Project Overview

Work with Berlin-based Healthtech Startup, Hanai, to build an app to better connect women in rural Kenya to healthcare information
 

Deliverables

Android App

Client

Hanai (hanai.eu)

UX/UI Design Lead

Denise Macalino

Stakeholders

Shamala Hinrichsen
Elizabeth Busch


 

Project Context

Through a past client, who is an engineer addressing affordable housing in Berlin, I was put in touch with Hanai - a healthtech startup based in Berlin, Germany. Hanai’s mission with their new app, Imarisha is to help women in rural and marginalized settings in Kenya have access to healthcare information. Women in these communities are prone to preventable sex and pregnancy related disease and death. I will be leading the UX Design of their new app, Imarisha, from end to end.

 

Problem Statement

After an initial conversation with the founder of Hanai, I identified the main problem to be that access to healthcare is limited and blocked by large technological and geographical barriers in the rural majority world.

How Might We Make Healthcare Information More Accessible and Digestible for Women in Rural Kenya?

Approach:
Understanding what constraints and barriers currently exist for women in these communities and creating a system that provides better guidance

 

Project Vision

“To save lives and improve individuals’ relationships to their own health. Basic healthcare and health information should be accessible for everyone"

 

 

Understanding the Problem


Our constraints

  • users with varying levels of literacy

  • users with limited internet connection

  • users using smartphones for the first time

In order to get a holistic view that considers the user’s experience as well as the business goals, I decided on the following methodologies: Stakeholder Interview, Competitive Analysis, Secondary Research, and User Interviews

 

Meeting With the Team

I had a stakeholder interview with the founder, another intern, and Hanai’s data scientist. The biggest insight I gained from our conversation was the features we will focus on based on the founder’s vision:

  • Content Consumption - the app will include pages of health info, so organizing it will be key

  • Support Chat or FAQ - since users can’t speak to physicians regularly, a support chat can stand in

  • Creating a Profile - Hanai eventually wants to enable users to track their own health

Click here for full interview notes

 

Speaking Directly to Women in Rural Kenya

The Challenge of Recruiting Users With Our Constraints

Recruiting participants for this study was a huge obstacle, as the people I needed to be interviewing - Kenyan women in rural communities - was a demographic that was difficult to reach, both because of a technological barrier and a language barrier. This pushed our timeline back significantly. In the future, I know now to allot much more time for interviews when working with a more edge-case user demographic.

In the end, I collaborated with Hanai to find 2 individuals through NGOs working in rural Kenya. I reached out to my own contacts as well to recruit women in Kenya who had grown up in rural Kenya. As we only recruited 3 participants in the end, it was of utmost importance that the questions we asked were specific and thorough.

The two archetypes that came through from these user interviews were:

  • Young Learners, who wanted to take initiative with their health and would be the “early adopters"

  • Self Helpers, who primarily took care of themselves, not really depending on the healthcare system

Click here for a view at the full interview summary

Case-Study-3_Interview-Demo.png
 

How Are Others Solving This Problem?

We will be looking at other African healthtech apps that are targeted at a more similar demographic.

The competitors I found that best matched our problem space were:

  • Gifted Mom: Cameroonian app preventing complications during childbirth)

  • Omomi: Web and SMS service based on the WHO childhood survival strategies

  • Sehatuk: Facilitates access to healthcare in Northern Africa (specifically, Morocco)

  • HelloDoctor: Allows you to speak with a doctor from your phone

Exploring these apps and seeing what features they prioritized helped me see areas of opportunity for Hanai to step in, as well as decide which features were non-negotiable. This will be further supplemented with a feature matrix, which you will see in the next phase!

 

A Multi-faceted Research Approach

This is a demographic that tech rarely designs for in mind. Through secondary research I sought to understand the femtech/healthtech problem space to make sure I was addressing the right problem and constraints.

