Tijani Bosun, Igbokwe Uchenna, Filani Temi, Adewemimo Adefemi, Ameyan Lola, Iyekekpolor Martins, Karera Steven, Oluyide Olatunji, Ezike Emmanuela, Akinreni Temidayo, Ogefere Obruche, Adetimilehin Victor, Amasiatu Valentine, Nwaokorie Chukwunonso, Kangkum Naanma, Fasawe Olufunke, Aigbogun Eric
Co-creation Hub Nigeria, Lagos, Nigeria.
Solina Centre for International Development and Research, 8 Libreville Crescent, Wuse, Abuja, 904101, Nigeria, +234 7031135557.
JMIR Hum Factors. 2025 May 7;12:e58577. doi: 10.2196/58577.
A significant cause of postpartum hemorrhage (PPH) is access to and delivery of maternal health care services. Several multisectoral strategies have been deployed to address the challenges with little success, thereby necessitating the use of human-centered design (HCD) to enhance health care delivery, particularly in PPH management.
This study aims to develop facility-level solutions for optimizing uterotonic supply chain systems and health service delivery in PPH management through an HCD approach in selected Nigerian states.
The research used a four-phase HCD methodology: (1) co-research, (2) co-design, (3) co-refinement, and (4) implementation. However, this paper focused on the first 3 phases. In the co-research phase, 203 interviews were conducted, involving 80 pregnant women and nursing mothers, 97 health care workers, and 26 key stakeholders. Additionally, 33 sites were observed across a 3-level continuum of care. Interviews and focus group discussions revealed insights into the distribution of health workers and observed PPH cases, alongside knowledge and administration of uterotonics. Data analysis was carried out using three key steps: (1) identifying key themes from the collected data, (2) developing insight statements that encapsulate these themes, and (3) translating each insight statement into actionable design opportunities.
About 150 ideas were produced and translated into 12 solution prototypes in the co-design phase. Progressive refinement following feedback from 140 stakeholders led to the selection of three final solutions: (1) implementing a referral linkage system to improve the transportation of pregnant women to nearby health facilities, (2) increasing demand for antenatal care services among pregnant women and their families, and (3) delivering a comprehensive uterotonic logistics management program for streamlined uterotonic storage and management.
This approach aligns with global health trends advocating for HCD integration in health care programming and aims to empower local champions to drive sustainable improvements in maternal health outcomes. Judicious implementation of the developed prototypes across the states can strengthen clinical care and potentially reduce maternal health service delivery gaps.
产后出血（PPH）的一个重要原因是孕产妇保健服务的可及性和提供情况。已经部署了几种多部门战略来应对这些挑战，但收效甚微，因此有必要采用以人为本的设计（HCD）来改善医疗服务的提供，特别是在产后出血管理方面。
本研究旨在通过在尼日利亚选定的几个州采用以人为本的设计方法，开发设施层面的解决方案，以优化产后出血管理中的宫缩剂供应链系统和医疗服务提供。
该研究采用了四阶段的以人为本的设计方法：（1）共同研究，（2）共同设计，（3）共同完善，以及（4）实施。然而，本文重点关注前三个阶段。在共同研究阶段，进行了203次访谈，涉及80名孕妇和哺乳期妇女、97名医护人员以及26名关键利益相关者。此外，还在三级连续护理体系中观察了33个场所。访谈和焦点小组讨论揭示了医护人员分布情况、观察到的产后出血病例，以及宫缩剂的知识和管理情况。数据分析分三个关键步骤进行：（1）从收集的数据中识别关键主题，（2）制定概括这些主题的洞察声明，（3）将每个洞察声明转化为可操作的设计机会。
在共同设计阶段产生了约150个想法，并转化为12个解决方案原型。根据140名利益相关者的反馈进行逐步完善后，选定了三个最终解决方案：（1）实施转诊联系系统，以改善将孕妇转运至附近医疗机构的情况；（2）增加孕妇及其家庭对产前护理服务的需求；（3）实施全面的宫缩剂物流管理计划，以简化宫缩剂的储存和管理。
这种方法符合全球卫生趋势，即主张将以人为本的设计融入卫生保健规划，并旨在使当地倡导者有能力推动孕产妇健康结果的可持续改善。在各州明智地实施所开发的原型可以加强临床护理，并有可能缩小孕产妇医疗服务提供方面的差距。
