Optimizing TB Check Tool
Human-centred nudges and inclusive UX to increase TB screening uptake in underserved communities
Project Scope
Improving the completion rate of a national TB self-screening tool delivered via WhatsApp and USSD, and on designing and testing behavioural nudge messaging to encourage high-risk users to follow through with clinic-based TB testing.
Outcome
A refined, more accessible self-assessment experience with reduced friction points, clearer location capture, and structured behavioural nudges that supported early diagnosis and public health referral pathways.
Role
Lead User Experience Designer
The Challenge
From a social and public health perspective, the challenge was not only low TB screening and follow-through but also the misalignment between human behaviour and the way digital health tools are typically designed. Stigma, fear of diagnosis, and economic insecurity made users highly sensitive to tone, language, and perceived risk, yet existing UX patterns often relied on clinical framing, long forms, and linear journeys that assumed trust, literacy, and motivation. For many users, small points of friction such as data costs, confusing interfaces, impersonal messaging, or poorly timed prompts were enough to cause drop-off. The core challenge, therefore, was designing a TB screening experience that felt safe, discreet, culturally attuned, and supportive, while gently nudging users through a complex public-health pathway without increasing anxiety or reinforcing stigma.
The Approach
I led the design of a behaviourally informed, low-friction digital screening experience that balanced public health requirements with empathetic UX to support TB testing and follow-through.
Human-Centred Behavioural Research
Grounded the work in lived realities by examining stigma, fear, economic pressure, and health-seeking behaviour to understand why people disengage from TB screening and follow-up care.
Behavioural UX and Nudge Design
Applied behavioural science principles to design subtle nudges, progressive disclosure, and non-clinical language that reduced anxiety and encouraged completion without coercion.
Low-Friction Digital Journeys
Simplified flows to minimise data usage, cognitive load, and decision fatigue, ensuring the experience worked for users with limited connectivity and digital confidence.
Trust-Led Messaging and Tone
Designed copy, prompts, and visual cues that emphasised privacy, safety, and support, helping users feel in control rather than monitored or judged.
Public Health Alignment and Validation
Ensured the UX journey aligned with TB care pathways and screening protocols, balancing user needs with public-health effectiveness and scalability.
The Solution
The solution combined stigma-sensitive UX, behavioural nudges, and low-data digital design to guide users from self-screening to TB testing in a way that felt safe, supportive, and actionable.
Streamlined the self-assessment journey to reduce cognitive load, data usage, and abandonment across WhatsApp and USSD.
Introduced timely, supportive prompts that addressed fear and uncertainty while encouraging completion and clinic follow-through.
Reframed clinical language into clear, reassuring copy that emphasised privacy, normalisation, and treatability.
Designed messages and decision points that responded to user behaviour and risk level, rather than a one-size-fits-all flow.
Ensured the digital experience connected seamlessly to referral, testing, and care protocols without adding friction for users.
The Evidence
User Testing
I led on-the-ground user testing during live community activations, observing how people interacted with the TBCheck tool in real conditions rather than controlled environments. Through direct interviews and usability observation, I identified a critical friction point in the USSD address input flow, where users struggled with formal address formats, leading to timeouts and drop-offs. These were insights that directly informed a redesign toward simpler, more intuitive location capture aligned with how people naturally describe where they live.
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Improving User Journeys
I redesigned the USSD user journey to reduce cognitive load and prevent unnecessary drop-offs by aligning the flow with how people naturally think and respond under time-constrained conditions. By simplifying location inputs into smaller, meaningful steps and introducing clear exit options, the experience became more forgiving, transparent, and respectful of user agency, improving completion rates while generating clearer insight into where and why users disengaged.
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Adding Behavioural Nudge
I introduced a behavioural nudge by embedding a clear commitment moment within the messaging flow, prompting users to actively choose whether they would get tested. By pairing commitment with immediate positive reinforcement and a low-friction incentive, the intervention leveraged behavioural science to convert intention into action while maintaining a supportive, non-punitive tone for those not yet ready to commit.
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The Impact
While the programme continues to evolve, the work has already delivered measurable structural outcomes:
Higher Conversion to Testing
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Reduced Drop-off Rates
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Faster Time to Action
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Improved Programme Efficiency
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Personal Reflection
Designing for Trust and Action
Working on TBCheck reinforced how small, well-designed behavioural and UX interventions can shift real health outcomes at scale. Seeing users move from hesitation to action through clearer journeys, respectful language, and simple nudges affirmed my belief that public health solutions must meet people where they are, not where systems expect them to be. This project strengthened my commitment to designing with empathy, especially in high-burden contexts where trust, clarity, and dignity are just as critical as the technology itself.
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