Objective:

  • Define the constraints that might exist for healthtech in rural and marginalized communities

Hypothesis:

  • The system for tracking healthcare needs to be simplified and offer lots of support, as the initiative will not exist immediately

Click here for a full view of the Secondary Research Report

 

Changing Direction

Based on our competitive analysis and user interviews, we decided to focus on creating a community forum instead of the user profile for this round of design. User interviewees unanimously claimed that they consulted their own peers and community before making online searches or consulting a physician. Creating a community forum like our competitors would allow users to get the emotional support they’re seeking.

 


To have a more 3-Dimensional understanding of her, I also created this Empathy Map

 

Relationship to her Health and Health Apps

To really dive into how our users might feel at each point of their journey to building a relationship with their health. This user journey is based on user interviewees’ response to how they manage health through apps like Flo

 
 

Prioritizing Features

From my research, For an understanding of what features we should work on, and features we should leave for later, I created a feature matrix which divides our features into four different quadrants: low cost; high impact, high cost; low impact, high cost; high impact, and low cost; low impact. This clarified for me which features need my immediate attention in regards to how directly they impact the users or Hanai as an organization.

 
 

The Blueprint (Information Architecture)

After identifying the main features for the project, I mapped out the specific components of each screen I will be working on in Hanai’s new app. This was a challenging sitemap to construct because of the technical constraints we are working with: limited wifi and literacy. This meant basically making sure the components were small and digestible, but also didn’t take up too much in terms of space.

 
 

Ideation

Once both the Hanai team and I were happy with the direction we were taking from our research and project defining, I started to ideate. I had to keep the most important questions forefront to make sure I was staying on track while ideating potential solutions to bridging the gap between Kenyan women in rural communities and healthcare. How can I make it really easy for them to use? How can I make the experience feel organic? How can I keep them coming back to keep Hanai afloat too?

 

How to Give Her Emotional Support

Referring back to my user journey, I created a task flow to make sure that every step of the user journey would be covered in the organization of the app.

 

Sketches

I spent time referring to Baby Center and What to Expect for design patterns regarding maternal health, while keeping in mind the constraints I’m working with for Hanai’s demographic. I also spent a lot of time referring to chat interfaces for the support chat, from places that Kenyan women would be accustomed to, such as WhatsApp and Facebook. On top of these Western apps, I referred to Hanai’s competitors to see how other designers in the space have approached the issue of limited digital literacy and connectivity.

 
 

Mid-Fidelity Version

Once I finalized these sketches I translated them to digital versions on Figma. There were a few changes pre-testing that came up: including a way to post to the forum anonymously to be considerate of people sharing confidential information, removing the “Read More” CTA in the symptoms area to minimize the UI, and a link right to the Mother’s Community in the featured post.

Click here for a view of all the mid-fi wireframe screens

Mid-Fi Wireframes.png

Prototyping


Usability Testing

We tested with 3 women from rural Kenya. Click here for a view of the full mid-fi prototype. Below you can find the demographics and the usability testing plan:

 
 

Here you can find the script for my usability testing. Click for full notes on these tests.

 

Let’s Iterate


Main takeaways from Testing

After finally recruiting some testers in our demographic, I gathered the main findings from these tests below. Click here for a full report on the usability testing results.

  1. Age Selection | Users felt it was important to be able to include their age, as it’s a factor that can affect pregnancy risks

  2. Support Chat | The support chat works well and is easy to understand. Users felt that it added a lot of value

  3. Create Post | All users felt that the icon for the Create a Post CTA should be more obvious than a plus button

 

Group Critique

To make up for a small number of user testers, I consulted my weekly group critique for some feedback. Through my DesignLab Bootcamp, I made note of the problem areas and got a second opinion from 10 students and 1 facilitator. The following are some takeaways from that feedback session:

  1. Comments Section | Some students felt that the comments were not differentiated enough from the post, so I’ve decided to make the colour of posts different from comments

  2. Tool Tip | To nudge users, especially users not familiar with many apps, a tool tip will be included on the “+” Create Post CTA

  3. Onboarding CTAs | The onboarding “Next” and “Previous” CTAs are not differentiated enough from the “Skip” CTA and should be made in the style of the secondary CTA

 

And Finally, a Stakeholder Meeting

Before moving onto the final hi-fidelity designs, the Hanai team and I had a walkthrough of the mid-fidelity prototype. They suggested a few changes based on their goals. The main changes we discussed were:

  1. When Things Go Wrong language on the Maternal Health page to be changed to “Watch Out For These Symptoms”, so as not to alarm users who or increase their anxiety.

