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National Health Insurance Scheme


Design Thinking for the Public Sector|1/10/2018

Since May 2017, the ILO´s Impact Insurance Facility has been working in partnership with the National Health Insurance Authority (NHIA) in Ghana. The project aims to expand population coverage of the National Health Insurance Scheme by designing a simplified user-friendly digital renewal process.

With the current renewal process, members have to queue at NHIA district offices in order to renew their membership. With nearly 11 million members, this process is an administrative burden on the scheme and cumbersome for members. Therefore, we needed a simple and robust process that is easy for our members to use and financially sustainable for the scheme over the long term.

To this end, we decided to employ design thinking as a framework to redesign the renewal process. ‘Design thinking’ or ‘human-centered design’ is a creative approach to problem solving that starts with people and ends with innovative solutions tailor-made to suit their needs. By using this framework, we hoped to make the design process all about the user, building greater empathy and understanding of our members among the team.

The exercise was organized as a ‘sprint’?—?a step-by-step system that guides teams through a shortened design thinking process of just three to five days. The sprint was attended by a cross-functional team from NHIA and was facilitated by experienced design thinking practitioners in Ghana, Ms. Ashlee Tuttleman and Mr. David Hutchful.

Solved more problems than one!

We went into the design thinking sprint hoping to develop a better renewal process, and we came out with a renewal process that delivered a superior user experience, a cheaper and more future-proof claims authentication solution, and a communication strategy to support roll-out. This demonstrates how the seemingly chaotic process of design thinking can broaden the horizons of business teams and lead to more holistic solutions.

Helped get buy-in from senior stakeholders

We built physical prototypes of our renewal and authentication solutions that users could interact with. Not only did this lead to more insightful user-feedback, it worked wonders in engaging senior stakeholders. The physical prototypes could be demonstrated to anyone within a few minutes and were instrumental in generating buzz and buy-in among decision makers. They say, “a picture is worth a thousand words.” In our case, a prototype was certainly worth a thousand presentations.

Drove the change agenda forward

The intensive period of gathering insights, building personas, idealization and prototype testing led to a much deeper and broader understanding of the change that was needed. For example, we realized that our district office front-line staff were as important as our members and that our processes need to work equally well for both. Furthermore, the time spent together working on a common problem away from day-to-day tasks cemented team-building and drove a sense of ownership within the organisation.

Saved money and time

The sprint was executed within just six days and facilitated by local design experts. Brainstorming sessions were conducted in the conference room at the local AFD office in Accra. In this short period of time, NHIA staff developed communication prototypes in three languages, gathered insights from around 50 users and developed process prototypes using not much more than a smart phone, computer and an empty plastic box! In summary, design thinking allowed us to make clever use of limited resources to develop a viable solution that we could then execute. In doing so, the process exceeded management expectations by a fair margin!

The sprint was only the beginning of what has now become a much more extensive design process. The prototypes have now been tested with additional users and their feedback has led to several rounds of refinements. A traditional process of brainstorming and piloting would have identified similar refinements much later in the process and consumed more resources to incorporate them. We are now busy implementing the renewals prototype as a proof of concept to test the technical feasibility of our ideas and the economic viability of implementing them on a national scale.

We will continue to share insights on how to incorporate design thinking into a broader organisation strategy, as well as learning from the proof of concept development and further user testing. 


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