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Co-innovating for antenatal care in fragile environments

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Apr 15, 2019

By the Philips Foundation team

​​​​The International Committee of the Red Cross (ICRC), Philips  Design and the Philips Foundation joined forces to help both lay and professional healthcare workers in providing better services to pregnant mothers with complications in fragile environment.*

The International Committee of the Red Cross (ICRC), Philips  Design and the Philips Foundation joined forces

One of the results of this cooperation are the High Risk Pregnancy (HRP) Referral Cards: a portable set of tear-resistant cards, which is part of a more comprehensive toolkit aiming to support early detection of high risk pregnancies, and to encourage referral to health facilities for safe delivery.

Now, the ICRC is going to integrate the High Risk Pregnancy Referral cards in their Digital Primary Care Resources Center. The integration of this jointly created tool in the ICRC’s way of working is an important milestone in its rollout.

Project background information

According to international literature, up to 20% of pregnancies are at risk and 99% of all maternal deaths occur in developing countries. The challenge, particularly in low-resource settings, is to identify these 20% earliest, to reduce maternal and infant mortality (Stéphane Du Mortier, former Head of the Primary Health Care Services, ICRC).

Innovation does not have to be high-tech to make a meaningful difference to people’s lives, but it does need to be developed collaboratively by experts who know and care about what matters most – understanding the needs of people they are trying to help. That is why Philips and the Philips Foundation support the n​eeds identified by the ICRC in countries affected by war and violence.

Sean Carney

Chief Experience & Design Officer, Royal Philips

The HRP referral cards are designed to help:


  • Recognize and explain the signs of high-risk pregnancies to women living in the contexts of operation of the ICRC;
  • Educate and raise awareness on practices for healthy pregnancy, as well as to encourage antenatal check-ups.

The HRP referral cards are designed to help

The tool is easy to understand for audiences with different levels of literacy. The graphics respects local cultural sensitiveness, and the content can be easily adapted to different languages to respect their use in their context.​


Philips Foundation’s mission is to reduce healthcare inequality by providing access to quality healthcare for disadvantaged communities, in support of UN Sustainable Development Goal 3: Ensure healthy lives and promote well-being for all.

I’m proud to see that – in partnership with the ICRC –​ we developed and deployed the HRP cards. We are committed to help scale the impact of the referral cards on the basis of further deployment in relevant settings.

Ronald de Jong

Chairman Philips Foundation

The HRP cards are the result of a simple, yet meaningful, co-creation process. Following feedback from both staff and communities, the cards have been updated and now can be seamlessly integrated into ICRC’s primary health care resource center and be made available to all health delegates to leverage in operations

Esperanza Martinez

Head of Health, ICRC

Iterative (value) co-creation, testing and deployment

The high risk pregnancy referral cards have been shaped by leveraging design thinking methodologies.  Philips Design engaged in multi-stakeholder collaborative workshops to gather insights and shape the proposition prototyped and tested in the field with ICRC’s healthcare professionals and beneficiaries. This co-create methodology made it possible to develop a solution truly meaningful and appropriate to the context of use.

Iterative (value) co-creation, testing and deployment

Between 2016 and 2017, the ICRC has collected insights to shape the content and the visuals of the tool from the field of operation in Somalia, Nigeria, South Sudan and DRC.  Between 2017 and 2018 the ICRC deployed the final tool. 2.350 sets of referral cards were distributed in 6 African countries - Cameroon, CAR, Mali, Niger, Nigeria, South Sudan - reaching approximatively 1.800 traditional birth attendants (lay healthcare givers). The use of the cards has been monitored over time to assess their potential benefits in relation to the original ambitions of the project. TBAs in Central African Republic (CAR)​

With the HRP cards it is easier for me to convince the mother and the family about the importance of being referred to a health facility. I can show them the pictures and because it has the logo of the ICRC, the community has more trust.

Feedback from TBAs in Central African Re​public (CAR)

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