned on a design direction.

“Artefact’s thoughtful ideation and quick and iterative process pushed us to think in a more expansive way. We are proud to launch a product that can empower many more children than our previous designs could reach.”

Schoolchildren playing, Tensae Birhan Primary School, Addis Ababa, Ethiopia

Research from UNICEF suggests that face-to-face handwashing promotes better hygiene. Yet the plumbing of most schools and orphanages requires drinking and handwashing stations to be built against a wall rather than a stand-alone station that children can access from both sides. We developed an innovative triangular design that allows children to more easily have eye contact and interact with each other while washing their hands side-by-side. A small and cost-efficient pedestal option can be installed to raise the station height to better suit older children as well.

Orange and blue colors clearly differentiate drinking and handwashing stations. Handwashing stations have shallow basins to discourage children from accidentally drinking non-potable water, while deeper basins at drinking stations comfortably allow you to fill up to 1.5 liter water bottles. Water fountains are included on the drinking stations to accommodate children who have forgotten their water bottle.  These are situated specifically on the right side of drinking stations to respect cultures that require eating and drinking with the right hand.

Kidist’s Story

Community-friendly design

Before children can use the drinking and handwashing stations, they need to be installed and maintained by the organizations that use them. We designed a smooth, more hygienic form for simple cleaning and an easy-to-remove front access panel for installation and plumbing repair. Additionally, the stations are shipped pre-plumbed with all internal piping and taps attached and leak-tested, making for easier installation on site.

Schools and other child-serving institutions often receive funding for drinking and handwashing stations from sponsors. We included a customizable backsplash so that organizations could credit their sponsors directly on the stations and encourage future funding. Alternatively, the backsplash can also be used as a messaging space to promote hygiene behavior change.

Animated cross-section render showing the simple plumbing within Artefact and Splash's orange handwashing stations.

Efficient local manufacturing

Before making the switch to plastic, Splash manufactured stations from a variety of materials, including concrete, tile, and fiberglass. These manufacturing processes were time and labor intensive. The new stations designed by Splash and Artefact are manufactured using rotational molding, which allows for production of the stations at scale, with less labor needed and consistent quality.

Reaching one million children in five years

Inspired by the stations’ success in schools and orphanages, Splash’s larger goal is generational behavior change. Splash will provide some 1,600 schools with the new drinking and handwashing stations, reaching one million children by 2023. They have also launched a wholly owned social enterprise that will sell them to other non-profit organizations and governments. The stations will help consistently reinforce good hygiene habits throughout the community for both children and adults.

Splash in the news

The Chicago Athenaeum Museum of Architecture and Design

   Mobility

A systems approach to healthcare innovation

Our focus on quantity and cost of care rather than its value has resulted in an inflexible, rigid system full of gaps, tensions, and friction for patients, care organizations and society. Innovations get bolted on to the complex, inflexible system, solving one problem, yet often creating a myriad of other, even more complicated ones. Just look at electronic health records.

To solve the interconnected problems in healthcare, we needed a system level approach. What is unique about the concept is less the individual components: a data platform, an autonomous vehicle, AI-powered diagnostics, some of which already exist, but how they connect and interact with each other in a system and experience that allows us to maximize value at the patient, provider and social level.

Deeper patient understanding and informed actions

Despite proliferation of connected devices and health apps, health data today is siloed and far from actionable. Aim is built on an integrated, multi-source data platform that facilitates action and eliminates blind spots for clinicians and care providers.


Immersive diagnostic environment for fuller picture


Aim’s self-driving clinic is optimized for self assessment with bridge diagnostics like thermography, imaging and breath analysis. The unit features a built-in, pressure-sensitive scale to measure weight, BMI, balance, and posture; a seat providing an acoustic analysis of respiration and cardiac rhythm; and controlled lighting that facilitates assessment via image recognition. Surround displays provide AI-driven, real-time instructions to the patient.

Augmented interactions for clear communication


Aim allows patients to use simple interactions to share details about how they feel and interface with the bridge diagnostics. Motion sensors paired with “on-body” projections and augmented reality help the user call attention to symptoms.

