Lab.Our Ward in Nepal

New Venture Fund and Chaudhary Foundation
Year: 2018-2019
Where: Nepal
Project Status:

The Lab.our Ward innovation project in Nepal collaborated with the Chaudhary Foundation to design a new service delivery model to improve the experience of care and support rebuilding efforts in the earthquake-devastated region.

The Lab.our Ward project aims to enable a smoother and safer maternal and newborn care journey in low-resource settings. Via cross-disciplinary explorations, it focuses on finding new approaches to improve the experience of care and co-create innovations for better intrapartum care experiences.

Current outcomes of Lab.our ward project include a set of recommendations for application when improving existing or developing new maternal facilities. It contains practical innovations and solution proposals which can be implemented in facilities to improve the quality of care as well as support women’s and care providers’ birth and delivery journeys.

The Chaudhary Foundation in Nepal requested M4ID to replicate Lab.our Ward innovations for a rural health post in Sindupalchowk and to refurbish a Primary Healthcare Centre (PHC) in Nawalparasi.

Rebuilding with Lab.Our Ward

Despite the impressive progress made in improving the overall health outcomes of its citizens, the primary health care system in Nepal continues to face multiple challenges. Hygienic standards, patient-overflow, under-staffing and sub-optimal general facility management practices continue to hinder access to quality care. The devastating 2015 earthquake put the system further under duress, contributing significantly to these challenges by destroying or partly damaging more than 25 hospitals and over 1000 smaller health facilities, in addition to the great loss of life.

The Chaudhary Foundation has been working closely with the National Reconstruction Authority of Nepal to develop a model village that will exemplify the process of rebuilding earthquake-devastated communities in a safe and sustainable manner. Chaudhary Foundation requested M4ID to support them in developing designs for the Dumkauli Primary Health Care Centre (PHC) including a maternity ward as part of a redevelopment project in the earthquake-affected district of Nawalparasi.

Additionally, M4ID was tasked with providing recommendations for the service delivery model of the forthcoming health post situated in the model village under construction in Sindhupalchowk, which could be applied to other earthquake devastated communities across Nepal.

A Service Delivery Model for Nepal

With the help of a participatory, human-centered design (HCD) approach, M4ID identified barriers and enablers to primary health care delivery in the selected location and designed solutions that took the form of a service delivery model and supportive spatial layout plan aimed at improving the quality of care for patients as well as providing a more ergonomic working environment for health personnel.

Background research was conducted to better understand the health needs and care seeking preferences of the people residing in Nawalparasi and Sindhupalchowk. This included a critical examination of demographic factors, main health challenges, care seeking practices and the general health system. As part of the research, relevant stakeholders for the project were also identified in order to be able to tap into their knowledge and experience in the subsequent phases of the project.

After completion of the background research, M4ID conducted a week-long design research immersion in Sindhupalchowk and Nawalparasi to better understand the community needs and preferences regarding primary health care service delivery, care seeking behaviour and their concept of health and wellbeing together with the actual provision of primary health care in the area. This covered spatial and service assessments through observation, interviews and focus group discussions with staff, patients and households from the surrounding community in Nawalparasi, Sindhupalchowk, as well as nearby Melamchi and Bahunpati.

The gathered data was subsequently analysed and synthesised into key challenges and opportunities for intervention, which were further explored in interdisciplinary ideation sessions at M4ID. The end result of these explorations – a service delivery model for the Dumkauli Primary Health Care Centre inclusive of a new lay out plan for the facility as well as recommendations for the forthcoming Sindhupalchowk-based health post that are replicable to other earthquake affected areas in Nepal. These outputs from Lab.our Ward efforts in Nepal will be incorporated into the Foundation’s initiative to develop a model village that exemplifies safe and sustainable rebuilding efforts for disaster-struck communities in the region.