The aim of this graduation project was to develop an ergonomic support tool to prevent work-related musculoskeletal disorders (WRMDs) among sonographers, particularly shoulder strain during ultrasound procedures. The project began with an examination of the clinical context, ergonomic challenges and physical demands of sonographic work. Through observations, interviews and electromyography (EMG) testing, key factors were identified, including prolonged shoulder abduction and high muscle activity, particularly in the supraspinatus.

This research resulted in the development of Lofius, a supporting device designed to reduce shoulder load while allowing full range of motion. The tool was adapted for use in the departments of paediatrics and gynaecology, to accommodate the different procedures performed in each department. Prototypes were developed and tested with healthcare professionals, resulting in a design incorporating a hinge and sliding system to provide flexible, ergonomic support. Surface EMG testing showed that using Lofius correlates with reduced supraspinatus activity, which is important during long ultrasounds, demonstrating its potential to reduce fatigue and prevent injury.

This study concludes that Lofius is a promising starting point for addressing WRMDs in sonography. However, several limitations were acknowledged, including limited clinical testing and inconsistencies in the setup during EMG assessments. Future development should include extended clinical trials, design adjustments for improved support and infection prevention, and exploration of additional force-assistive solutions. Lofius meets the key design requirements identified through user-centred research, providing targeted support during sonography and addressing the most critical risk factor: sustained shoulder abduction.

This graduation project, focussed on the environmental impact of the ECG-lead sets used at Erasmus Medical Centre (EMC). It explores how circular design techniques can help create a more sustainable healthcare system. Although ECG-lead sets are crucial for cardiac monitoring and diagnostics, they are frequently single-patient use (SPU), this greatly increases CO2 emissions and medical waste. Although there are multi-patient-use (MPU) alternatives, hygienic concerns, cleaning workload, and regulatory limitations limit their wider adoption. The project set out to redesign ECG-lead sets using an evidence-based and context-specific methodology, in order to evaluate theoretical sustainability strategies and their actual implications.

The research phase consisted of an in-depth exploration of the current ECG-lead set used across multiple EMC departments. Through interviews, direct observations, user journey mapping, and stakeholder analysis. The environmental impact of both SPU and MPU sets was measured using a Life Cycle Assessment (LCA), which revealed that MPU options become more sustainable after just four use cycles. Cable tangling, unclear ownership resulting from multiple department transfers, and inconsistent cleaning procedures were among the main obstacles found. The need for system-level thinking was highlighted by the frequent conflicting stakeholder interests, which ranged from procurement logistics to patient safety.
With a focus on co-creation, the design phase adhered to the triple diamond process: explore, ideate, implement. The concept for a modular, reusable ECG system with enhanced usability, durability, and lifecycle transparency was influenced by three co-creation sessions and multiple expert interviews.

Digital traceability to track usage cycles and maintenance, visible cleanliness indicators, and easy-to-use cable management were among the possible design interventions. In order to address user experience and operational viability, core concepts were validated through prototyping and testing with nurses and technical staff.

A reusable ECG-lead set that minimizes environmental impact and fits in the EMC context is the end result. Implementing dry electrode technology in the design, it reduces valuable material waste from conventional electrodes and keeps these in the loop of the circular economy. Embedding RFID tags to allow traceability, and lifecycle monitoring. The design enables individual part replacement and greatly reduces material waste by supporting circular strategies like reuse, repair, and refurbishment. This design shows how circular principles can be effectively translated into workable, scalable medical device solutions through co-created and context-specific design.

According to the project's findings, systemic knowledge and stakeholder involvement are both necessary for future healthcare transformation. In addition to producing better design, the project is an example that offers a scalable framework for implementing circular design in other medical product industries, making it a validated case study.

