Family Health Map: Immunisation Chart

The Family Health Map is meant to work as a bridge between two existing child health record systems in Ghana: connecting the print vaccination record - Child Health Record (the Green Booklet) and MOTECH mobile phone system records to the information recorded in the booklet. (MOTECH is an open source, mobile-phone-based health information system). To inform the process, primary researchers from Moment interviewed parents and healthcare workers experienced in caring for families in countries including the United States, Ghana, Zambia, Mali, Senegal, Guatemala, and Bangladesh. Secondary researchers gathered information on existing health record systems, mobile-phone-based healthcare systems, and durable materials for printing. The findings of the research revealed the following list of constraints and requirements:

• Reduce the amount of time health workers spend on paperwork
• Select a format that is easy to manufacture
• Keep technology requirements to a minimum
• Help to enhance the caregiver's memory
• Provide a highly visual solution
• Facilitate easy entry of new information, especially additional vaccines
• Create a solution that is easy to read, interpret, and use
• Provide value for healthcare workers and caregivers
• Include a physical artifact that keeps track of vaccines
• Recommend a material that is resistant to water and oil

Because the healthcare workers that Moment researchers interviewed repeatedly emphasised the lack of resources available to clinic workers, they sought to improve accuracy while simultaneously decreasing the paperwork burden on healthcare providers. Thus, the timeline layout of the immunisation chart ensures that a healthcare provider only needs to complete one column during a single visit. Color-coding and iconography individuate vaccine doses, and small details like slashes in date fields encourage legibility without increasing workload. Integration with MOTECH streamlines availability of records across locations. Also, the redesign of the Green Booklet is intended to lighten the cognitive load of interpreting the table indicating the schedule of required vaccines by leveraging people's ability to parse information visually. Designers recommend that the vaccination record be placed at the front of the booklet, in foldout form, so that health workers, parents, and surveyors can access it more quickly.

With the goal of improving legibility of the immunisation chart for families, as well as usability for healthcare workers, designers placed a space at the bottom of each date column for the health worker to note the next upcoming appointment. This space is differentiated from the rest of the page with bolder, black lines and curved corners in an attempt to decrease the potential for confusion between appointments and vaccine dosage dates by isolating the area parents need to check. Along the top of the chart, icons mark milestones along the journey of expected child development. In addition to helping parents understand the timing of appointments and vaccinations, these checkpoints are meant to provide educational content and invite parents to take an active interest in their child's vaccination progress. They also provide a supplementary means of tracking appointments for parents with low literacy skills. During the first year of a child's life, MOTECH provides the family with appointment alerts, reminders to seek care, and ways to address the challenges of infant care; Moment recommends that it continue to provide this information through the child's second year within a coordinated system with the redesigned immunisation chart.

Noting that researchers and surveyors rely on accurate immunisation records, the redesigned features of the chart include colours and chronological organisation that are meant to clearly connect vaccines with their administration dates and their batch numbers. Symbols reinforce the visual system in an effort to ensure that the document is legible, even if copied in black and white.

The immunisation chart also includes a space to record the unique ID number that MOTECH assigns to each baby that is born to a mother enrolled in the system. By recording this number in the Green Booklet, the goal is to establish a direct connection between the information printed there and the information retrieved by mobile phone. Inclusion of the MOTECH ID number in this redesigned immunisation chart has the purpose of allowing parents, healthcare workers, and surveyors to retrieve sustainable, detailed vaccination and health records.

Immunisation and Vaccines

For this project, Moment was recognised as a finalist in the Bill and Melinda Gates Foundation's global design competition to improve child health records, Records for Life. Criteria for eligibility included key demographic and immunisation information, and submissions were judged on clarity, adaptability of the record, durability, and value to caregivers and health workers.