Visualized data summary for easy prioritization


A highly visual summary of the Aim session helps the patient easily understand and act on the diagnosis. These insights stay with the patient via the Aim mobile app for a new level of continuity of care


Self-driving clinic for increased, more consistent engagement


Aim delivers on-demand healthcare via a self-driving clinic. This minimizes the logistical burden on the patients and makes them more likely to engage in their care, before conditions and costs escalate. At the same time, Aim helps clinicians focus on the more complex cases, where higher-value expertise is needed.

On-board pharmacy for better medication adherence


Aim dispenses the most frequently needed pharmaceuticals, like prescription analgesics, antibiotics, or contraceptives. Maintaining a small inventory of the most common drugs removes the logistical burden of picking up new medication from the pharmacy.

Telemedicine consults for clarity


If the self-guided assessment indicates the patient needs to consult a specialist, the Aim platform connects the user to one of the on-call specialists from participating fleet partners. The Aim clinic can also provide immediate transport to the emergency room, reducing the critical time to get the patient into a clinical environment.

  Health

Most teenagers and young adults worry about finishing homework, finding the right college or landing that first post-grad gig. But for young people diagnosed with a serious illness like cancer or a chronic condition like Type 1 diabetes, life takes on an entirely new dimension of difficult emotions. The doctors at Seattle Children’s Hospital have seen firsthand the toll a serious medical diagnosis can take on the young people they treat, and they know maintaining hope can be crucial to their patient’s care. That’s why Dr. Abby R. Rosenberg and Dr. Joyce Yi-Frazier developed PRISM, an emotional wellbeing program that helps young patients build resilience and manage stress in the face of serious conditions.

Seattle Children’s Hospital is at the forefront of treating the physical and emotional health of patients holistically as well as in harnessing the potential of digital health interventions. When Seattle Children’s recognized the potential of PRISM as an app for patients, they turned to Artefact to design a convenient and trustworthy digital version of the PRISM program.

Animated GIF of a breathing exercise from the PRISM wellness app being used on a mobile phone.
Animated GIF of a gratitude exercise from the PRISM wellness app being used on a mobile phone.

A new frontier in digital health

The PRISM intervention is a powerful example of healthcare viewed not just through a medical and physical lens, but by recognizing the personal and emotional journey of patients. And in app form, PRISM demonstrates the huge potential of digital healthcare solutions, thanks to its scalability, portability, and prospective application across many types of patients and conditions. As Seattle Children’s pilots the PRISM app, we remain inspired by the incredible work of all the practitioners and patients who made PRISM a reality with their perseverance, optimism and hope.

“With Artefact’s elite design skills, General UI’s architecture and Dr. Rosenberg’s fastidious research, we have a marriage of unique skills that allow us to leverage the PRISM program to reduce suffering not just here in Seattle but for teens and families experiencing stress and illness elsewhere, too. The partnership affords us a chance to reduce suffering at scale and we’re thankful to begin the work and iteration process to understand how to support even more children and their families.” 

What we delivered

+ Generative research

+ Concept envisioning

+ Strategic assessment

+ Experience design

Learn more about our expertise

    Design

Empowering the next generation of African leaders

Thousands of students from African countries pursue their education each year through the support of The MasterCard Foundation Scholars Program. Becoming a MasterCard Foundation Scholar can be a life-changing moment that opens up opportunities to study at top universities in Africa and around the world. Madit grew up in a farming community in South Sudan during a time of civil war. As a MasterCard Foundation Scholar, he is now studying business, economics, and public policy so that he can set up a college preparatory program in his home country after graduation. Stories like Madit’s are what make The MasterCard Foundation Scholars Program such a powerful and transformative program for the next generation of African leaders.

MasterCard Foundation Scholars are driven academically and dedicated to their education, but the experience of adapting to life at university can be daunting without a support system. The need for support continues after graduation as well. Many Scholars return home to lead change within their communities, but require connections to resources, collaboration with others and continued education to accomplish their goals.

Together with Arizona State University and The MasterCard Foundation, we set out to design a community that would support Scholars throughout their education and set them up for success long after graduation. The result was Baobab, a social learning platform that elevates scholarship into a source of lifelong learning and empowers the next generation of African leaders to create social change.