The in-flight entertainment (IFE) systems provided by airlines significantly contribute to the environmental footprint of air travel. A common example of this impact is the distribution of millions of disposable headsets to passengers each year. These headsets not only generate considerable material waste but also add to aircraft weight, thereby increasing fuel consumption and associated carbon emissions.
This project explores alternative forms of IFE aimed at reducing the environmental impact of current systems. Conducted as part of the SESAME project—a collaboration between Airbus, various airlines, equipment suppliers, and the Georgia Institute of Technology—this research focuses on identifying and developing more sustainable IFE solutions that align with broader aviation industry goals.
The project presents several key findings that influence the final design showcase. These include the identification of distinct consumer groups and the behavioural reasoning behind their headphone use, a sustainability impact analysis of current IFE systems, an examination of the relevant EU Green Deal legislation influencing airline operations, and a market analysis of the current IFE systems.
This thesis presents a strategic framework to assist airlines in moving toward carbon neutrality by 2050. The strategy offers a method for integrating sustainability into business planning, which can also be used to create similar strategies in different settings. One of these is worked out into a product-intervention combination. This comprises a modular Bluetooth adapter and a set of digital touchpoints designed to encourage passengers to use personal headphones instead of disposable ones. Together, these components aim to reduce waste, lower emissions, and enhance the overall sustainability of in-flight entertainment.

LAYCO Medical Devices BV needs a packaging solution for their new product, vela®, a
reusable vacuum extraction device aimed at replacing single-use devices in Dutch hospitals
by 2025. The challenge was to design packaging that not only meets stringent medical
and logistical requirements in the Netherlands, but also aligns with LAYCO’s commitment
to sustainability, reducing environmental impact while ensuring the device’s safety and
usability.

The proposed packaging solution is a compact box made of corrugated board. The use of
this material has a low environmental impact as it is renewable and easy to recycle. The
corrugated board cutout of the packaging is cunningly designed to fold into a rigid box with
designated placeholders for the product parts. The folding and unfolding of the packaging
is specifically designed to increase the ease of use.

The packaging solution accumulates 0.046 Grams of CO2eq. in its life cycle whilst competitor
packaging solutions are responsible for at least double this number. The design stimulates
correct disposal through its usecues. The solution is seamlessly implementable in the existing
systems in the healthcare ecosystem. The protective capabilities are validated in several
tests with extreme conditions.

The importance of this project lies in the fact that packaging solutions currently are all
designed to be disposed of. While the transition to a world without the need for disposable
packagnig is desired in order to sustain life on earth in the long run, smaller changes right
now can significantly decrease our impact on the environment. In this thesis it is explained
that by redesigning disposable packaging solutions, we can already half our impact today.

Cervical cancer is the development of abnormal cell growth on a woman’s cervix. It is a highly preventable and highly curable disease if detected early. Notably, 22.5% of cervical cancer related deaths occur in Africa but, they have the lowest rate of cervical cancer prevention measures worldwide.

This project focuses on increasing women’s participation in cervical cancer screenings through redesigning the C Spec, a product that lowers the patient discomfort barrier associated with cervical cancer screenings.

The C Spec was developed by the startup company GIC Space. Its design utilizes a narrow body and an endoscopic camera to visualize the cervix via a live mobile phone feed, reducing the diameter needed to stretch the vaginal walls to view the cervix.

Although the original C Spec design improves patient comfort, healthcare professional ease of use was limited. This new C Spec design therefore utilizes a speculum style handle attached to the original C Spec main body to allow for intuitive use by healthcare professionals while maintaining patient comfort.

This research, part of the Master Integrated Product Design Engineering at Delft University
of Technology, is a collaboration between Red Cross Kenya, TUDelft, INSPiRED, the
MakerSpaces of I.O.Me 254 and its participating students.

Originating in the 2021 Advanced Embodiment Design course at TUDelft, the Eduscope
project aims to improve microscopy accessibility in Sub-Saharan African countries.
Leveraging accessible manufacturing technologies, such as 3D printing, and collaborating
with local MakerSpaces, it empowers communities by giving them control over the project
and enables the fabrication of low-cost digital microscopes.

