The lobby and waiting room of a hospital that looks very welcoming.

Social impact through service design: case studies from health and wellbeing

November 12, 2021

Three inspiring service design case studies that showcase people creating positive change.

Reading the daily news, it can be easy to fall into a trap where it seems that everything in the world around us is turning to chaos, is dysfunctional or heading in the wrong direction.

However, on any given day there is an outstanding amount of positive work being done all around the world that often falls short of our attention, simply because it isn't dramatic enough or considered "newsworthy”.

In a world where everything seems to be going wrong, sometimes we need some inspiration from the places where things are going right.

So on the hunt for inspiration, where should we turn? One avenue to explore is the world of service design case studies, and the different types of projects that people are creating using human-centred design approaches. Case studies are a particularly great source of inspiration for positive change. Here you can find some of the most innovative, holistic and empathetic ways organizations are improving the lives of everyday people.

In this article we showcase some of these great examples where service design tools and approaches are being used to create positive ripples that impact individuals, communities, and even whole countries. This edition will have a particular focus on the Sustainable Development Goal of Health and Wellbeing and covers three case studies from New Zealand, the Netherlands and Zambia.

So let's step out of the doom and gloom, dread and despair and explore some innovative projects that have created healthier communities around the world using service design.

In this collection you get three case studies. Jump there directly or read through the whole collection.

1. Divas sexual health clinics in Zambia – creating less intimidating ways for teenage girls to access sexual health services

2. Rotterdam eye hospital – changing the hospital environment to be more fun, safe and supportive

3. Young Māori women's smoking cessation project – supporting young women and their communities to have a healthier, smoke free future

1. Divas sexual health clinics in Zambia - creating less intimidating ways for teenage girls to access sexual health services

Country: Zambia

Sustainable Development Goal: #3 Good health and Wellbeing

Year: 2014-Present

A lack of sexual health education can lead to life-changing consequences for teenagers and young adults, whether this is the transmission of sexual diseases or unplanned pregnancies. In Sub-Saharan Africa there have been significant challenges in assisting teenagers in receiving proper support for their sexual health and overall wellbeing. This project was a collaboration between Marie Stopes Zambia (MSZ) and IDEO to uncover the reasons why Zambian teenagers weren't visiting traditional sexual health clinics and help them towards receiving better family planning services.

In sub-Saharan Africa, young women and adolescent girls accounted for one in four new infections in 2019, despite making up about 10% of the total population.
UN Aids Data 2020, page 2
5 personas, called divas with visualizations and suggestions for birth control.
The personas that were created at Diva Centres in Zambia.

Source: Guidebook: developing a Diva Centre, page 6

Overview

Through their research the team uncovered insights about why traditional sexual health initiatives were not reaching teenagers most in need. These ranged from traditional clinics being too intimidating to visit, girls being faced with confusing choices around contraception or myths and perceptions around contraception. This project sought to break down some of the barriers, misconceptions and fear associated with sexual health and provide better support for teenagers.

As a result of engaging and listening to teenagers a clinic was developed that challenged the traditional norms of what a clinic looked like, felt like and how education was delivered. The result? The Diva Centres, a nail salon where girls can speak freely and openly with their peers about sexul health in a safe environment that makes them feel comfortable. At the Diva Centres teenage girls are able to hang out with their friends, learn from trained peers and receive access to birth control methods which they may otherwise not have access to.

We don't want them to have children by chance, we want them to have children by choice.
Video: Choosing the future, 09:38

Process at a glance

  • The project team spent weeks immersed in the lives and aspirations of Zambian teens. Through this process they uncovered that teenagers were much more comfortable sharing their experiences and questions relating to sex while they were connecting in informal settings.
  • Using this insight The Divine Centres were developed as a welcoming, judgement-free location for teenagers to socialize, while simultaneously receiving sexual health advice and support.
  • The Divas were created as a fictional group of inspirational characters that represent different contraceptives. Using this as a tool girls were able to navigate options and lifestyles that best suited them.  