Named after “Africa’s Tree,” Baobab is a social learning platform where Scholars gather to share knowledge, exchange ideas and learn from each other. It fosters connection and collaboration within the Scholar community, provides a curated learning environment, and maximizes mentorship opportunities.

Throughout every step of the design process, Scholars provided direct input into what they were looking for and needed from Baobab, and we used their experiences studying at university and returning home to inform our design process. MasterCard Foundation Scholars expressed that the Baobab experience would need to prioritize conversation around real issues, make opportunities and mentors more accessible, and provide resources for continued learning. As a result, Baobab is built on principles of inclusivity, community, and connection. All of these design principles keep Scholars at the front and center of Baobab and give the platform purpose beyond the typical social network.

“Our cross-sector collaboration with Artefact and The MasterCard Foundation pushed the limits of a first-of-its-kind social learning platform. Together, we draw upon the strengths and expertise of a foundation, university, and design firm to create a global force for change.”

“Before Baobab, I was worried what would happen to me after the scholarship. Would I be able to continue my education? How will I stay connected to all the people I met during my scholarship? Now all that worry is gone. Students are sharing so many great opportunities with each other that I never knew were available, and we can stay connected with each other on Baobab.”

“My level of confidence and curiosity now has greatly improved. This semester I have answered and asked more questions just because I feel confident in airing my views. And Baobab had contributed to that!”

What we delivered

+ Generative research

+ Foresight

+ Concept envisioning

+ Strategic assessment

+ Experience design

+ Evaluative research

Learn more about our expertise

    Technology


After years of false starts, the technology is finally sophisticated enough to deliver on its promise to help us forget where we are and allow us to experience things we never thought possible. But as the first generation of virtual reality devices from different manufacturers starts hitting the market, what are the implications for enjoyment, productivity, social interactions, man-machine-interfaces, and health? How will opportunities within these areas help create a preferable future for both VR brands and their customers?

From rehabilitation to virtual robotic surgery, from field trips to Machu Picchu to empathy-building experiences, from enjoying Henry the hedgehog to creating your own magic with Tilt Brush – healthcare, education and media and entertainment are emerging as the areas where VR can have a clear positive impact. But how much more fun would a school trip to Mars be if the kids could see their classmates and interact with them while they are there? Having just created an amazing Tilt Brush artwork, wouldn’t it be great for a kid to be able to make eye contact with her dad to see how he approves? As VR helps us to develop empathy for people afar, will it at the same time numb us in understanding and sharing the feelings of the person next to us?

“Artefact presents two VR headsets that could feasibly exist by 2020– and the medium never looked so promising.”

With Shadow, the computer and battery are built into the hood and shoulder cloak, untethering the user from cables (and reality). Immersion extends beyond sight – it incorporates the sense of sight, hearing, and touch. Sensors in the arms, hands and body bring the experience to a new level of ultra-immersion. For the hardcore gamer, inclusion is meaningful primarily in the context of a shared gaming experience. Eye tracking enables Shadow to detect the user’s emotions, which can be reflected through a virtual avatar or using displays within the mask that mimic the user’s eyes.

It allows the user to stay connected not only to the virtual reality but to her environment and the people around her. A front facing camera allows the user to “see” what is going on around her, while a shareable mode gives them a chance to show others the content they are experiencing. Light connects wirelessly to other devices, letting others share the experience on a phone or a larger screen. Sound is transmitted through adjustable bone conduction audio system that allows the transmission of ambient sound. Ease of interactions is key for this concept– from putting on the lightweight device, to switching modes – everything is designed with the social user in mind.

No technology is inherently good or bad. VR has been called the “church of our imagination” by some and “virtual insanity” by others. Whether or not it becomes more than an addictive trap that insulates us from each other is within our control. And while I doubt I will ever dispel my grandma’s fear of tuning out the real world, it is my duty as a grandson, a father and a designer to try. To dive deeper into our process and the ideas we explored, or to find which headset is right for you, check out the VR Demystified project on 10,oooft.