The Eduscope project has focused on real-world testing at I.O.Me 254, serving as a crucial
testing ground and incubator. This research builds on this collaboration, starting with an
in-depth exploration of Eduscope V2 and the MakerSpace at I.O.Me 001 in Mombasa,
Kenya. Three categories, featural, structural & sourcing improvements, were identified, but
more essential four missing pieces between the I.O.Me 001 students and the projects’
success were unveiled. Continuing on the four missing pieces, Understanding, Curiosity,
Trial & Error and Independence the research goal of “Empowering the students at I.O.Me
001 to develop digital microscopes targeting low-resource secondary schools in Kenya" was
outlined. With this research goal three deliverables have been developed to ensure a holistic
approach.

The Eduscope Rig is an essential tool in initial recruitment of the students by fostering
curiosity and understanding. Next to the educational function, the Rig functions as an
essential design tool by boosting Trial & Error practices and reducing supply chain
independencies. The Eduscope STEM project is a series of workshops crucial to bringing
the students up to the level where they can make actual improvements to Eduscope
products. Lastly, the Eduscope V3 Prototype serves as tangible and visual presentation for
the three improvement categories, creating an updated reference point for the students and
boosting the development of the Eduscope V3.

Cataract surgeries using phacoemulsification (phaco) are standard practice, accounting for the large majority of all cataract surgeries. Reliance on sterilization processes has significant environmental implications, giving its energy and resource intensive nature.

This thesis introduces a novel hybrid phaco handpiece design, eliminating the need for sterilization by adding a disposable to facilitate sterile use, combined with a reusable as driver of ultrasound. This product is the first step towards a proposed fully circular system. This project has a focus on reducing impact, while maintaining phaco functionality; it does so by testing for phaco ultrasound characteristics and functioning fluidics while addressing the challenges associated with sterilization. The design emphasizes quick, secure, and sterile assembly in the operating room (OR) while maintaining cost-effectiveness and minimizing environmental impact.

The hybrid phaco handpiece achieves its functional design by carefully managing the components responsible for ultrasound and fluidics. The internal sonotrode, driving ultrasound, is split between the disposable and reusable components, connected securely through a threaded interface. Fluidics are managed by splitting off before reaching the reusable part, employing a simple yet effective O-ring design in the disposable product.

Maintaining sterility in the OR is a critical aspect of the hybrid phaco handpiece design. Mechanical seals in O-rings provide internal sterile barriers, and a blister pack facilitates sterile interaction between non-sterile and sterile components. The contact-free assembly of the disposable into the reusable ensures a tight connection, validated by a torque ridge that breaks at a specified torque, offering a visual cue for successful connection. This usability design, validated with healthcare professionals, adds safety and fits the quick nature of cataract procedures.

The innovative sterile handover method is implemented through the packaging itself, acting as a sterile barrier between different nurses handling the disposable and reusable components. During handover, a pre-attached sterile tube sleeve is unrolled over the non-sterile component. This ensures a seamless and sterile transition during assembly, minimizing the risk of contamination.

A comprehensive functional analysis validates the hybrid design, ensuring it meets specifications. Insights gained from this analysis guide further mechanical tuning, particularly in aspects influencing ultrasound characteristics. Beyond functionality, the hybrid phaco handpiece design has environmental implications. By eliminating the need for energy-intensive sterilization procedures and reducing waste from disposable wraps, the design reduces its climate impact by 67% over the entire life cycle.

This hybrid phaco handpiece design represents a step towards a circular system in the field of cataract surgeries. Balancing functionality, sterility, and environmental impact, this novel approach not only provides new insight into sustainable phacoemulsification procedures, but also shows the potential of hybrid reusable and disposable products in healthcare.

