Using and improving the PHISICC paper-based tools in the health facility laboratories: Examples of Human Centered Design taking systems thinking into practice, in Côte d'Ivoire and Nigeria
Health workers in low- and middle-income countries are increasingly demanded to collect more and more data to report them to higher levels of the health information system (HIS), in detriment of useful data for clinical and public health decision-making, potentially compromising the quality of their...
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| Vydané v: | Frontiers in public health Ročník 10; s. 916397 |
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Switzerland
Frontiers Media S.A
15.09.2022
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| Abstract | Health workers in low- and middle-income countries are increasingly demanded to collect more and more data to report them to higher levels of the health information system (HIS), in detriment of useful data for clinical and public health decision-making, potentially compromising the quality of their health care provison. In order to support health workers' decision-making, we engaged with partners in Côte d'Ivoire, Mozambique and Nigeria in a research project to conceive, design, produce, implement and test paper-based health information tools: the PHISICC tools. Our aim was to understand the use of PHISICC tools by health workers and to improve them based on their feedback.
The design Health Facility Laboratories (HF Labs) in Côte d'Ivoire and in Nigeria were set up after months of use of PHISICC tools. Activities were structured in three phases or 'sprints' of co-creative research. We used a transdisciplinary approach, including anthropology and Human Centered Design (HCD), observations, shadowing, structured interviews and co-creation.
Health workers appreciated the standardization of the tools across different health care areas, with a common visual language that optimized use. Several design issues were raised, in terms of formats and contents. They strongly appreciated how the PHISICC registers guided their clinical decision-making and how it facilitated tallying and counting for monthly reporting. However, adherence to new procedures was not universal. The co-creation sessions resulted in modifications to the PHISICC tools of out-patient care and postnatal care.
Although health systems and systemic thinking allowed the teams to embrace complexity, it was the HCD approach that actually produced a shift in researchers' mind-set: from HIS as data management tools to HIS as quality of care instruments. HCD allowed navigating the complexity of health systems interventions due to its capacity to operate change: it not only allowed us to understand how the PHISICC tools were used but also how to further improve them. In the absence of (or even with) an analytical health systems framework, HCD approaches can work in real-life situations for the ideation, testing and implementation of interventions to improve health systems and health status outcomes. |
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| AbstractList | BackgroundHealth workers in low- and middle-income countries are increasingly demanded to collect more and more data to report them to higher levels of the health information system (HIS), in detriment of useful data for clinical and public health decision-making, potentially compromising the quality of their health care provison. In order to support health workers' decision-making, we engaged with partners in Côte d'Ivoire, Mozambique and Nigeria in a research project to conceive, design, produce, implement and test paper-based health information tools: the PHISICC tools. Our aim was to understand the use of PHISICC tools by health workers and to improve them based on their feedback.MethodsThe design Health Facility Laboratories (HF Labs) in Côte d'Ivoire and in Nigeria were set up after months of use of PHISICC tools. Activities were structured in three phases or ‘sprints' of co-creative research. We used a transdisciplinary approach, including anthropology and Human Centered Design (HCD), observations, shadowing, structured interviews and co-creation.ResultsHealth workers appreciated the standardization of the tools across different health care areas, with a common visual language that optimized use. Several design issues were raised, in terms of formats and contents. They strongly appreciated how the PHISICC registers guided their clinical decision-making and