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Training caregivers in public hospitals after birth to change intentions, attitudes and community standards around vaccination.

Train new mothers and families about Immunization practices in public hospital wards after delivery through an engaging training program.

Photo of Shahed Alam

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Describe what you intend to do and how you'll do it in one sentence (required 250 Characters)

Noora Health trains new mothers, fathers family members on how and why to vaccinate their children during a health course taught by certified nurse educators in the wards of public Indian Hospitals.

Explain the idea (less than 2,000 characters)

Noora Health reimagines the way marginalized patient families are engaged in their health. We take compassionate family members and train them with high impact health skills in order to improve outcomes and save lives. We do this by turning hospital wards in India into classrooms and transform the hospital stay into a capacity building experience where families are prepared for the best outcomes in the hospital and at home. All of our interactive training materials, videos and curriculum are designed in partnership with our low literacy trainees, so that our highly visual hands-on training approach is engaging during the hospital stay. We utilize a train the trainer approach to deliver in-hospital hands on trainings run by pre-existing nursing staff at public hospitals that reach the most underserved communities. After leaving the hospitals families get follow-up messaging and personalized support from medical professionals through our WhatsApp+SMS platform in order to support their recovering and prevent complications. We help families take on their own health conditions, in the community, with the best chance of success. As part of our comprehensive training for the families of newborns we plan to incorporate training around the importance, breaking stigmas around, and necessary behaviors for vaccinating children at the point of delivery. Though vaccination rates have greatly increased over the last decade in India due largely to frontline health-workers, especially ASHAs, there is still a large gap that we believe can be bridged by creating demand for timely vaccination. By reaching large numbers of families at trusted hospital institutions through skilled health professionals we are able to shift community norms and practices with authority and motivate families to actively seek vaccination, rather than passively relying on inconsistent frontline health-worker networks.

Which part(s) of the world does this idea target?

  • Southern Asia

Geographic Focus (less than 250 Characters)

While our initial work will be across India and Bangladesh, the concept can be scaled across the world. Our work in India spans multiple states across the vast country, including Madhya Pradesh, Karnataka, Punjab, Maharashtra.

Who are your end users and how well do you know them? (750 characters)

Our end users are families seeking healthcare in public hospitals in India. Since the Indian government is pushing for facility based deliveries and basic delivery care is provided free of cost, facility delivery rates have risen and now represent the vast majority of births occurring (94% in Karnataka, 90% in Punjab, 80% in Madhya Pradesh). Since we are partnered with public facilities we are reaching many of the low income families in India. Our organization is based around the principles of human centered design and was born out of the Stanford d.School, so everything we create is in collaboration with our users and serves a deep need they are facing.

How is the idea unique? (750 Characters)

Noora Health reimagines the way patients and families are engaged within the healthcare environment. We take passive family members and turn them into a part of the healthcare team that can save lives. To date we have trained over 300,000 families and evidence suggests our training is effective, for example, reducing post-discharge complications by 70%. By turning waiting areas of hospitals into classrooms and transforming hospitals into institutions of learning, we are building the capacity of communities to provide some of their own care and reinforcing a community centered approach towards improving health outcomes.

Idea Proposal Stage (Select 1)

  • Majority Adoption: We have expanded the pilot significantly and the program product or service has been adopted by the majority of our intended user base (i.e. 50% to 83% of the target population or 50,000 to 1,000,000 users).

How many months are required for the project idea? (140 characters)

We expect to incorporate training around vaccination into our programs within 6 months, and begin training > 200,000 families per year.

Organization Name (less than 140 characters)

Noora Health

Type of Submitter

  • We are a registered NGO or Non-Profit Organization

Organizational Characteristics

  • Female-led organization
  • International/global organization (implementing in multiple countries)

Organization Location (less than 140 Characters)

Our implementation partners are based out of Bangalore, India.

What is the current scale of your organization’s work?

  • National (expansive reach within one country)

Website URL

www.noorahealth.org

Tell us more about your organization/company (1-2 sentences)

Noora Health was born out of a Stanford d.School class project and has grown into an HCD centered organization spreading caregiver training as an intervention. We are on target to reach millions of families in India through partnering with state health ministries and have partnerships to test the model abroad, with an eye towards research that will further the understanding around how caregiver training can change healthcare globally.