Myopia, or nearsightedness, represents a significant and escalating global issue, with projections indicating that by 2050, 50% of the world’s population will be affected (Holden et al., 2016). Because myopia is a progressive condition, early onset significantly increases the risk of severe visual impairment and, in extreme cases, permanent vision loss. Immediate and effective interventions are essential to mitigate this risk. While treatments to slow myopia progression currently exist, they are often suboptimal. To address these limitations, a novel treatment [confidential information withheld] is being developed at Amsterdam UMC to more effectively arrest myopia progression.

Given the novelty of this procedure, only makeshift instruments have been produced and used to date. This thesis focuses on the design of a scalable, safe, and effective instrument to perform this novel treatment.

A prototype was developed to facilitate further development of the treatment by supporting ex-vivo testing. Considerations, including manufacturability, anatomical compatibility, sterilization, and compliance with medical device regulations, have been integrated into the design process. The final concept provides a feasible instrument design that minimizes the need for modifications during transition to series production, ensuring scalability as the treatment advances toward clinical application.

Dressings like mayonnaise can be stored in different ways. A popular way is in a rigid plastic bottle made from PET with a PP closure. This packaging can be designed top-up (the closure is on top of the bottle) or top-down (the bottle stands on the closure). The top-down rigid plastic packaging is the most used by Unilever for their dressings. This top-down configuration has an iconic closure, Figure 2. Figure 2. The Original closure The original closure has a unique aesthetic of a tapered design towards the nozzle. Besides helping the product move more easily towards the opening, this design also helps the user aim the mayonnaise onto the plate. The closure has a silicone valve to create controlled dosing and maintain cleanness inside the closure after dosing. Ensuring this dosing experience is vital to Unilever and Unilever brands. This silicone valve fits into a PP insert, which then is inserted into the closure, Figure 3. Figure 3. The silicone valve and PP insert that goes into the closure. Despite the advantages described above, the downside of this closure is the silicone valve inside. With the upcoming Packaging and Packaging Waste Regulation (PPWR) changes in 2030 and the new legislation in France, the silicone material of the valve is no longer recognized as a recyclable material. The current closure is not recyclable according to the new PPWR legislation. A solution for the original closure is thus required. 7 This is why this new closure is developed, Figure 4. A valveless closure in line with the upcoming legislation and ensures the desired dosing experience. Figure 4. The newly designed valveless closure This newly developed closure consists of multiple features to create the so-called experience. The orifice of the closure is re-designed, to create ease of dosing, and the lid is designed to ensure a leakproof closure. This newly designed closure as a replacer for the original closure is more sustainable since it is a mono-material closure, which enhances recyclability.

This graduation project focuses on the problem of solid waste, specifically passenger waste at Schiphol Airport. The project aimed to enhance passenger separation behaviour to reduce the amount of residual waste that would be incinerated.

The project began by exploring the FF3 bin's context, including its attributes, pilot tests, waste mapping, and user ecosystem. Design conclusions were drawn to align bin elements with Dutch recycling standards, enhance signage visibility, accommodate waste types, prioritize separation, and consider user perspectives. Insights were gained through stakeholder interviews, observations, and engagements with relevant organizations like airports and bin manufacturers. Design adjustments included organic waste separation, cultural diversity accommodation, and communication enhancement. Behavioural analysis using the FOGG model led to strategies for improved separation ability and motivation, accounting for cultural differences. These conclusions formed the problem statement, which could be translated into a roadmap. The roadmap guides actions to enhance waste separation ability and motivation. The iterative design process utilized this foundation, leading to the 'Time To Waste' proposal integrating an FF3 bin skin, campaign, and projectors. This project offered Schiphol insights into how to tackle its zero waste and circular goals, along with a strategic plan for others to achieve similar objectives.