What was the result?

  • In 2015 the project had created three diva centres that served over 5000 young adults in Zambia.
  • For teenage girls who visited a Diva Centre, 82% received contraceptive services and 36% made a return visit. As a result teenagers have much more control over their sexual health and futures.
  • Teen connectors are able to use the resources developed in the project to engage with young females in a non-formal, less intimidating way to provide peer-to-peer education about sexual health and contraceptive methods.
  • The team have successfully created experiences for teenagers that are less discriminating than traditional approaches to family planning leaving teenagers freeling more understood and supported.  

Want to know more?

  • In this video the project is explained and clients as well as Teen connector tell about their experience with the Diva centre.
  • The team around the Diva project also created a guidebook on how to develop a Diva Centre.
  • You can get more context on the whole project on this website.

2. Rotterdam eye hospital - changing the hospital environment to be more fun, safe and supportive

Country: Netherlands

Sustainable Development Goal: #3 Good Health and Wellbeing

Year: 2016

How might we create a hospital experience that is bright, comfortable and makes patients feel safe during their stay?

The lobby and waiting room of a hospital that looks very welcoming.
The warm and welcoming lobby and waiting room of Rotterdam eye hospital.

Who has had a hospital experience that was uncomfortable, scary, or involved locations that felt out-dated, unwelcoming or overly sterile? Hospitals can be intimidating places to visit, especially at a time when we feel particularly vulnerable with our health. This project based in the Netherlands sought to understand and improve the environment in which patients receive medical care.

The project team aimed to shift the usual dreary and clinical experiences of visiting an Ophthalmology clinic. To do this they made a series of changes to the environment that gave it a more hopeful, human and optimistic feel. By continuing to make small, low cost shifts to the hospital environment they have been able to prototype ever increasing ways to make patients feel comfortable and connected when visiting the hospital.

Design process at a glance

  • A research team was put together which included the CEO, CFO, managers, staff, and doctors at the Rotterdam Eye Hospital who would take a deep dive into customer experience throughout their hospital journey.
  • The team adopted a "patient-first” approach to researching and uncovering the needs of people who visited the hospital. This meant interviewing and exploring the needs of patients while they received care.
  • The team researched diverse industries such as airlines and supermarkets to find processes that supported their customers such as easeful scheduling methods.
  • With their insights they developed a series of low-cost prototypes for different changes that could be made around the hospital to improve their customers' experience. Through these tests they could get a sense of what worked, and what didn't and could allow the best ideas to organically become permanent features of the hospital.

What was the result?

  • The hospital made some really simple and creative changes that had a powerful effect on their patients' experience. One example was a strategy to build kinship and connection with children that were due to visit the hospital. They did this by sending them a t-shirt with a beautiful image of an animal in advance of their stay. When their consultation day came the ophthalmologist who was treating them wore a button with the same animal image. This created a unique and immediate connection between practitioner and patient, increasing feelings of connection and community.
  • They also made shifts to the interior design of the hospital, such as including stepping stones for children that allowed them to communicate eye to eye with staff members and curating art for the space to make it feel more fun and interesting.
  • A complex shift that resulted from the project was to create a cultural training program called “Eye Care Air”. This program was inspired by airline safety training and sought to give employees the skills to communicate and support patients at a time when they were feeling anxious and vulnerable. As a result of this process staff became more competent in the way they dealt with patients and provided them with a better sense of safety and security.  
  • These changes in design and service delivery have also resulted in tangible improvements in patient recovery time and satisfaction. There has been an overall decrease in the number of procedures which require an overnight stay (95% of operations are now able to return home on the same day) and the hospital is scoring higher in its customer satisfaction surveys. (8.6/10)  

Want to know more?

Would you like to get a little overview of the project? Here's an outline and some visual impressions on how the hospital’s transformation process went.

3. Young Māori women’s smoking cessation project - supporting young women and their communities to have a healthier, smoke free future

Tia, the persona and her daily smoking journey.