Who will work alongside your organization in the project idea? (750 characters)

Noora's training programs have received enthusiastic support from the state governments of Karnataka, Punjab, Maharashtra and Madhya Pradesh. Working through the Ministry of Health & Family Welfare in each state we are able to work with the public healthcare system through their infrastructure and staff. We are partnered with Ariadne Labs, a health innovation center from Brigham and Women’s Hospital and Harvard T.H. Chan School of Public Health. With Ariadne, rigorous and best-in-class methods from implementation science and evaluation will be used to assess which components of the program are working and which need to be improved.

How many people are on your team?

84

Tell us more about you and your team

We have a diverse team of designers, public health practitioners, and researchers. All of our core team members are based in India, close to the users we serve. Each individual brings a unique skillset, but we are all united in our hope to make better patient-family caregiver engagement the standard of care throughout the world. Our Leadership Team consists of: Edith Elliott, CEO - BA Tufts, MA Stanford https://www.linkedin.com/in/edith-elliott-633b7a37/ Shahed Alam, President - BS, MHS Johns Hopkins, MD Stanford https://www.linkedin.com/in/shahedalam/ Katy Ashe, Chief of Design - BA, MA Stanford https://www.linkedin.com/in/katyashe/ Anjali Gupta, Chief Growth Officer - MBA, Wharton https://www.linkedin.com/in/anjalig/ Varun Rangarajan, Director of Implementation - BS University of Madras https://www.linkedin.com/in/varun-rangarajan-b5a6507/ Deepali Thakur, Director of Operations and Finance - BS, MPhil BITS Pilani https://www.linkedin.com/in/dr-deepali-thakur-

Overview of How Your Concept Has Evolved (5-6 sentences):

User research informed us of different things to consider while offering education about immunization. For example, after delivery mothers move to their mothers' house which results into either poor immunization follow-up or complete dropout which is associated with harms of missing a particular vaccine. The business model canvas helped us internally discuss logistics of incorporating detailed immunization module at a big scale in our program and identified the need to improve the current support of our WhatsApp+SMS engagement. Unfortunately, we couldn’t participate in other activities, however, we went through the resources offline which helped us at various stage of the refinement phase.

Viability (3-4 sentences and activity upload):

http://bit.ly/nooracanvas Business model canvas helped us to list down the support required from different stakeholders to implement detailed immunization module into our existing curriculum for 105 districts in 3 states. Similarly, it helped us identify technology infrastructure required for post-discharge immunization reminders over WhatsApp +SMS. Overall, the viability of our proposed program is strengthened after consideration of important logistical components.

Feasibility (3-4 sentences):

Care Companion Program(CCP)trains nurses to teach mothers caregivers on the public health importance of and how to access vaccination services. CCP’s presence in the prenatal & postnatal phases enables caregivers to voice out their concerns and helps the educator break misconceptions. We send immunization reminders over WhatsApp+SMS until the baby is fully vaccinated. Prototyping helped us design content which covers immunization in detail and address common beliefs and practices. We didn’t receive prototype support but did prototype content and session materials in 5 hospitals in 5 locations.

Desirability (3-4 sentences and activity upload):

http://bit.ly/UXMAP Our interviews with families made us realized that they have poor knowledge of the importance of immunization along with the available services in their community. After vaccination, if a child gets the side effects such as fever, pain, diarrhea, then families prefer to skip the next dose as they fail to understand the long term serious health consequences of it. Families are interested in understanding vaccines, their benefits and how they work though. Interviews with families validated our assumption which is, to change the attitude and beliefs of families around immunization we need various interventions starting from the antenatal period and continue until the baby is fully vaccinated.

Community Focus (2-3 sentences):

Though vaccination rates have increased in India, community norms still deprioritize completing the full schedule of vaccination. From our experience, we notice that while health facilities provide information on vaccination, at-home taboos and family cultural beliefs often diminish the value of getting fully vaccinated. Through CCP, we aim to emphasize, and through post-discharge mobile engagement - reinforce, the importance of vaccination in context of families’ sociocultural norms in order to better motivate not only patients, but all caregivers to actively seek vaccination for their baby.

Community Impact (2-3 sentences):

Across districts in our 3 currently implemented states, we expect to see an increase in family activation and awareness of proper vaccination, and eventually an increase in vaccination rates across the communities we serve. We aim to see the difference of our program in the next 2 years, and with the support of our government partners, we would be able to sustain implementation over the long-term.

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Photo of Isaac Jumba
Team

Hi Shahed Alam ,

Great to see the updates for your idea during this refinement phase. As the deadline fast approaches, it will be great to provide the additional information as required (the business model canvas, the user experience map and ask any specific feedback you might want the community to look into.

Photo of Shahed Alam
Team

Thanks, @Isaac Jumba we're working on it and planning to upload remaining documents soon.

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