Service Improvements
Designing services that are accessible, usable and valuable
Introduction
What is Service Design, and why is it important?
The same process of designing the look, feel, and function of a product, can also be applied to services. Service design is critical to ensuring that people, especially the most disadvantaged and marginalized, actually value the service and use it. The health, education, and social services that are the most critical to our well-being are too often designed to suit the needs of service providers rather than the needs of the people for whom the service is intended.
Service Design turns that equation on its head. It’s a method that focuses on designing services for people, not institutions. The principles of Service Design can help you improve the demand for, impact, and use of services, by making the experience better for those who need it most.
Service Design 101
Like product design, Service Design is an interdisciplinary process that uses design thinking . It approaches the design of services from the perspective of the users, not by guessing what they might want, but by utilizing collaborative co-creation to uncover what would make services relevant, accessible and useful to them. Creating services that respond to people’s needs and motivations, suit their social and cultural norms, fit within their daily realities, and are user-friendly and desired by their intended clients are all the basic principles of service design.
There are many ways that services discourage uptake in their design. Health services that only offer male nurses and doctors to women in conservative societies, fixed vaccination services for nomadic communities, and parent-teacher conferences scheduled during parents’ working hours are all examples of Service Design flaws. These service elements create barriers, or friction, that actively works against the behaviours we seek to promote.
Service Design is a tool to increase and sustain positive behaviours. In particular, it is used to:
- Make an existing service more accessible, in particular to underserved populations
- Improve equity
- Improve the quality of the service and make it more appealing to its target users
- Simplify the number of steps or tasks required to use a service
- Digitize components that can be made more efficient online (feedback, reminders, etc.) when suitable
- Transfer initiative and ownership to citizens
Key Terms
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Behavioural objectives
Service Design is a useful tool for increasing the likelihood of social outcomes and the uptake of desired behaviours. The list below provides a selection of priorities that service design can support. However, nearly every strategic priority involves service design in some way.
- Educational enrolment and retention, particularly for girls
- Use of vaccination services, maternal and child health services or other health services
- Registration process for birth and vital events registration
- Use of sanitation facilities in schools, communities and health settings
- Breastfeeding support towards achieving exclusive breastfeeding
- Nutrition screening and counselling services
- Registration/uptake of social safety net programmes
The limits of Service Design
Although Service Design is an important component of Social and Behaviour Change, it is not a miracle cure for all demand-related issues. Now that we have outlined what Service Design is good for, let’s be clear about some challenges for which a Service Design approach is not always sufficient;
- Solving complex social problems: Issues like child abuse, low demand for health services, and educational disparities are complex and cannot be fully addressed by redesigning one service or intervention. Make sure you investigate the root causes of the problem, and use Service Design in conjunction with other tools to address the issue holistically.
- Communication with communities: A Service Design process involves target users and local stakeholders but is entirely different from setting up a structured dialogue for communication or engagement purposes. Participatory Service Design in itself doesn't offer a complete method for getting buy-in from communities. To support the design of better services, structures and systems like local management committees, feedback and social accountability mechanisms and stronger local governance and development committees are needed to properly engage with communities.
- Designing to reach the most vulnerable: Service Design can help create more equitable societies by making services more culturally, physically and financially accessible. Co-creative Service Design can be one of the tools used to give vulnerable groups a voice in the design process, but it can never be the only instrument. Consider how wider sectoral systems strengthening interventions can promote more equitable societies, and how services can be designed to support them.
Case studies and examples
You may have seen UNICEF’s Caregiver Journey to Immunization. This is an example of a user journey with multiple touchpoints. This helps public health professionals understand the journey to vaccination as something much larger than simply moving a caregiver from point A to point B (usually the health clinic or vaccination site). There are a number of practical and emotional steps that must be taken before a caregiver decides to go to a clinic. There are also a number of touchpoints at the vaccination site and after the vaccination service. These are all crucial parts of the journey that should be seen as opportunities to improve Service Design.
Below is a list of touchpoints that exist before, during, and after vaccine uptake with resources to help you reduce any friction around these key moments.
Pre-vaccination | Vaccination | Post-vaccination |
|---|---|---|
Positive reinforcement for the child and caregiver | ||
Explanation of what to expect | ||
Experience in the waiting room (queue, paperwork, cleanliness, child-friendly, interaction with staff) | Pain management | Payment and follow-up |
Check-in to the clinic |
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Additional examples of service improvements:
ZIMBABWE Providing peer-led community-based support for adolescents undergoing antiretroviral therapy for HIV led to improved treatment adherence and reduced viral load
ZAMBIA Strengthening community-based action groups led to improvements in maternal and neonatal health outcomes, including through increased skilled birth attendance at delivery
GHANA Use of a simple, objective checklist improved teacher training outcomes
GLOBAL The use of home-based records improves maternal and child health outcomes, including increased immunisation completion and ANC attendance and reduced likelihood of pregnancy complications
MEXICO Increasing access to electronic payments increases savings and reduces reliance on loans
Key principles
There are a number of Service Design principles, but the four below are fundamentals you should keep in mind. Make sure your service is:
- Easy to access. For example, a caregiver who wants to send their child to school must be able to identify and access a school within a reasonable distance of their home.
- Designed to accommodate multiple populations, especially underserved groups. The service should fit within its users’ reality. No user should be excluded from a service on account of their ability, identity, or lack of resources. For example, services that are overly digitized, while more efficient, may exclude those with lower technological literacy or access.
- Encouraging the right behaviours from users and service providers. The service should encourage safe, productive, and mutually beneficial behaviours from users and providers. The user should never be exposed to harm. For example, users should never be asked to provide data without knowing how it will be used. Staff should never be incentivized to provide poor service - for example, provider evaluations that consider the volume of patients seen each day could potentially erode the quality of each interaction.
- Actionable for all users. A service should always direct users to a clear outcome, regardless of whether they are eligible for the service. No user should be left behind or stranded without knowing how to continue or where to get support. In other words, the service should have no dead ends.
Service design is already beginning to take hold in sectors like public health and engineering. It has contributed to innovations in new products and improved the design of spaces, processes and systems. However, it remains an untapped resource across all development sectors despite the tremendous opportunities it offers to improve the lives of children. Consider how you can use service design to improve services, processes or systems in your work.
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