CKS has always strived to develop systematic innovations that improve lives. Based on years of experience and a range of consulting projects, we’ve developed a routinizable methodology for innovation that we call the CKS Innovation Cycle. While the scope of many of our projects is limited to a part or certain arc of the Innovation Cycle, there are some that cover the entire gamut, from ethnographic research to final design and implementation. The Vaccine Delivery Innovation Initiative (VDII) is a case in point. This project started in 2009 as a research and design collaboration between CKS and Dr. John Sherry of Intel Corporation, with support from the Bill & Melinda Gates Foundation and in partnership with the Government of Bihar.
The purpose of the project was to apply the methodology of ethnographic research to better understand the barriers to routine immunization from the unique perspective of the frontline health workers and the recipient families. Further, the project aimed to identify innovative solutions that could account for user-preferences and help them overcome everyday challenges, so as to increase immunization coverage. While the project started with coverage being the central aim, we discovered in the course of our work that quality of service delivery is equally critical. CKS identified 6 key challenge areas in the service delivery process, and based on these, came up with 34 product, service and system solutions that would address them. Subsequently, the Gates Foundation team wanted to take some of these propositions further, especially focusing on the delivery of vaccines.
We then initiated a new project which focused on developing a new product, the Vaccine Delivery Kit (VDK), which would help ensure more efficient and higher-quality delivery of immunization services, turning the innovation cycle back into its research phase.
The VDK project began with an ethnographic inquiry in Patna and Saharsa districts of Bihar, so as to gain a deep understanding of the dynamics of routine immunization. The research focused on understanding areas of ergonomics and load stress, remote and uneven terrain, transit routines, inventory management and ANM (Auxiliary Nurse Mid-wife) work practices and how the tools that they worked with impacted their self perception and esteem. Methodologies such subject shadowing, in-depth interviews, work practice observation, photo-documentation and participatory designing were employed. This data was then analyzed using various statistical and illustrative techniques so as to understand the complex relationships between different data-points, identify failures and direct the design process. The next step was to develop concepts in systematic alignment with the nature of the failures. The intent was to address all 90 odd failures discovered in the research, increase the efficiency of the service and introduce best practices into the routine tasks of an ANM. CKS conducted collaborative design workshops involving sociologists, designers, engineers as well as healthcare experts for this purpose. The concepts were then prioritized and permuted to develop 3 complete solutions and prototype models.
These prototypes were then deployed in the field context for a span of two weeks and validated with multiple ANMs, with an aim to identify pain points and the most impactful design features.
The Vaccine Delivery Kit designed by the CKS team is now in the final lap of the innovation cycle, where it is being engineered and refined. We hope to pilot the kit in the next year with 50 ANMs across 8 districts of Bihar. This project has been geared to drive innovation that can be used to make routine immunization services efficient and high quality with a hope to reduce child mortality in India.