    Design

Half of the 78 million people who have been infected with HIV since its identification in the 1980s have died, making it one of the most merciless epidemics in history. Today, more than 1 in 200 people is infected, with two million new infections recorded each year. While medical advances have made HIV easier to manage, researchers agree that an HIV vaccine is the most likely, and perhaps the only way by which the AIDS pandemic can be stopped.

In the face of all this, the Statistical Center for HIV/AIDS Research & Prevention (SCHARP) is on a mission to help HIV and other vaccine researchers around the world collaborate through data. SCHARP partnered with Artefact and LabKey Software to help define the objective, design a solution, and build the DataSpace, a web tool to empower vaccine investigators to explore data across HIV studies, generate new hypotheses, and accelerate the path to discovery.

[SCHARP DataSpace] is giving me the freedom to play with the data. It’s filling a niche that is totally empty right now.”

HIV has many strains, mutates quickly, infects the very cells meant to fight it, and exposes very little of itself to attack. Researchers have conducted hundreds of HIV vaccine studies over the years, each setting out to explore a specific hypothesis about how it works or how we might fight it. Hidden within and across these studies are other important insights that were not part of the analysis plan. They remain undiscovered because the data can be incomplete, inaccessible, and difficult to stitch together. Researchers have to wait years before they can access their colleagues’ results in published research papers. More importantly, the actual data that produced the papers is often unavailable, relegated to a huge data graveyard where potential clues to vaccine stay buried.

In light of this, the Global HIV Vaccine Enterprise, the group of top HIV experts and funders, called for “a dramatic shift in the culture and practice of sharing research data.” Their top priority? Creating “databases for sharing trial data globally and an insistence on pursuing diverse hypotheses.”

The DataSpace brings researchers information that is easy to access, filter, explore, interpret, and export for further analysis. By using DataSpace, they can identify gaps in current research, review and learn about past work that can help them secure grants, and test new ideas to see if they are worth further exploration.

A new way
of thinking

The purpose of the DataSpace is to make data more open and broadly available, changing the way researchers think about and share it. In order to design a solution that researchers would embrace, we needed understand how they work. We went through several key immersive steps to understand the science of HIV vaccine research and the culture of the community.

Our most critical design choice came down to figuring out how to organize the data in the system. Previously, researchers needed to know their specific question ahead of time to align the data and make a valid combination (if they had access to the data at all). But after talking with researchers we flipped the model on its head: what if we pre-combined all the data? Doing so takes a lot of upfront work but enables users to pose any number of questions that lead them to exploring new directions. The DataSpace gives researchers the opportunity to uncover connections they had not anticipated.

For the DataSpace to be truly useful, we had to design analysis tools that provide value across a large range of experiments and data sources. Unlike specialty tools targeting results from only one test, we developed a core set of visualizations that show data from any test. For instance, the plot visualization lets users take one to three variables from different sources and find patterns in post-vaccine immune response across tests, studies, vaccine types, and more. Unlike generic visualization platforms, the DataSpace is easy to jump into, has many unique visual analytics features made just for vaccine science, and empowers users to see and interact with data based on multiple relevant criteria.

What we delivered

+ Generative research

+ Foresight

+ Concept envisioning

+ Experience design

Learn more about our expertise

    Strategy

The Microsoft Emerging Markets team tapped Artefact to investigate how to extend the value of feature phones by understanding the needs and desires of low-income South Africans and mapping them to scenarios and opportunity areas that could narrow their technology gap.

Understanding through immersion

While South Africa’s population is quite young, their unique needs as consumers are often overlooked. Our goal was to research the daily behaviors, motivations and group dynamics of South Africa’s urban youth in an effort to uncover key design opportunities. For weeks, we immersed ourselves in several teenagers’ lives. From observing everyday life in their townships to interactions with each other and their families, we developed an understanding of the role of their phones in their lives.

Using research techniques that involved uncovering group dynamics between teens and their friends, we were also able to identify genuine interactions between the teens and their phones. Through a series of design thinking exercises, we established several design principles and business recommendations for a new mobile platform experience that was unique to this market.