how it facilitated tallying and counting for monthly reporting. However, adherence to new procedures was not universal. The co-creation sessions resulted in modifications to the PHISICC tools of out-patient care and postnatal care.DiscussionAlthough health systems and systemic thinking allowed the teams to embrace complexity, it was the HCD approach that actually produced a shift in researchers' mind-set: from HIS as data management tools to HIS as quality of care instruments. HCD allowed navigating the complexity of health systems interventions due to its capacity to operate change: it not only allowed us to understand how the PHISICC tools were used but also how to further improve them. In the absence of (or even with) an analytical health systems framework, HCD approaches can work in real-life situations for the ideation, testing and implementation of interventions to improve health systems and health status outcomes. Health workers in low- and middle-income countries are increasingly demanded to collect more and more data to report them to higher levels of the health information system (HIS), in detriment of useful data for clinical and public health decision-making, potentially compromising the quality of their health care provison. In order to support health workers' decision-making, we engaged with partners in Côte d'Ivoire, Mozambique and Nigeria in a research project to conceive, design, produce, implement and test paper-based health information tools: the PHISICC tools. Our aim was to understand the use of PHISICC tools by health workers and to improve them based on their feedback. The design Health Facility Laboratories (HF Labs) in Côte d'Ivoire and in Nigeria were set up after months of use of PHISICC tools. Activities were structured in three phases or 'sprints' of co-creative research. We used a transdisciplinary approach, including anthropology and Human Centered Design (HCD), observations, shadowing, structured interviews and co-creation. Health workers appreciated the standardization of the tools across different health care areas, with a common visual language that optimized use. Several design issues were raised, in terms of formats and contents. They strongly appreciated how the PHISICC registers guided their clinical decision-making and how it facilitated tallying and counting for monthly reporting. However, adherence to new procedures was not universal. The co-creation sessions resulted in modifications to the PHISICC tools of out-patient care and postnatal care. Although health systems and systemic thinking allowed the teams to embrace complexity, it was the HCD approach that actually produced a shift in researchers' mind-set: from HIS as data management tools to HIS as quality of care instruments. HCD allowed navigating the complexity of health systems interventions due to its capacity to operate change: it not only allowed us to understand how the PHISICC tools were used but also how to further improve them. In the absence of (or even with) an analytical health systems framework, HCD approaches can work in real-life situations for the ideation, testing and implementation of interventions to improve health systems and health status outcomes. Health workers in low- and middle-income countries are increasingly demanded to collect more and more data to report them to higher levels of the health information system (HIS), in detriment of useful data for clinical and public health decision-making, potentially compromising the quality of their health care provison. In order to support health workers' decision-making, we engaged with partners in Côte d'Ivoire, Mozambique and Nigeria in a research project to conceive, design, produce, implement and test paper-based health information tools: the PHISICC tools. Our aim was to understand the use of PHISICC tools by health workers and to improve them based on their feedback.BackgroundHealth workers in low- and middle-income countries are increasingly demanded to collect more and more data to report them to higher levels of the health information system (HIS), in detriment of useful data for clinical and public health decision-making, potentially compromising the quality of their health care provison. In order to support health workers' decision-making, we engaged with partners in Côte d'Ivoire, Mozambique and Nigeria in a research project to conceive, design, produce, implement and test paper-based health information tools: the PHISICC tools. Our aim was to understand the use