Pregnancy tests are the most used diagnostic test in the world where the market is expected to be worth $1.5 Billion. However, since its introduction to the market in 1976, it has experienced limited innovation. Despite its importance in providing crucial information about a significant life event, women continue to rely on outdated and limited options. The existing tests are often expensive or of poor quality, and their single-use nature fails to address the diverse need for sustainable practices. This gap in the market arises from a reluctance among established players to disrupt their stable revenue streams and a lack of investment in female health.
This master thesis intends to present a comprehensive investigation into enhancing the user experience of pregnancy detection and attempting to enhance its overall experience for its intended and unintended users. The project aims to address the limitations of existing single-use pregnancy tests and present an alternative option which would fit the current and future scenarios.
Given the costs associated with essential feminine hygiene products, such as sanitary pads, tampons, and other menstrual care items, as well as fertility products including contraceptives and potential expenses related to fertility treatments, women face a considerable financial burden that accumulates over time.
SureSign aims to disrupt the testing experience for women, providing them with a clear and user-friendly solution while trying to minimize the financial barrier associated with repeated testing. By offering an affordable and inclusive testing option, the product intends to empower women to make informed decisions about their reproductive journey. It envisions a future where women can test multiple times without worrying about the financial implications and sustainability impact, enabling them to confidently navigate their next steps based on accurate and reliable results.
The thesis is carried out in collaboration with Pharmista Technologies. Their role in this master thesis extends to providing initial market insights and to provide expertise in the technology behind potentially making the testing process sustainable - by making it reusable. They provide their existing knowledge about a patent sensor they develop, which in theory allows one to take multiple tests from a singular device. Their goal is to make this action of reusability take place at least 10 times.
The project is divided in two main phases: the research phase of the current scenario and subsequently a development phase for the future scenario. The research phase involves conducting user interviews to gain insights into user needs and challenges related to pregnancy tests. This phase also establishes if the requirement of reusable test actually exists. The project then delves into the embodiment phase which involves form factors related to the overall product experience. Drawing from the gathered insights, a user feedback oriented design process is employed to develop prototypes of the new pregnancy test, considering factors such as usability, accuracy, and ergonomics. The prototypes are evaluated through user testing, allowing for continuous loops of refinement.

The outcome of this master's thesis aims to not only push the field of pregnancy detection forward but also forge a significant stride towards sustainability within the femtech industry. This will be realized through the presentation of fresh perspectives aimed at enhancing the user experience, need for accuracy, and dependability of these devices. The findings will provide valuable recommendations for design refinements and the eventual market launch of this product for Pharmista. This holds the promise of uplifting the experiences of couples navigating their fertility path and women embracing sustainable approaches throughout their reproductive journey.

Our society is becoming increasingly aware of the necessity of inclusion. However, some individuals are frequently not heard or understood and, therefore, not (yet) included in design projects and designs. Designing inclusively requires a good understanding of the abilities and experiences of a diverse group of people to strive for an inclusive design. This can be achieved when designers partner up with people while considering the full range of human diversity to design for their desired participation in society. Including these individuals in the design process will benefit a much broader audience.

For this project, I researched the context of Inclusive Design activities by Industrial Design Engineering students at Delft Technical University. I studied the perspectives of students regarding their experiences with Inclusive Design projects. Findings reveal that students do not experience Inclusive Design as a learning process. They are afraid to make mistakes and mainly work towards the final design. Additionally, students experience barriers to starting Inclusive Design activities, such as their insecurities, uncertainties, moral aspects, time pressure, and high expectations. To break down these barriers, students express the need for support and information that they can directly apply to feel better prepared for the activities because they would like to work from existing knowledge rather than explore and discover it themselves. While there are tools to support Inclusive Design projects, they do not consist of fixed, predetermined steps that can be followed, which means they cannot be applied literally, and require students to experiment.

To allow students to explore Inclusive Design activities, a safe learning environment has to be created to reduce the barriers. This should ensure that each team member feels safe, supported and comfortable exploring during an Inclusive Design project.

The project’s research and design activities resulted in the co-design of a refocusing of the Master elective Inclusive Design. During my graduation project, an edition of the Inclusive Design elective ran in which several interventions were implemented based on my project findings. These interventions aim to break down barriers to exploring Inclusive Design (activities) by establishing a safe learning environment for students. Additionally, I designed a workbook for students that bundles and serves as a tool to lower the barrier. The workbook provides reflective exercises for students to process information throughout an Inclusive Design project iteratively.