Prioritizing
social experiences



We discovered most of the teens used their phones for socializing: messaging friends, visiting chat rooms, listening to and discussing music, and viewing, taking and sharing photos with each other. Yet, few of the existing platforms allowed feature phones to do many of these activities easily or affordably, due to their limited memory and processing power. It became clear through research discoveries like this that the Microsoft feature phone platform needed to prioritize social behaviors, with features like low-cost messaging and chat room conversations, as well as file sharing for music and photos. To create a truly shared social experience, we also recommended that the platform support multitasking. This way, teens could listen to music while chatting with their friends, exchanging photos and just being teenagers.

Providing support through celebrity

On the verge of adulthood, the youths in our research were in a period of transition in their lives, grappling with new situations and encountering complex topics like love, sex, and identity. Many of them were not comfortable broaching these topics with their families due to the expected generation gap, but also because of a unique cultural gap that made these topics taboo. Their parents had often grown up in rural villages with traditional values and had moved to urban areas, drawn by their higher economic potential post-apartheid.

Most of the teenagers we spoke with were the first generation of their families to have grown up in an urban environment and needed help sorting through their growing pains, but couldn’t speak with their families. Instead, they sought advice in chat rooms, building relationships with celebrities and influencers. This presented a unique opportunity for Microsoft. Through celebrity sponsorships, the company could have a positive impact and raise awareness about the important issues teens deal with, such as sexual activity and violence, racial tensions, and the pressures to partake in illegal activities, while attracting and retaining teens to the Microsoft platform.

Increasing safety through design

High crime rates plague youth in the townships and mobile phone theft and muggings are, unfortunately, a common experience. As a result, teens were wary of using their phones on their daily commutes, which were often upwards of three hours long. Yet, their desire to speak with their friends and listen to music often resulted in risky behaviors of concealment, like trying to use their phones while hiding them inside a backpack. Artefact recommended that the Microsoft platform allowed for an ‘out of sight’ usage experience. Features such as listen-to-text and voice-enabled phone commands were key considerations for this experience.

Using research to set emerging market strategy

Artefact’s and Microsoft’s partnership set the foundation for defining the platform’s user experience, and also prioritized an often-overlooked segment of the mobile user population in South Africa. The human-centered design techniques we used uncovered opportunities that continue to influence the Microsoft emerging economy strategy today, developing high-function phones with limited technical storage and capabilities. There are few companies who have dedicated as many resources as Microsoft to servicing emerging markets with meaningful solutions designed for their specific social, cultural and economic contexts.

What we delivered

+ Generative research

Learn more about our expertise

    Design

The power of prevention and intervention 

PATH is an international nonprofit organization that transforms global health through innovation. PATH takes an entrepreneurial approach to developing and delivering high-impact, low-cost solutions, from lifesaving vaccines, drugs, diagnostics, and devices to collaborative programs with communities. Through its work in more than 70 countries, PATH and its partners empower people to achieve their full potential.

PATH and Artefact partnered together to investigate and explore solutions to one of the most serious yet preventable health challenges in the developing world: maternal morbidity and mortality. We set out to identify the factors that influence how and when new mothers seek care in these rural areas. Our goal was to design diagnostic product concepts that would reduce the life-threatening infections that occur during pregnancy and labor.

“One of the most successful experiences in our project on maternal and perinatal infections was the collaboration with Artefact for the primary research in-country. Their use of techniques such as storyboards for use scenarios and hypothetic product concepts provided us with richer, more complete data.”

Grounding care in a user-centered perspective

According to the World Health Organization, in 2010, 287,000 women died during pregnancy and after childbirth. The issue is most severe in remote rural areas of developing countries, where information access, cultural beliefs, and environmental conditions serve as barriers to receiving proper care. One of the main causes is untreated, yet often easily preventable: infections. During our partnership with PATH, we challenged stakeholders to rethink how pregnant women and the caregivers who influence them, could detect early signs of infections and subsequently seek treatment. Our approach was grounded in a user-centered perspective and began with ethnographic field research in Bangladesh and Uganda. We aimed to deeply understand the environments, social systems, and cultures that impact care-seeking behavior and ultimately, life-threatening infections.

