By Subecha Dahal, Nepal Project Coordinator

 

We want health workers to think of VaxTrac as beyond a technology, but a tool to help them in their work. How does understanding their work do that?

 

The user is at the center of any successful design process. A technology becomes a successful tool if it aides the user. And to ensure this adoption of technology, identifying the workflow of a health worker gives crucial understanding and insight into the user’s behaviour and how she fits into a larger health service delivery ecosystem of Nepal. And subsequently, how to design a tool that best aides the user, instead of creating a burden.

So we set out to understand what happens inside a health post in Nawalparasi district in Nepal. We discussed and designed a ‘workflow activity’ to conduct with health workers. The aim was to understand how the health worker can best adopt VaxTrac as a part of their regular work and to recognize where and how to best fit it.

The use of VaxTrac and the tablet goes beyond the vaccination session when the vaccine is getting administered to the child. VaxTrac has features that the health workers can use when they need to see aggregate data for the past week or month, send reports or even prepare for the day ahead. We wanted to ensure that health workers recognize it as a tool to make their jobs easier and faster.

Amidst one of the workflow session, we sat down in a group as a health worker explained the process to us.

Amidst one of the workflow session, we sat down in a group as a health worker explained the process to us.

The first step to understanding a workflow starts with creating a framework within which to initiate those conversations with the health worker. We had to come up with the right questions, the right probes and most importantly explain to the health worker how her input is crucial to designing a successful project.

First, we divided the workflow into three different categories: what happens during the vaccination session when children come to get vaccinated, what happens after the vaccinations session has been completed and what happens before the next session starts. The first would give insight into how raw data is collected, second into how the collected data is used and analyzed and the third into the planning process involved. And although a typical vaccination session in Nawalparasi may spread over only a few days every month, but the complete process extends long beyond the vaccination days. Additionally, in Nawalparasi, there are two different vaccination sessions in a month. There are some clinics that conduct the vaccination session from 5-10 of every Nepali month and the rest conduct their from 15-20 of each Nepali month.

A group of health workers from Ramnagar health post in Nawalparasi district who participated in the workflow activity.

A group of health workers from Ramnagar health post in Nawalparasi district who participated in the workflow activity.

We gathered a group of health workers, including the vaccinators, health post in-charge and other health workers, and explained the purpose of the activity and also got their consent. To keep it visual to a certain extent, we had brought plain chart papers with us to note down key points they share which we stuck on one of the walls. As facilitators, Arati and I conducted the session in Nepali and noted the points they shared on the chart paper. At the end of the session, we went over the points jotted to ensure accuracy and clarity.    

Writing down notes on charts on the wall.

Writing down notes on charts on the wall ahead.

One of the many things we observed is that both health posts were slightly different. We knew that although there would be a standard process, because of various factors there are slight differences in how each health post conducts their immunization sessions. During the workflow activity, we saw that while one clinic used computer printed tally sheets, the other used a separate register to tally up total vaccines given for that day or vaccination session.

While we would aim to include more health posts in the future to create a  standard workflow, the resultant workflow we created based on the information we gathered helped us understand the perspective of the health worker and where their needs are the most intense and ways to address it with VaxTrac.