Ankle osteoarthritis (AOA) or degenerative joint disease (DJD ) of the ankle, is a progressive condition characteristic by the thinning of cartilage between the tibia and talus bone. Eventually, this leads to complete ankle joint loss. When looking at surgical treatments, joint sacrificing treatments are the golden standard. Young active people with end-stage AOA find these treatments scary and often want to preserve their joint and ankle motion as long as possible. Therefore, they are postponing these surgical treatments and retain the painful symptoms that accompany AOA.

It is believed that ankle distraction arthroplasty is an alternative, joint sparing treatment. This technique uses an external frame to mechanically unload the ankle joint to support the regenerative capacity of the body to restore cartilage. This frame is fixed to pins in the tibia and talus. The current devices limit joint movements and restrict the surgeon in their pin placement, which results in a painful stiff joint during the treatment period. Furthermore, these devices do not always fit the patient properly. Therefore, the goal is to develop a personalized hinged ankle distractor that allows for ankle movement. This will be a new alternative treatment for young active people with end-stage AOA.

The developed ankle distractor is an external fixator that will be adjusted to the placement of the pins, allowing the orthopaedic surgeon for better pin placement. The pins are placed using a drilling and alignment guide. After this surgery, a CT-scan is made to determine the pin placement and the rotation axis of the patient which are both incorporated within the device. A combination of the distraction device and tibia and talus clamps will be placed at each side of the lower leg to allow for symmetrical distraction. This design results in semi-personalized distraction device that allows for walking with optimized patient comfort while maintaining a partially reusable system.
 

This research aims to explore the experiences and needs of social support after the teenager’s parental loss within the secondary school environment and proposes a design intervention.

Teenagers perceive grief more intensely compared to younger ages and adults since it aligns with the rapid transitions of their adolescence. In this vulnerable stage it is important to invest in support to prevent negative consequences on their mental health in the long term. Research stresses the importance of social support for the adaptation of bereavement. Considering the social support, schools are crucial organizations, since teenagers spend a large amount of time there.

The current state
In general, teenagers want to be seen, heard, and acknowledged in their loss. At the same time, they do want to be treated the same as their peers. These ambiguous needs make providing support from the school environment complex. Additionally, the community members, such as teachers and peers, often encounter a lack of experience and knowledge in offering social support.

This research identified that the lack of a protocol or uniform plan results in each teenager perceiving different levels of social support. Also, the experienced support decreases over time, even though their desire for support remains.
Bereaved teenagers often rely on chance encounters with individuals within the educational system, such as mentors, teachers, or peers, to determine whether their desired social support needs will be met. Some teenagers do experience a lack in receiving social support, and feelings may arise that there is no space for grieving in the school environment.

The need
Therefore, teachers, peers, and bereaved teenagers need empowerment to initiate and maintain the social support. A design intervention should provide clear pathways to highlight opportunities for support and offer guidance in having supportive interactions.

The design focus
The primary focus of the design is to offer tools to community health workers in order to enhance the social support network in school. This involves facilitating opportunities for bereaved teenagers to easily connect within the school with preferred school staff, the natural helpers. Natural helpers are members of a community to whom other network members naturally turn to for advice, support and other types of aid. The natural helper has thereby their own support from other community health workers within the school, the school social workers, empowering them to offer support.

The design
As a result of the design process, the card set called Handreiking Rouw was developed. The toolbox, provided to the teenager by the school after the loss of a parent, contains a variety of cards presenting feelings, needs, experiences, and suggestions.

Handreiking makes it easier for bereaved teenagers to communicate with natural helpers by providing them with low-key options to get in touch with particular staff members. The toolkit also provides schools with a consistent approach to support bereaved teenagers. This involves providing mentors with instructions on how to welcome these teenagers, enabling teachers to have an empathic understanding of parental loss, and establishing a support network within the school for natural helpers that enables them to provide support to bereaved teenagers.

