Designing a Self Aware Public Health Delivery System for Bihar

A couple of days back I wrote on the design of public decision making. This piece is an extension to that: a more focused reflection on the health service delivery system of Bihar and some design deliberations on how evidence based decision making and creative problem solving can become a way of working.

The question we ask: ‘how self aware and informed is this delivery system and how empowered are its players to diagnose and solve for needs of their immediate environment? There is a three-fold argument to be made here: Firstly, a lot of new learnings, practices and systems innovation is happening all over the world in the realm of maternal and child health, is the system using this knowledge to its advantage? Secondly even within the system, there is the risk of attempting to read and basing delivery strategies on outcome based, symptomatic data which is unsuitable to make decisions on how to improve things, rather than having a rich understanding of causality and systematically responding to that. Thirdly, a lot of problem solving, strategizing, and decision making within the public health system is impacted by the skewed relationship between power and accountability i.e. while the power to take decisions is high up and centralized, the accountability and operationalization is decentralized to the lowest levels of the hierarchy. This approach poses a major challenge, that of ‘less than effective responsiveness to local contexts and phenomena’.

At Health Public on 22nd August, we explore the question of ‘how to create an service delivery system that is self diagnosing, self correcting and self governing – basically self aware?’

A wide array of design implications and concepts will be discussed:

. Seasonal System Strengthening Strategies to address Demand in Floods, Mobilize in Harvest Seasons, Reconfigure Resources in High Volume Birthing seasons, Align Specific Health Services around Migration and other Socio-Temporal Phenomena

biharinnovationlab-sociotemporalcycle

. Village Qualitative Profiling Dashboards for block level planning (that map Cultural or Attitudinal Resistance, Local health Vulnerabilities, Coverage, Health Outcomes, Emerging Phenomena etc.) Collecting the right, qualitative and diagnostic data sets at a village, block and district level as base-plate and permutations of data ‘sense-making’ models to better plan for program delivery and institutions. 

bihar innovation lab - village profiling tool

. A Best ‘maternal and child’ health practices dashboard that collates local and global learnings and can be surfed through a hashtag logic for quick solutions and rapid piloting.

best practices dashboard - biharinnovationlab

. Converting FLW meetings into ‘reflective’ workshops where players deliberate ‘what we did’ and free associate ‘what we could have done better for different results’ and note them in learnings and micro-innovation dashboards.

Join us at Health Public on 22nd August at the Vihara Innovation Campus to build these solutions further and chart a path to reality for the most compelling ideas.

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