2026
The Vanga Hospital Project
The Vanga Hospital Project was a 10-week collaboration between MA Service Design and MA Industrial Design students at UAL. Working remotely with Dr Mudji and the healthcare team at Vanga Hospital, we explored how maternal and neonatal care could be improved across the hospital, surrounding health centres, and rural communities of Kwilu Province, Democratic Republic of Congo.
The project examined maternity care as a connected system shaped not only by clinical practice, but also by infrastructure, communication, social beliefs, family decision-making, and access to resources. Four student teams developed complementary interventions across community engagement, patient information,
emergency care, staff experience, and resource organisation.
Outcome: My team focused on strengthening community engagement around Vanga Hospital. We designed the Pregnancy Pathway Kit and an accompanying flipchart, while also contributing content to the Pregnancy Passport developed by another project team.
Project partners:
Project Details:
Duration: 10 weeks
Team: Maitreyi Mandrekar, Maja 
Rowecka, Yuan Tao
Methods: Literature review and secondary research, remote stakeholder interviews, participatory research, patient and pregnancy journey mapping, co-design, prototyping, remote testing and validation and cross team collaboration.
Project Context
Image received from the Vanga Hospital by Dr Mudji and his team.
Vanga Health Zone serves approximately 362,000 people across 119 villages. Some communities are located around 90 kilometres from Vanga Hospital. The health zone includes 63 healthcare facilities, but only five have a doctor present. The remaining facilities are largely led by nurses, who often provide maternity care with limited staff, equipment and resources.
The wider infrastructure is also highly constrained. Only two facilities have a reliable water source, fewer than half have electricity, and only two have internet access. Although mobile phones are more widely available, communication and coordination across the system remain difficult. For many women, pregnancy is first understood and managed at home. Decisions about seeking formal healthcare are influenced by family members, local beliefs, fear of medical procedures, transport availability and previous experiences of care.
Vanga Hospital is often perceived as a last resort rather than a place for early support. This can delay referrals and emergency decisions until a woman’s condition becomes critical. Reaching care is also difficult. Without a formal ambulance service, women may travel by foot, bicycle, motorbike or whatever public transport is available. As a result, maternal healthcare in Vanga is shaped not only by clinical challenges, but also by infrastructural, logistical, cultural and social factors.
Image received from the Vanga Hospital by Dr Mudji and his team of the neighbour villages and community.
My team's focus area
Secondary Research
Primary Research
Most communication took place through Zoom, WhatsApp and shared documents. Photographs, videos and descriptions from Vanga became essential for understanding the physical context. We also conducted remote interviews through the hospital staff by creating questionaires and surveys.
We also asked Dr Mudji’s team to reflect on the data collection process, so we could understand the context behind the answers. A key input was a video of a nurse-led antenatal care meeting, held every Thursday at Vanga Hospital, where women receive prenatal education and ask questions.
Breaking down and mapping insights from the debrief sessions with the researchers at Vanga
Key insights from the research
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Emergency decisions are often negotiated too late. Stories from Vanga showed that decisions around surgery, cost, and family support need to be prepared long before a crisis.
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Vaginal delivery is often seen as the only “good” birth. Referrals, surgery, or procedures can therefore feel like a failed or negative birth experience.
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​Women’s perceptions of formal care are shaped by past experiences and community stories. Fear of the delivery room or hospital staff can directly affect whether women feel comfortable seeking care.
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Women often fear referrals to Vanga because they can feel like a failure or a sign that something has gone wrong.
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Trust is built mainly through conversation and word of mouth, through friends, village mothers, and community health workers.
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Preparedness is usually practical, focused on transport, cost, and danger signs, while relational questions such as who will support, speak, or decide for the woman are less visible.
How might we enable nurses and midwives at Vanga Hospital and the surrounding health centres to facilitate more effective antenatal care meetings, so that women and their families can build trust, understand different pregnancy pathways, and open conversations about birth preparation to navigate emergencies safely?
Co-discovery and Co-design
Co-design became part of our process through hospital staff and Dr Mudji, who helped us understand the community through their patients’ experiences.
At first, we created tools to gather more information, but we realised the key anchor point had already emerged: regular ANC meetings at Vanga, that women were already attending, interacting, and sharing their stories. This made ANC the right touchpoint for our intervention.
Prototyping and iterations
As we developed the tool, we stayed in close contact with Dr Mudji and his team.
We recorded ourselves testing the facilitation format and shared it for feedback. Dr Mudji then showed the prototype to nurses and midwives, whose responses helped us iterate and understand how the tool could work in practice.
Remote exchange and facilitation
Our process worked through two loops.
The research loop helped us move from context, interviews, and observation into mapping, insights, and co-design. The response loop helped us move from validation and feedback into prototyping, iteration, and final delivery.
The Output
The Pregnancy Pathway Kit is a low-resource facilitation tool designed for use during antenatal care meetings. It uses illustrated cards, prompts, blank cards and thread to help nurses and midwives build and discuss different pregnancy and birth pathways with women and their companions.
The kit makes invisible decisions and possible complications easier to see, discuss and prepare for.
It does not attempt to predict a single birth experience. Instead, it shows that pregnancy can follow different routes and that timely decisions can help women reach appropriate care.
Watch the video below to understand how the kit and flipchart work:
Limitations
Every solution has limitations, and ours does too. The impact of the kit depends on how confidently nurses and midwives facilitate the discussion, especially in busy ANC settings.
The tool supports preparation and awareness, but lasting behavioural change would require repeated conversations, family involvement, and wider community and health-system support. And while the feedback page creates a route for women’s voices, the hospital will need a clear process to review and act on that feedback.
Way Foward
