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Global health · design research · 2013–14
Records
for Life
How a global design contest became a field-tested framework for rethinking the child immunization record — as an identifier, a reminder, a counselling tool and a bridge into the health system.
Field research
Service design
Co-design
Systems thinking
Child health record
One record. Many moments of care.
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Country leadershipIndonesia research lead
My role
1 of 3Country research legs led
Led the Indonesia leg of the research.
Owned the Bandung field-research stream within the three-country programme, bringing the Indonesian context into the project’s wider evidence base and cross-country synthesis.
01 / Scope
A worldwide challenge, tested in three local realities.
The Bill & Melinda Gates Foundation, with WHO, UNICEF and CKS, set out to improve the accuracy, value and legibility of child health records for frontline health workers and families.
Countries represented
Concepts selected for field testing
Research locations: Bihar, Bandung & Kisumu
“
The object was small. The service problem around it was not.
02 / The challenge
01
Presence without dependable use
Cards were often missing, damaged or incomplete at the moment of care.
02
Information without comprehension
Dense schedules, abbreviations and growth charts were difficult for many parents to interpret.
03
Records without shared responsibility
In some contexts, families relied on health workers and verbal reminders rather than the record itself.
04
Innovation without context
Technologies such as QR codes and biometrics held promise, but infrastructure and workflow realities determined feasibility.
03 / Approach
From open call to grounded recommendations.
The project combined expert review, structured down-selection and cross-cultural qualitative research — then translated field evidence into design and system-level recommendations.
01
4 weeks
Frame the landscape
Literature review, six expert interviews and a detailed location-selection process established the research context.
6 expert interviews
02
1.5 weeks
Build the evaluation framework
A five-part assessment balanced design quality, clinical utility, comprehension, adaptability and qualitative feedback.
Design + health lenses
03
2 weeks
Down-select with intent
Entries moved through layered review for innovation, reviewer scores, diversity of propositions and technological feasibility.
314 → 144 → 30
04
Research design
Turn concepts into stimuli
The team decomposed full records into cue cards for identity, schedules, growth, counselling, new data fields, colour, material and form.
12 scenarios · 11 personas
05
1.5 weeks
Test with people in context
Six focus groups in each location brought frontline health workers and beneficiaries into structured comparison, discussion and voting.
18 groups · 6–8 each
06
2 weeks
Synthesize across cultures
Field observations were linked into shared themes while preserving differences in literacy, infrastructure, trust and local practice.
3-country synthesis
07
5 weeks
Move from evidence to strategy
An expert jury reviewed findings, debated feasibility and helped shape strategic design recommendations and systems implications.
UNICEF · WHO · BMGF · GAVI
04 / Findings
Five shifts in how the record should work.
Across locations, the strongest ideas were not decorative. They reduced ambiguity, helped people act and fitted the realities of care delivery.
01 — IDENTIFY
Design for failure, not just the ideal journey.
Identity information must remain useful when a card is forgotten, damaged or presented by another caregiver. Passive or backup identifiers can reduce judgement-based decisions.
02 — ORIENT
Make time visible.
Clear sequencing, prominent next-visit dates and age-aligned colour coding helped families and workers understand where a child was in the vaccination cycle.
03 — EXPLAIN
Translate data into meaning.
Concrete visuals, plain language and tabular values outperformed abstract imagery and complex charts where literacy or graph literacy was limited.
04 — CONNECT
Give the record a path back to care.
Emergency numbers, clinic contacts, allergy information and warning signs made the card useful between appointments — not only during vaccination.
05 — VALUE
Create an object worth keeping.
Durable, compact formats and personally meaningful details could build emotional value, encourage retention and help shift the record from passive paperwork to an active health companion.
05 / Systems view
The breakthrough was reframing the card as a service interface.
The final report moved beyond a single artefact. It positioned the record as the closest tangible link between families, frontline care and the wider public-health system.
One record can connect three layers of the health system.
Families
Understand progress, remember the next step and act on health information.
Frontline workers
Identify, record and counsel with fewer ambiguities and stronger safety checks.
Health system
Receive more dependable data and feedback for policy and service decisions.
This expanded frame introduced opportunities for reminder and recall, behavioural reinforcement, service feedback, safer data flows and future digital integration.
06 / Outcomes
Research translated into a practical design agenda.
The work produced both near-term recommendations for better records and a longer-term architecture for strengthening public-health information systems.
Clearer information design
Prioritize legibility, plain language, visible next steps and concise critical content.
Context-adaptable records
Allow localized fields, culturally legible visuals and format decisions grounded in use.
Built-in safety checks
Use redundancy, backup identifiers and accessible data placement to reduce process errors.
A reusable global resource
Create common minimum data guidance and a library of designs and practices for local adaptation.
Continuous feedback loops
Make the record a channel for improving frontline processes and responding to user needs.
Future-ready data flows
Design today’s physical artefact to support progressive technology and better system decisions.
07 / Capability signal
What this work demonstrates.
A portfolio is strongest when methods connect to decisions. This project shows the ability to work from ambiguity, study real service conditions and carry evidence into strategy.
Adithya led the Indonesia leg of the research; project-scale activities and outcomes are presented as team achievements.
Cross-cultural field research
Working across language, literacy, infrastructure and care-delivery differences.
Research operations
Turning a large concept pool into testable stimuli, protocols, personas and scenarios.
Facilitation & evaluative research
Structuring comparative discussion and testing with health workers and beneficiaries.
Information & service design
Connecting the usability of a physical record to the behaviour and reliability of a service.
Synthesis & systems thinking
Finding cross-location patterns without flattening contextual differences.
Strategic communication
Translating research evidence into design principles, system opportunities and a future direction.
Designing the record meant redesigning the relationship around it.
Case-study summary based on the final “Records for Life” report. All numerical claims, methods and findings are drawn from that source; project outcomes are credited to the team.