Behavior design for better health care access
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This document discusses a case study of Jacaranda Health, a network of maternity hospitals in Nairobi, Kenya. Jacaranda aimed to increase the number of patients delivering at their hospitals. They found that while mothers were motivated to deliver at Jacaranda for its high quality care, their husbands who made financial decisions often lacked the $100 needed at delivery time. Jacaranda launched a mobile savings platform called MamaKiba to make saving simpler through automatic enrollment, small deposits, and reminder messages. Testing messages with expecting fathers identified the best time for reminders was end of month when most were paid. This tripled the number of fathers able to pay for delivery at Jacaranda through small regular savings.
Behavior design for better health care access
- 1. Behavior re-design for health care access CASE STUDY JUNE 8, 2015 Alexandra Cristea acristea@stanford.edu
- 2. The need: increase patient numbers for network of maternity hospitals Jacaranda Health provides high-quality, yet affordable maternity care to women in peri-urban, low-income areas of Nairobi. Delivery at a public hospital Increased maternal mortality risk Delivery at Jacaranda Excellent quality of care Delivery at other private hospitals Similar levels of care as Jacaranda FREE $100 $1000< < Alexandra Cristea Stanford GSB
- 3. Behavior design challenge: how might more patients deliver with Jacaranda Health? Client interviews: I wanted to come to deliver at JH but I couldnt! I want to come to deliver at JH! I love the quality of care! Why not?!?!? When the moment came, my husband took me to a public hospital. JH was too expensive. Before delivery After delivery Alexandra Cristea Stanford GSB
- 4. The father to be is the decision-maker for the mothers health care In our patients culture, the father-to-be is little involved in the antenatal care process His main responsibility is to pay for the delivery and all the costs thereafter Faces a myriad of competing financial priorities The father-to-be Does not experience our services Is the financial decision-maker Is strapped for cash Alexandra Cristea Stanford GSB
- 5. A behavior occurs when motivation, ability and trigger converge Find out more about BJ Foggs Behavior Model here: http://www.behaviormodel.org/ One-time desired behavior: Mother-to-be (JH antenatal care client) to deliver at Jacaranda Health Trigger: Mother-to-be goes into labor Alexandra Cristea Stanford GSB
- 6. Our clients had high motivation. Find out more about BJ Foggs Behavior Model here: http://www.behaviormodel.org/ Motivation=high: Desire to deliver with Jacaranda Health All surveys and mystery shoppers showed that client satisfaction and trust were high Quality of care.. Bedside manner Cleanliness Respect.. Alexandra Cristea Stanford GSB
- 7. but low ability Find out more about BJ Foggs Behavior Model here: http://www.behaviormodel.org/ Ability = low due to financial constraints Mothers told us that lack of cash on hand at the moment of the delivery led expecting fathers to decide to take their partners to deliver elsewhere Desired behavior failsDesired behavior Alexandra Cristea Stanford GSB
- 8. New behavior-design challenge HOW MIGHT WE support expecting fathers to obtain the $100 necessary for the delivery? Alexandra Cristea Stanford GSB
- 9. Applications of behavior design principles Make the behavior simpler Help people feel successful in the desired behavior Trigger the right sequence of baby steps Use snap-testing Put hot triggers in the path of motivated people who have the ability Find out more about BJ Foggs Behavior Model here: http://www.behaviormodel.org/ 1 2 3 4 5 Alexandra Cristea Stanford GSB
- 10. Behavior-design challenge #3 HOW MIGHT WE Make the behavior of saving simpler? ~38 cents per day = = ~1 soda per dayDue date = $100 1 Alexandra Cristea Stanford GSB
- 11. MamaKiba: Mobile-based savings platform Mobile-based savings platform + Reminder messages to save small amounts Find out more about MamaKiba - Jacaranda Healths Mobile Savings Platform - at jacarandahealth.org/innovation/ Alexandra Cristea Stanford GSB
- 12. MamaKiba: Mobile-based savings platform Find out more about MamaKiba - Jacaranda Healths Mobile Savings Platform - at jacarandahealth.org/innovation/ Behavior simple and natural: clients already used to saving with mPesa To make it even simpler: automatic enrollment at time of mothers first visit 1 Make it simpler Alexandra Cristea Stanford GSB
- 13. MamaKiba: Mobile-based savings platform Find out more about MamaKiba - Jacaranda Healths Mobile Savings Platform - at jacarandahealth.org/innovation/ Deposited $10 at the time of enrollment to create success momentum 2 Help people feel successful *Effectively a marketing discount to encourage saving Alexandra Cristea Stanford GSB
- 14. MamaKiba: Trigger design to increase savings Find out more about MamaKiba - Jacaranda Healths Mobile Savings Platform - at jacarandahealth.org/innovation/ Reminder messages to save small amounts 3 Trigger the right sequence of baby steps Alexandra Cristea Stanford GSB
- 15. MamaKiba: Trigger design to increase savings Find out more about MamaKiba - Jacaranda Healths Mobile Savings Platform - at jacarandahealth.org/innovation/ 4 Use snap-testing Snap testing: test many super low-resolution versions of the product to gain feedback Informally tested a lot of versions of the reminder messages with any young male could encounter who was an expecting father, a recent father, or knew a young father including Cab drivers Security guards Or anyone who would speak to us Alexandra Cristea Stanford GSB
- 16. MamaKiba: Identified optimal time for trigger Find out more about MamaKiba - Jacaranda Healths Mobile Savings Platform - at jacarandahealth.org/innovation/ 5 Put hot triggers in the path of motivated people who have the ability Our snap tests revealed the insight that the best time for the reminder messages was ~at the end of the month ~ when people were usually getting paid and had a higher ability to save Alexandra Cristea Stanford GSB
- 17. Success applying behavior design principles Find out more about MamaKiba - Jacaranda Healths Mobile Savings Platform - at jacarandahealth.org/innovation/ Tripled the number of fathers who were saving small amounts with the mobile platform and who were able to deliver with Jacaranda Health Great application of behavior design Many more next steps to increase the ability of our clients to deliver with Alexandra Cristea Stanford GSB