An extensive evaluation with the involved stakeholders and experts with different backgrounds showed the potential of the design for enhancing social support within the school environment. However, future research is required to evaluate the effectiveness of enhancing social support.

This master thesis described the embodiment design process of a new full-range directional hi-fi loudspeaker using a cardioid radiation pattern for Dutch & Dutch. Directional speakers minimize room boundary reflections to ensure the listener listens only to the direct sound waves coming from the speaker instead of also listening to the non-direct sound waves that come from reflections against the wall, floor, and ceiling. Dutch & Dutch current 8c-speaker implement a directional cardioid radiation pattern for frequencies above 100Hz. However, as the human hearing goes to as low as 20Hz, a new concept was developed to accommodate a full-range cardioid radiation pattern.

An analysis of the company and its portfolio, sound acoustics, the target group, and design language is presented. The analysis provided guidelines to start the embodiment design, which focuses on aesthetics, materialization, production, and assembly. Experts on these different topics were consulted to provide expertise-feedback and evaluation of the designed solutions. Multiple prototypes were made for evaluation and communication purposes. The final design proposition beholds an embodied concept, including acoustical concept, aesthetical design, and materialization of a full-range directional high-end hi-fi loudspeaker reflecting the values of Dutch & Dutch.

The kato katz method was, and still is, an invaluable tool to diagnose schistosomiasis mansoni en masse in high and medium intensity infection areas that are economically backward. Due to the current sensitivity capabilities of 24 EPG, the standard kato katz method is unable to diagnose very low intensity infections. And even though alternatives are sought, none are as affordable, cost-effective and easy to use as kato katz in the context of LMICs.
As the goals of the world health organization shift from disease mapping and treatment, to post treatment surveillance and eradication of S. Mansoni, more sensitive means of egg detection are necessary. The lack of a cost effective diagnostic tool will mean a rebound in the prevalence and intensity of infection, as medication cannot be given without a diagnosis. An accurate, cost effective, and easy to use method such as the currently used kato katz thus becomes a necessity. In this light, it was thought to be prudent to explore the idea of improving the kato katz process itself, in terms of sensitivity, ease of use and sustainability.
The context of this project was strictly limited to the sample preparation process only, and the seven steps recomended by WHO were classified into filtration and smearing phases. Three concepts were generated for each phase, and evaluated relatively using the harris profile. The template filter and the draw down smearing method were chosen to be the most desirable, and were finalized for prototyping and evaluation.
Material selection was based on their ability to withstand multiple cycles of cleaning using water and regular soap. Silicone strips with a stainless steel mesh insert and PLA for draw down smearer were chosen for their resistance to soap as well as economical value. Preliminary testing with synthetic feces showed that silicone strips were too flexible during the filtration process and did not allow for consistent deposit of fecal sample onto the glass slide. Hence the material was changed to a more rigid polycarbonate.
The components were taken to Nigeria to be tested on field by one of the stakeholders, Mr. Prosper Oyibo. He let two experienced lab technicians test the components using actual feces, and took notes of their feedback, based on a questionnaire prepared before hand. Overall, the lab technicians found the improved kato katz method to have potential for on field use, given that a certain amount of changes were made, such as reduction in the amount of fecal sample, and changing the template so that feces do not collect at the corners. It may be concluded that with certain steps taken in the future, the improved kato katz method will certainly be useful.

