It is the understanding of people’s experiences and perspectives towards a particular program or service that enhances a design’s importance. Essentially, without empathy, a design task, no matter how extensive it might be, is a pointless task. A team of designers from Stanford’s School delved into the process of designing an incubator that could be user-friendly and above all serve the purpose for which it was intended. This blog post is the sequel of the podcast “Introduction to User Centered Design” and will introduce you to a case study that involves positive approach and point out the most important aspects to our main topic.
A study by the Embrace-Design for Extreme Affordability (2017) showed that premature babies are born in large numbers worldwide. To such babies, the infant mortality rate is high due to hypothermia, a challenge that can be addressed by using incubators. The Extreme design team identified the problem and saw the need to solve it by designing an incubator that could help save the infants’ lives that were likely to suffer from hypothermia. To achieve the objective, the team needed a proper understanding of the problem to design an effective incubator. The team sought empathy from doctors, hospital staff, and the most significant group, parents of the endangered children. The program design was later named to Embrace, which was also the incubator’s name to be designed.
The team started by visiting a Nepal hospital to gain empathy, where they noticed an unexpected observation. The hospital had empty incubators. On engaging the doctors, the team learned that children were being born but far away from the hospital. Therefore, it was hard for such parents to travel more than 30 miles to access the hospital (Embrace-Design for Extreme Affordability, 2017). Seemingly, the incubators were there, fully functional but empty. The observation was an eye-opener to that team to seek more empathy as they initially thought redesigning the existing incubators into more cost-effective and simpler ones was the easiest solution. The insight gained from the doctors’ observation was a turn around to the team.
A report by Embrace-Design for Extreme Affordability (2017) shows that to gain more empathy, the team interviewed parents in India to help iterate their solutions. The team found out that the parents had a strong belief in Western medicines, which prompted them to have children at home and comfortably administer them. However, medicines could not solve hypothermia. Parents also emphasized that the hospitals were located far away from their homes. Most of them stated that by the time they arrived, their premature babies were already dead. The insight was similar to that gained from the doctor. Their regions had no electricity, making it impossible to incorporate incubators at home.
Inspired by the story, the team realized the need to develop an incubator compatible with the prevailing local factors. The team decided to develop a portable incubator that could be easily sterilized among several babies born at home. The incubator was to be cost-effective such that the parents could afford it at home.
This user-centered design study on Embrace offers a solution to the millions of infant immortalities experienced in India and globally. It creates a chance to design the incubator from empathy— the most crucial aspect of developing a user-friendly and centered design. The designers get a deep understanding of the community they serve, storm each other’s minds, and create an innovative program designed to solve the actual people’s problem. A user-centered design follows a six-phase process (Brown, 2008). The first step involves specifying the usage context. All the information about the user’s needs is collected. Secondly, the product’s requirements are specified and detailed by the designers, followed by generating a design solution to the user’s need. The design is then evaluated in terms of its usability. It is then implemented, and then finally, the product is supplied for use by the target community. The project commences by analyzing the people’s needs and concludes with a solution that meets the needs. The following figure shows the structure of a user-centered design.
Figure 1: The structure of a user-centered design
From the structure above, user-centered design involves researching and analyzing the user, their objectives, and contexts. Empathy is then embraced to understand the users’ current problems, while iteration is used to evaluate and improve the design (Misra, 2013).
Annually, more than 20 million babies are born prematurely and with low-weight. The mortality rate among such babies is high due to inaccessibility to incubators, especially in Third World countries. Although hospitals in such countries may have several incubators, they may be located in major cities, denying accessibility to millions of people from rural areas or the few incubators costly to hire. Moreover, the existing incubators required electricity for their operation, another service that seemed a problem for many people, especially in developing countries. For these reasons, the Extreme team from Stanford University challenged themselves to design an incubator that could be easily accessible and readily available by most people, especially in third-world countries.
Developing the Idea of Embrace
Since 2017, the Extreme team has been rolling over their sleeves to innovate the Embrace incubator. Based on the problem statement above, the challenges faced by parents who get premature babies include inaccessibility of incubators due to long distances to hospitals, high cost of acquiring an incubator, and unreliable electricity to those who can access the available incubators. To solve the problems, the Embrace team began their research to develop an incubator that could serve most people who needed an incubator’s services globally.
The team began by empathizing with the people of Kathmandu, the present capital city of Nepal. In the city, they observed the neonatal unit of the capital’s hospital and later traveled to the interior areas to observe premature babies’ handling. In their empathy journey, the team learned that an overwhelming majority of premature babies were born in Nepal’s rural areas. Besides, sadly enough, the team realized that those premature babies were never taken to the hospital. To those parents who attempted to take the children to the hospital, most of the infants could never make it.