  2. Including Audio Buttons: This is something I waited to consult the Hanai team on, since there is so much content. We agreed that it made most sense to include them on the symptoms, which had a lot of text to read through, and will make it easier for users with limited literacy to consume the information.

  3. Support Chat: We changed Azizi's (the support chatbot) first question from “what problem can I help you with today?” To “what can I help you with today?” To be more personal

 

User Interface

 

Design System

For longevity, I wanted to create a design system for Hanai to be able to keep for reference when building out the rest of the application. With this design system, I included a new logo for their Kenya app, typography, a colour palette, card and illustration styles, button styles, and icons. I wanted the app to feel safe and feminine, so I went for soft tones, and simple typography and illustrations. The illustrations will likely be placeholders for now, as Hanai has an illustrator they hope will be able to design bespoke illustrations for the app, but this is the general look and feel we are going for:

 
 

Final Version

Finally, the last stage (for now, always for now): The hi-fidelity prototype! After finalizing the user interface and design system, I went ahead and applied the designs to the mid-fi wireframes, bringing the app to life.

This version has a short and sweet onboarding process, that is also easy to follow and understand for users with limited digital literacy. It also makes it clear what users are opting into and what kind of personal information they are giving. After the iterations, the Maternal Health area really reflects the kinds of immediate information that our users will be looking for, without being overwhelming. It has an improved support chat that acts as a directory of information for now, which will be doable for the Hanai team, as well as easy to follow for their users. Finally, the mother’s community is an extension of the conclusion we drew from our research that our users expect to get guidance from their peers. Overall, I believe the app really achieves what we set out for it to do: make healthcare digestible and foster a preventative and educational relationship to ones health.

Check here for the full prototype

Reflection

Constraints

This is by far the most difficult project I’ve undertaken so far. The constraints were abundant, but allowed for real creative problem solving

  • Considering limited internet connectivity forced me to really narrow in on the most immediate issues so as not to take up too much space. This meant a more streamlined process for getting health information that isn’t cumbersome and overwhelming.

  • Taking limited literacy and digital literacy into account also made me consider other forms of communication, through more visual cues than written ones

  • Having few users to be able to conduct tests allowed me to look for solutions for getting feedback and making sure I was getting as many second eyes on the project as possible. It taught me the value of getting feedback from a range of perspectives rather than solely relying on user tests for answers

Learning

Thorough research helped me get into the habit of really understanding the user: women in rural Kenya. It was such a specific demographic to work with compared to my other projects and really forced me to put aside my assumptions (for instance, assumption: women in the rural majority world just need health information provided for them in one place). I quickly learned that the main thing these women were looking for was actually emotional support. They can conduct Google searches for health information, but they don't necessarily want to be given a diagnosis in such a cold manner. They want to feel cared for and looked after by their community.

Working with the constraints that I mentioned above also meant that I needed to do much more extensive research than I have before, which included listening to and speaking with Kenyan women, reading literature on how technology and healthcare works extremely different in the majority world, and knowing that I couldn’t take just any design pattern and hope it would solve the problem at hand. This project forced me to branch out in many ways.

Moving Forward

I feel really grateful to have had the chance to work on this project with Hanai. It’s a cause that means a lot to me and something that makes me feel connected to the reason I wanted to get into UX design anyways - using design thinking to help improve people’s lives. This has always been my North Star and I feel fulfilled knowing that I can serve others with the power of empathy and design. Hanai was also very happy with the work I put out and we will continue working together on this application.

The next steps will be working with the developer to bring the application to life. My hope now is to conduct a few tests on the hi-fidelity version, and build out the flows that we’ve focused on for this project to render a Beta version.

One thing I’ve taken away from this project is something that was really re-iterated (to use design lingo) in the 99% Invisible Podcast Episode I referenced in my research:

Designing for the edge case actually makes design better for everyone.