The industry devoted to keeping us healthy is also one of the largest contributors to climate change: one of the greatest threats to our well-being. Medical devices and services are often designed in and for high-income countries. However, they are also used in low- and middle-income countries. Due to this mismatch of context, they are often not functioning properly in these emerging markets. This results in a lack of proper healthcare and a large (e-)waste problem in countries where the majority of the world’s population resides. This aforementioned situation asks for the next generation of medical practices: innovations targeting the large global need for healthcare. This thesis explores the three design domains Medical, Inclusive, and Circular Design simultaneously for the first time. The answer to the stated research question is found through an extensive exploratory literature review, many low- and high-fidelity prototypes, interviews, and test sessions. An iterative design process led to (1) creating a theoretical model that provides a structured, understandable, and descriptive design journey, and (2) a physical toolkit to offer a low-barrier, engaging and memorable usage of this model. The final concept is the COEVOLVE toolkit which includes the COEVOLVE approach. This approach provides grip on the process of redesigning a medical practice more inclusive and circular. The intrinsic value of a medical device/service increases by being beneficial to the planet and being prosperous to people. Likewise, the concept encourages designers in education to change their mindsets to tackle our future challenges. The developed theoretical model provides design students with a design process fulfilling their ambition to have an impact. It aids in exploring the different perspectives needed, creating awareness of the life cycle of a medical device/service, and finding opportunities that emerge to improve its circularity and inclusivity. Likewise, the model facilitates the exploration of trade-offs necessary to design a more inclusive and circular medical device/service, for a specific context of use. The model was tested by facilitating two workshops with design students which confirmed the impact of the model. However, the participants of the workshop also expressed that simultaneously addressing the three design domains is perceived as overwhelming. Hence, its usage needs to be as understandable as possible and, to effectuate the mindset, memorable as well. Thus, the model was transformed into the COEVOLVE toolkit. This toolkit provides the next generation designers with a fun and collaborative way to engage with the complexity and uncertainty of designing medical practices more inclusive and circular. The toolkit consists of an understandable and engaging Design Guide and a series of canvases. Furthermore, it includes Inclusivity and Circularity Card Decks, which encourage new ideas in a homogeneously thinking group, and a Circled Map, a physical experience resembling the complexity of the COEVOLVE approach. The COEVOLVE toolkit, developed for modular usage globally, encourages dialogue and discussion. Multiple evaluation activities with design students and experts were conducted, and the outcome was clear: the impact of the model and the toolkit on its users can be guaranteed.

In Low-to-Middle-Income Countries more than 95% of the medical equipment are devices donated by NGOs, usually second hand, refurbished devices from High Income Country Hospitals. However, the lack of consumables and spare parts and infrastructural limitations lead to 70% of that equipment not working, or working improperly shortly after being received. The surgical suction pump at Masanga Hospital is such an example. The use of the suction pump is hindered by: • Lack of consumables and appropriate tubing, leading to a mismatch between the different components • Frequent power shortages Therefore, the goals defined for the project together with the client were to • Solve the dimensional mismatch between the medical consumables and • power the device independently from the Hospital’s solar grid by leveraging locally available resources and manufacturing opportunities. Discover, Define, Freeze The project was started with a profound analysis of the principles of suction at a HIC hospital, followed by the use and function of suction at Masanga, to better understand the current challenge and Masanga and the envisioned use of the suction pump that the design solutions should achieve. The research on suction was followed by an extensive contextual analysis. where the gathered insights helped understand the factors that influence the current situation, as well as limitations and opportunities were The findings were transformed into a List of Requirements and principal design solutions. Executive Summary Develop Various iterations, more than 50 prototypes and an extensive testing protocol were made to achieve the following goals: • To locally 3D print reusable medical tubing connectors, independently from Masanga’s current supply chain and • To make a conceptual plan for building a portable power-pack based on a 12V car battery as the power source to power the suction pump during power shortages Final Deliverables • A tested method of 3D printing reusable medical tubing connectors using PETG filament The connectors were developed through 1. Embodiment Design, 2. Design for Manufacturing and 3. Material choice. The final concept was validated on a TRL level 6. • A detailed concept plan for building a portable power- pack based on a 12V car battery with locally sourced components Conclusion The final validation phase and usability testing showed that the proposed solutions would improve the use of the suction pump, while promoting local manufacturing of spare parts and using common locally popular solutions. Both design solutions however still need to undergo testing in the context before applying them.