of PHISICC tools by health workers and to improve them based on their feedback.The design Health Facility Laboratories (HF Labs) in Côte d'Ivoire and in Nigeria were set up after months of use of PHISICC tools. Activities were structured in three phases or 'sprints' of co-creative research. We used a transdisciplinary approach, including anthropology and Human Centered Design (HCD), observations, shadowing, structured interviews and co-creation.MethodsThe design Health Facility Laboratories (HF Labs) in Côte d'Ivoire and in Nigeria were set up after months of use of PHISICC tools. Activities were structured in three phases or 'sprints' of co-creative research. We used a transdisciplinary approach, including anthropology and Human Centered Design (HCD), observations, shadowing, structured interviews and co-creation.Health workers appreciated the standardization of the tools across different health care areas, with a common visual language that optimized use. Several design issues were raised, in terms of formats and contents. They strongly appreciated how the PHISICC registers guided their clinical decision-making and how it facilitated tallying and counting for monthly reporting. However, adherence to new procedures was not universal. The co-creation sessions resulted in modifications to the PHISICC tools of out-patient care and postnatal care.ResultsHealth workers appreciated the standardization of the tools across different health care areas, with a common visual language that optimized use. Several design issues were raised, in terms of formats and contents. They strongly appreciated how the PHISICC registers guided their clinical decision-making and how it facilitated tallying and counting for monthly reporting. However, adherence to new procedures was not universal. The co-creation sessions resulted in modifications to the PHISICC tools of out-patient care and postnatal care.Although health systems and systemic thinking allowed the teams to embrace complexity, it was the HCD approach that actually produced a shift in researchers' mind-set: from HIS as data management tools to HIS as quality of care instruments. HCD allowed navigating the complexity of health systems interventions due to its capacity to operate change: it not only allowed us to understand how the PHISICC tools were used but also how to further improve them. In the absence of (or even with) an analytical health systems framework, HCD approaches can work in real-life situations for the ideation, testing and implementation of interventions to improve health systems and health status outcomes.DiscussionAlthough health systems and systemic thinking allowed the teams to embrace complexity, it was the HCD approach that actually produced a shift in researchers' mind-set: from HIS as data management tools to HIS as quality of care instruments. HCD allowed navigating the complexity of health systems interventions due to its capacity to operate change: it not only allowed us to understand how the PHISICC tools were used but also how to further improve them. In the absence of (or even with) an analytical health systems framework, HCD approaches can work in real-life situations for the ideation, testing and implementation of interventions to improve health systems and health status outcomes. |
| Author | Rodriguez Franco, Damaris Ekpenyong, Nnette Berté, Salimata Oyo-Ita, Angela O'Donnell, David Eteng, Glory Heitz Tokpa, Kathrin Guessan Bi, Gouzan Bernard Nwankwo, Ogonna Undelikwo, Veronica Bosch-Capblanch, Xavier Auer, Christian Amani Kouassi, Simplice |
| AuthorAffiliation | 3 University of Basel , Basel , Switzerland 8 Ministry of Health and Public Hygiene, Directorate General of Health , Abidjan , Côte d'Ivoire 5 Post Normal , Chicago, IL , United States 6 Sonder Collective , Madrid , Spain 1 Department of Community Medicine, University of Calabar Teaching Hospital , Calabar , Nigeria 9 Department of Social Work, University of Calabar , Calabar , Nigeria 4 Swiss Centre for International Health, Swiss Tropical and Public Health Institute , Allschwil , Switzerland 2 Centre Suisse de Recherches Scientifiques en Côte d'Ivoire , Abidjan , Côte d'Ivoire 7 Ecological Research Center, University of Nangui Abrogoua , Abidjan , Côte d'Ivoire 10 Department of Sociology, University of Calabar , Calabar , Nigeria |