Recognizing formal and informal influences on care 

At the outset, we recognized that women receive care and advice from a wide variety of places during pregnancy. Our goal was to identify these information sources and understand which are influential, which act as barriers, and which come from formal (i.e., trained) vs. informal (i.e., untrained) health care providers. One key discovery that impacted our product design criteria aligned around providing a strong sense of authority. Pregnant women’s primary points of care are family members, traditional birth attendants who are largely untrained, and formal care providers who have approximately 2 days to 1 week of training.

In addition to this, pregnant women are seldom “in-charge” of their own health-related decision-making. These insights meant it was imperative that the diagnostic device provided authoritative and unambiguous evidence to women, their care providers and family members to seek treatment (see infographic below). It is only with this type of information that those involved would be willing to reconsider deeply ingrained cultural beliefs or take on overcoming barriers, such as treacherous road conditions, to seek formal care.

Finding the opportune time for intervention

No matter how perfectly designed the diagnostic tool was, we realized that if it wasn’t disseminated in a culturally acceptable way, widespread adoption would not follow. Through immersive research, we identified several factors that keep women from giving birth in clinics or hospitals, thus increasing the risk of infection for themselves or their babies. One of these cultural factors is the fear of “the evil eye” (a curse) that might be placed on a vulnerable newborn.

Fearing this, women deliver babies in their homes, or in the homes of traditional birth attendants. The often unsanitary conditions of childbirth and the low visibility in the environment, as well as the lack of training of caregivers, mean that labor can be extremely dangerous. We had to accept this strong bias towards giving birth at home and reframe this risky infection period in a way that would allow us to introduce the diagnostic tool, yet not threaten traditional beliefs.

Understanding acceptability within cultural context

We recognized that we could have the most impact by introducing the diagnostic during labor (see infographic above) and set out to ascertain the ideal form factor of the diagnostic. Collecting a specimen such as blood or urine might be most accurate, but would it be acceptable, and therefore, practiced? To learn about acceptability, we conducted scenario-based acceptability research with pregnant women, their mothers-in-law, husbands, and other people who influenced how they sought and received care.

We discovered that women were not comfortable self-administering diagnostics that require any type of specimen collection. They also did not trust birth attendants, family, and community members to collect specimens or to interpret test results. Not only did they worry about testing accuracy, but they were apprehensive of the possibility that gossip in the close-knit community would strip them of confidentiality.

From insights to solutions

After months of discovery-design-iteration cycles, we formulated product design criteria that would serve to inform the development of the infection diagnostic. Criteria included specifics about who should deliver the diagnostic and how it should be administered, given the location of use. For example, if formal providers have the opportunity to provide care, the diagnostic should provide on-the-spot diagnosis to help patients avoid additional trips and also be bundled with the frequently used “maama kits” women are familiar with. If the diagnostic is used at home with an informal provider, the diagnostic must provide authoritative evidence to seek further treatment, be administrable by patients themselves, and not be invasive.

We also explored several design concepts that met these design criteria. One concept is a fever patch that women would wear immediately after labor. The patch can detect a continuous fever over a 25-hour period, which is a signal of infection at such a vulnerable time. As women experience intermittent fevers during labor, the seriousness of a continuous fever is commonly ignored. The fever patch is a non-invasive measure that shows when the wearer has a fever by filling with a red pattern that spreads over the patch. It gives an authoritative, yet unambiguous signal to women and their untrained caregivers that immediate help should be sought.

We also explored two kinds of kits, the first is a pregnancy care kit, assembled at the manufacturer, that includes diagnostics for all points of care: during the first antenatal care visit, the follow-up, and the post-natal care visit. The kit can be customized based on regional factors. For example, an HIV diagnostic would be included in Uganda, but not Bangladesh. The kit also could give providers guidance for how to administer diagnostics, and also, as patients could see which diagnostics they should be receiving, they could hold providers accountable to administer them.

The second kit is a diagnostic kit (pictured below) that would be assembled by a provider within a clinic. We found challenges in trying to keep current records, so the diagnostic kit helps keep patient information and test results together. The kit also incorporates the current method of test distribution and procurement that occurs in clinical settings, and can be customized based on what is in stock at the clinic.

What we delivered

+ Generative research

+ Concept envisioning

+ Strategic assessment

+ Evaluative research

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