Designing Healthier Urban Environments for a Healthier Urban World March 5, 2013 Sandra Plaza
SNEHA Project Overview
Š Design Impact 2013
Project Summary •
Our initial proposal was to look at developing a sustainable business model in which new services would offset the costs to deliver existing SNEHA service
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We soon realized the costs to deliver SNEHA services was high
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We decided to alter our focus on the improvement of the delivery of existing services
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We began by conducting interviews with all the Program Directors to understand the different strategies and processes used to delivery SNEHA services
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We created a SNEHA strategy matrix
SNEHA Project Overview
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CHN = CHILD HEALTH AND NUTRITION PVWC = PREVENTION OF VIOLENCE AGAINST WOMEN AND CHILDREN
SNEHA Strategy Matrix
MNH = MATERNAL AND NEWBORN HEALTH SRH = SEXUAL AND REPRODUCTIVE HEALTH © Design Impact 2013
SNEHA Strategy Matrix
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SNEHA Strategy Matrix
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SNEHA Strategy Matrix
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WHAT SNEHA PERCEIVES AS BEING EFFECTIVE
Cross Comparative Study of SNEHA Services
WHAT BENEFICIARIES ACTUALLY FIND EFFECTIVE
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SRH
CHN SNEHA CENTRE MODEL CO
MNH
SNEHA Centre Model
PVWC
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Breakup of Cost per Centre (INR in lacs) Cost Heads Personnel cost for Program Staff Personnel cost for Common Operations Staff Training Cost Monitoring & Evalaution cost(including data team) Running Cost for Centre Food, Medicines, Educational Materials for DCC kids Other Program Cost Set up Cost for Centre Overhead Cost for Staff Capital Cost Administrative Cost
Total Cost SNEHA Centre Project Overview
Amount 6.33 0.52 0.14 0.38 2.10 2.72 0.21 0.30 0.51 0.82 1.40
15.42 Š Design Impact 2013
Percentage Breakup of SNEHA Centre
SNEHA Centre Project Overview
Š Design Impact 2013
SNEHA Centre Project •
Total of 20 centres participating in the trial, conducted in three phases in M/East ward
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M/East ward has the poorest human development ranking and a high proportion of slum settlements as per the Human Development Index 2009
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Lowest literacy rate (66%)
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Highest infant mortality rate (66.4%)
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Target beneficiaries are women of reproductive age (15-49 yrs) and children < 5
SNEHA Centre Project Overview
© Design Impact 2013
* Sanjay Nagar Phase I
Phase II
Phase I Phase II Phase III
Catchment Area Per Centre • 600-650 Households • 400-450 Families • 2250 Population
Feb 2012 Aug 2012 Feb 2013
SNEHA Centre locations
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UNDERSTAND CHALLENGES AND BARRIERS IN DELIVERING HEALTH CARE SERVICES
HOW CAN WE IMPROVE THE DELIVERY AND QUALITY OF HOME BASED INTERVENTIONS?
WHICH STRATEGIES EMPLOYED RESULT IN POSITIVE HUMAN BEHAVIOR
Value Exercise Workshop #1 Met with the beneficiaries of Prevention of Violence Against Women and Children to understand their aspirations for the future
Community Workshop Overview
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Desire to own her own home
Education is a must
Community Workshop Overview: Womenâ&#x20AC;&#x2122;s responses
Honest doctors
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PVWC Responses – Using Wordle
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Value Exercise Workshop #2 Met with the beneficiaries of Sexual and Reproductive Healthâ&#x20AC;&#x2122;s Adolescents Gaining Ground program
Community Workshop Overview
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Community Workshop Overview
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Reduce child labour
Education helps build a career
Community Workshop: Adolescentâ&#x20AC;&#x2122;s responses
Doctors are important, villages have less doctors
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Community Workshop Overview
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SRH Responses – Using Wordle
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Conducted interviews with SNEHA staff Discussed the basic concept of Home Based Interventions to understandthe process and strategies used to deliver the service
SNEHA Centre Overview: Shastri Nagar & Sanjay Nagar
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SNEHA CENTRE STRUCTURE PD 1 PROGRAM DIRECTOR OVERSEES
PC 1 PROGRAM COORDINATOR MANAGES
1 PROGRAM OFFICER RESPONSIBLE FOR
PO
2 COMMUNITY CENTRES EACH
CO 3 COMMUNITY ORGANIZERS ASSIGNED PER CENTRE
SNEHA Centre Organization Structure
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SNEHA Centre Overview
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Centre #1 located on main street, highly visible
View of centre space
SNEHA Centre Overview: Sanjay Nagar
View of community inside lane
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Centre #2 located on main street, highly visible
View of inside lane
SNEHA Centre Overview: Shastri Nagar
Street life
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Shadowed the work of Community Organizers Conducted individual home visits to understand the strategies used in delivering home based interventions
SNEHA Centre Overview
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Children very much enjoyed the Behavior Change Communication images
Pregnant mother, 22 years old
SNEHA Centre Overview: Individual home visits
Mother, 25 years old, 4 children
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Shadowed the work of Community Organizers Community Organizer reviewing sonogram from doctorâ&#x20AC;&#x2122;s visit
SNEHA Centre Overview
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Next •
Conducted a Cognitive Walkthrough Exercise to better understand the process, attitudes, and challenges of administering SNEHA’s home-based intervention program
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Goal is to visualize the entire process and steps in one map
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Identify “clusters and gaps” as places for potential ideation
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Form new conclusions and hypotheses about how to improve the system’s design
SNEHA Centre Project Overview
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Cognitive Walkthrough Exercise Conducted internally
Home Based Intervention Process Overview
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Home Based Intervention Process Overview
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Cognitive Walkthrough Exercise Conducted with COs Process and strategies reviewed
Home Based Intervention Process Overview
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Home Based Intervention Process Overview
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Cognitive Walkthrough Exercise Exercise to be reviewed with other staff members including the PD and PC
SNEHA Centre Overview
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Next •
Review research and findings with Executive and Program Director
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Validate cognitive walkthrough exercise with the beneficiaries of SNEHA services
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Conduct workshops with beneficiaries of home based interventions
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Ideate and co-create solutions with the community
SNEHA Centre Overview
© Design Impact 2013
Thank You Contact: Sandra Plaza sandra.plaza@d-impact.org www.d-impact.org
Š Design Impact 2012