| AuthorAffiliation_xml | – name: 2 Centre Suisse de Recherches Scientifiques en Côte d'Ivoire , Abidjan , Côte d'Ivoire – name: 7 Ecological Research Center, University of Nangui Abrogoua , Abidjan , Côte d'Ivoire – name: 9 Department of Social Work, University of Calabar , Calabar , Nigeria – name: 4 Swiss Centre for International Health, Swiss Tropical and Public Health Institute , Allschwil , Switzerland – name: 1 Department of Community Medicine, University of Calabar Teaching Hospital , Calabar , Nigeria – name: 8 Ministry of Health and Public Hygiene, Directorate General of Health , Abidjan , Côte d'Ivoire – name: 5 Post Normal , Chicago, IL , United States – name: 6 Sonder Collective , Madrid , Spain – name: 3 University of Basel , Basel , Switzerland – name: 10 Department of Sociology, University of Calabar , Calabar , Nigeria |
| Author_xml | – sequence: 1 givenname: Nnette surname: Ekpenyong fullname: Ekpenyong, Nnette – sequence: 2 givenname: Kathrin surname: Heitz Tokpa fullname: Heitz Tokpa, Kathrin – sequence: 3 givenname: Ogonna surname: Nwankwo fullname: Nwankwo, Ogonna – sequence: 4 givenname: David surname: O'Donnell fullname: O'Donnell, David – sequence: 5 givenname: Damaris surname: Rodriguez Franco fullname: Rodriguez Franco, Damaris – sequence: 6 givenname: Salimata surname: Berté fullname: Berté, Salimata – sequence: 7 givenname: Simplice surname: Amani Kouassi fullname: Amani Kouassi, Simplice – sequence: 8 givenname: Glory surname: Eteng fullname: Eteng, Glory – sequence: 9 givenname: Veronica surname: Undelikwo fullname: Undelikwo, Veronica – sequence: 10 givenname: Christian surname: Auer fullname: Auer, Christian – sequence: 11 givenname: Gouzan Bernard surname: Guessan Bi fullname: Guessan Bi, Gouzan Bernard – sequence: 12 givenname: Angela surname: Oyo-Ita fullname: Oyo-Ita, Angela – sequence: 13 givenname: Xavier surname: Bosch-Capblanch fullname: Bosch-Capblanch, Xavier |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/36187697$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.2147/IJGM.S223882 10.1146/annurev.an.24.100195.000523 10.1186/s12961-021-00768-0 10.1186/1478-4505-13-10 10.1002/14651858.CD011086.pub2 10.1186/1478-4505-11-14 10.17157/mat.5.2.537 10.1186/s12874-017-0349-x 10.1007/s00779-005-0024-9 10.1371/journal.pone.0186744 10.4081/jphr.2020.1759 10.1080/02681102.2019.1667289 10.1002/(SICI)1099-1727(199722)13:2<149::AID-SDR122>3.0.CO;2-S 10.1186/s12913-021-06652-5 10.1016/S0140-6736(08)61634-7 10.1002/14651858.CD011942.pub2 10.1136/bmjgh-2021-005780 10.1136/bmjopen-2021-051823 10.1186/1478-4505-12-19 10.1002/14651858.CD011084.pub2 10.1002/14651858.CD011083.pub2 10.1186/1478-4505-12-51 10.1002/14651858.CD011085.pub2 10.1186/s12874-017-0468-4 10.1186/s12913-018-3397-y 10.1093/heapol/czab062 10.1145/2470654.2470715 |
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| Copyright | Copyright © 2022 Ekpenyong, Heitz Tokpa, Nwankwo, O'Donnell, Rodriguez Franco, Berté, Amani Kouassi, Eteng, Undelikwo, Auer, Guessan Bi, Oyo-Ita and Bosch-Capblanch. Copyright © 2022 Ekpenyong, Heitz Tokpa, Nwankwo, O'Donnell, Rodriguez Franco, Berté, Amani Kouassi, Eteng, Undelikwo, Auer, Guessan Bi, Oyo-Ita and Bosch-Capblanch. 2022 Ekpenyong, Heitz Tokpa, Nwankwo, O'Donnell, Rodriguez Franco, Berté, Amani Kouassi, Eteng, Undelikwo, Auer, Guessan Bi, Oyo-Ita and Bosch-Capblanch |
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| Keywords | decision-making Côte d'Ivoire health workers Nigeria Human Centered Design equity quality of care health information system (HIS) |
| Language | English |
| License | Copyright © 2022 Ekpenyong, Heitz Tokpa, Nwankwo, O'Donnell, Rodriguez Franco, Berté, Amani Kouassi, Eteng, Undelikwo, Auer, Guessan Bi, Oyo-Ita and Bosch-Capblanch. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Reviewed by: Michael Thiede, IU International University of Applied Sciences, Germany; Orvalho Augusto, University of Washington, United States These authors share first authorship Edited by: Kara Durski, World Health Organization, Switzerland This article was submitted to Public Health Policy, a section of the journal Frontiers in Public Health |
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| SubjectTerms | Cote d'Ivoire Côte d'Ivoire equity Health Facilities health information system (HIS) Human Centered Design Humans Laboratories Nigeria Public Health quality of care Systems Analysis Universal Design |
| Title | Using and improving the PHISICC paper-based tools in the health facility laboratories: Examples of Human Centered Design taking systems thinking into practice, in Côte d'Ivoire and Nigeria |
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