Following the above alarming observations, the Extreme team realized that their new incubator needed to address those challenges. It dawned that no matter how good the incubator was to be made; their efforts could be pointless without addressing those challenges. More incubators into the hospital could also not help eliminate the problem as very few infants reached the hospital. The team realized that it needed to be functional in the rural setup for their design efficiency. That meant that the system must be culturally appropriate, sterilizable, intuitive, transportable, and most importantly, economically viable. Also, their system must not use electricity as the only power supply.
Innovating the Prototype
The empathy was successful as the Extreme team developed a prototype called the Embrace Incubator. Itsdesign was different from the other incubators in many factors. The Embrace design structure resembled a sleeping baby and could be wrapped around a premature baby. It had a pouch of phase-change material (PCM), which served the incubator’s primary purpose. The pouch maintained the infant’s body temperature to the required temperature for four to six hours without being recharged. The most exciting aspect about the pouch was that it was maintained by immersing it in boiling water for only a few minutes. It needed no electricity. Again, boiling water is readily available in all parts of the world as it involves just heating water. It could therefore be used even in the interior-most part of Nepal.
The sleeping-bag like incubator was light and small to be transported anywhere. It was easily portable and could be transported to rural areas. The material making the incubator was also easily sterilized when submerged in boiling water. It was the most intuitive incubator ever to be innovated. The incubator also enhanced the practice of Kangaroo Care by the mother to the child. Most importantly, the incubator cost was mere $25 (25 dollars), cutting the traditional incubator’s cost by about 800 times (Embrace–Design for Extreme Affordability, 2017). The following figure shows the appearance of the Embrace incubator.
Figure 2: Embrace sleeping bag incubator (Embrace Nest)
The pouch, which is the primary temperature regulator in the Embrace incubator, is innovative wax. The wax is heated in boiling water and keeps the whole incubator warm. The product has no moving parts and uses no electricity as compared to the traditional incubator. The product is safe, portable, and intuitive to use. The product’s design allows it to be used in a community setting, transporting babies, and in a hospital setting. Both the Embrace Nest and Care can serve those purposes as they have an almost similar structure. The following picture shows the Embrace Care.
Figure 3: The Embrace Care
The Embrace Nest is mostly used for medical purposes, such as in ambulances for a premature infant’s transportation. It is also used inwards in hospitals where skin-to-skin care is not possible. Embrace Care can be used in hospitals and homes and can be used as a complement to skin-to-skin care. Compared to the nest, it extends reliable thermal care, especially to vulnerable infants.
The Embrace portable incubator was first launched in South India in 2011. It was distributed to clinics that were easily accessible in rural areas. The technological innovation has impacted many infants in India as partnerships have accelerated to distribute it globally. The innovation was made by a class at Stanford University that was challenged to develop an incubation system that was about 1% of the traditional incubator’s total cost (Salvador et al., 2010). The Extreme team developed an almost perfect incubator and has seen development since then. The company is currently based in India and continues to partner with other organizations to improve their life-saving operations.
The incubator has been tested in multiple hospitals in India and has been approved by governments. It is highly effective, and more than 200,000 infants have been helped in more than 20 countries (Embrace–Design for Extreme Affordability, 2017). Both private and public organizations buy the product for either commercial purposes or voluntary services. The team continues to launch new baby products such as the Little Lotus Baby, which are blankets and swaddles that help babies sleep better by maintaining an ideal temperature. They have a special program that gives an Embrace warmer for a Little Lotus Baby purchased. The Embrace technology has contributed a significant percentage in saving infants’ lives without putting in many resources.
The Embrace user-centered design is empathetic, iterative, and interdisciplinary. The Extreme team started by paying attention to the target group in India. The team integrated the community in their research by learning the problems that faced them in the health sector. The team analyzed the problems and immersed themselves in solving the problem, ensuring the user needs were catered for. Suggestions and views of all users in the user-centered design were considered in the design of the incubator. Besides, UCD helped the team integrate all disciplines, such as ethnographers, engineers, and psychologists, who developed the incubator.
Lastly, designers should integrate the principles of user-centered design to maximize the usability of their design. It enhances a deeper understanding of the user’s problems and, thus, crucial for any design. The solution stage ensures all designers ideate any possible solution enhancing the final solution as the best is picked. The iterative design borrowed from UCD will enhance the design since it provides assessment and validates the design since its commencement. Furthermore, UCD is a complete cycle that enhances the improvement of the product design. It allows for mistakes helping the designers make a better design product. The most exciting thing about the user-centered design is its iteration. Iteration gives more room for improvement, which is responsible for the popularity and growth of prototyping.
Brown, T. (2008). Decision thinking (pp. 3-7). Harvard Business Review.
Embrace–Design for Extreme Affordability. (2017). https://extreme.stanford.edu/projects/embrace/
Misra, M. (2013). Warmth for newborns: The embrace infant warmer. Innovations in maternal health: Case studies from India, SAGE Publications, New Delhi, India, 147-157.
Salvador, T., Bell, G., & Anderson, K. (2010). Design ethnography. Design Management Journal (Former Series), 10(4),35–41. https://doi.org/10.1111/j.1948-7169.1999.tb00274.x
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