Country: New Zealand

Sustainable Development Goal: #3 Good Health and Wellbeing

Year: 2020

In Aotearoa New Zealand, people have differences in health that are not only avoidable but unfair and unjust. Equity recognises different people with different levels of advantage require different approaches and resources to get equitable health outcomes.
– Ashley Bloomfield, NZ Director-General of Health; Achieving equity

When it comes to health people have differences that are not only avoidable, but unfair and unjust. Health equity recognizes that people from all walks of life and different levels of advantage have the resources they need to lead a healthy life.

One such challenge in New Zealand is the prevalence of smoking behaviors in Māori women which is seen as a health equity issue. Reflected in the data are much higher rates of self-reported daily smoking for Māori women (42.7%) compared to non-Māori women (8.6%) who are between 18-24 years of age.

The aim of this project was to understand the complexities of what it means to give up smoking for young Māori women, and to highlight opportunities and insights that could assist them to give up smoking habits easier. Based on user research, four prototypes were developed that had their roots in an understanding of the social, cultural and environmental context in which smokers lived. Through trialling these prototypes strong principles and success factors were identified that could assist in providing young Māori women with greater equity on their health journey to give up smoking.

The environment where young Māori women live, learn, socialise, work and belong is also the environment in which they learn to smoke, continue to smoke and try to quit smoking.
Stop smoking guidance – Ministry of Health, NZ

Design process at a glance

  • The project team conducted 37 face-to-face semi-structured interviews with young female smokers. Because some interviewees brought a friend, the number grew to 50.
  • These interviews were mined for themes and distilled into six meaningful insights. These insights were presented as revelations in first person, for example ”We learnt that smoking is a coping mechanism for stress, and many women are reluctant to stop. Many fear quitting because they have nothing to replace smoking with or are fearful of withdrawal.” – Stop smoking guidance – Ministry of Health, NZ
  • To accompany the face-to-face interviews, research was commissioned that provided a statistical analysis of relevant data for the determinants of smoking behaviour.
  • Using the insights, interviews and data the team co-designed five personas to illustrate the stories that were collected.
  • Based on the research and insights prototypes for new service solutions were developed and trialed.

What was the result?

  • Across the four health provider sites, 54 females participated in the prototypes.
  • The findings demonstrated a range of positive outcomes for the participants who engaged in the prototypes, including:
  • Fewer experiences of domestic violence and increased knowledge of strategies and support services
  • New or strengthened connections to people, information and services
  • Pride in providing smokefree environments for their children, being motivated to quit and successfully quitting
  • Lower stress and greater knowledge of strategies to manage and mitigate stress

The project was able to identify five critical factors that helped females successfully give up smoking. These included:

  • A holistic wellbeing approach,
  • Reframing quitting in the context of living well
  • Being responsive to the needs of women with priorities set by the women
  • Making non-smoking more attractive than smoking
  • Using culture as a connector and enabler  

The project helped to illuminate different principles for ways of working with women that would ensure better outcomes. These included making the process creative and fun, measuring wellbeing changes and including friends and family in the process.

“The project not only helped young Māori women to quit smoking - it has also had a much broader and positive impact on their lives and that of their children.”

Source: Scoop Independent News – New approach for Maori women to quit smoking.

Want to know more?

In this beautifully presented and comprehensive case study you can learn more about the initiative to help young Maori women stop smoking.

This news article will give you a nice overview of the project.

Summary

There is a lot of amazing work being done around the world that is clever, human centred and innovative. In the world of Health and Wellbeing there are lots of small shifts that can be made during service delivery that can make a difference to people's lives. Whether it's making the places that people receive services more inviting, providing more connection for people on a health journey or thinking up novel ways to engage marginalized groups.

These case studies can serve as a reference point for inspiration, and motivation for the potential of service design to have a positive impact on the world around us. Perhaps they have even provided some insights for your own service design projects!

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