Innovation isn't always about adding more features, but meeting user needs.

This insight guided the development of the updated Moyo, our fetal heart rate monitor designed to support labor management through clearer information, better usability, and improved support during clinical decision-making.

Building on the features of the original device, the updated Moyo uses Doppler ultrasound technology to support both intermittent and continuous fetal heart rate monitoring during labor. It’s designed to help healthcare professionals make timely, informed decisions, especially in low-resource settings where reliable monitoring can impact the survival of mothers and babies.

But before we could improve the product, we first needed to understand how it was really being used.

Looking Beyond the Technology

Through in-depth discussions with healthcare workers and observing the use of the device, one theme surfaced repeatedly: trust.

Not trust in the technology itself, but trust in the information it provides. In order to accommodate users with limited clinical and technical experience, the original Moyo had been modified and simplified. However, we learned that this compromised some of the usability of the device and the perception of its capabilities, leading to confusion and less trust with the end-users. This insight was an eye-opener and changed the direction of the project.

Rather than asking what new features we could introduce, we stepped back to understand how clinicians interpreted the information on the screen and how that influenced their decisions during labor management.

When Simplicity Becomes Too Simple

Medical devices have a difficult job. They need to present complex clinical information in a way that's quick and easy to understand for the users, especially in busy environments where every second counts.

As we spent more time with users, it became clear that there were opportunities to make that experience even better. We wanted to keep the interface simple, while making sure it still gave the health workers the context they needed to support their own clinical judgement.

One example was how some visual elements on the screen were being interpreted. Originally, they were designed to provide quick reassurance using a traffic light reference with green meaning proceed as expected, yellow meaning proceed with caution and minor interventions, and red meaning this is a critical case that requires immediate action.

We realized it was needed to display the status of the whole progress of labor, rather than indicating the status of the fetal heart rate, which is only one part of a broader clinical assessment. We also looked closely at how we presented fetal and maternal heart rates.

From data we collected and analyzed over 10 years, we saw that Doppler monitoring can occasionally detect the mother's heart rate instead of the baby's. We identified this as an opportunity to highlight that distinction for the user.

For me, that was one of the biggest takeaways from the project. Technology wasn't the challenge. It was about helping people understand the information more intuitively. By refining the way the device communicates, we could support clinicians using Moyo with greater confidence and consistency.

Listening to Different Perspectives

One of the most valuable parts of the project was spending time with the people who rely on Moyo every day.

While we were testing concepts, we saw that midwives often valued more guidance and the straightforward interface because it supported quick decisions in busy clinical environments. Doctors, on the other hand, expressed concerns that overreliance on the device without enough consideration of the broader clinical picture could be a risk. Those perspectives reflect different responsibilities rather than conflicting opinions. Our challenge as designers was to create an experience that supported both groups while reducing opportunities for misunderstanding.

Designing for Better Decisions

The design process focused on improving clarity rather than adding complexity. Some of the most important changes were intentionally subtle.

We removed color coding from numerical values to reduce the risk of overinterpreting individual readings. Data from the use of Moyo enabled us to represent the distinction between maternal and fetal heart rate more clearly, guided by alarms that alert users when maternal heart rate is being monitored instead of fetal heart rate. When signal quality is poor, the interface now guides users towards appropriate next steps instead of leaving uncertainty unexplained.

We tested providing more guidance, adding suggested actions to be taken, but realized this could cause too much dependency. We realized our focus should instead be increasing efficiency to free up time for midwives to care for mothers.

So, we removed embedded clinical advice. The goal was never to replace professional judgement, but to help clinicians use the device correctly and consistently. One new feature we added was the continuous display of both the instantaneous fetal heart rate and the baseline heart rate. The baseline provides an important reference for comparing changes over time and supports more consistent clinical assessment.

Improvements in Practice

The updated Moyo introduces several improvements driven directly by user feedback and observations from clinical environments.

A larger, high-resolution display makes information easier to interpret at a glance. Clinicians can now review up to two hours of monitoring history, compared with 30 minutes on the previous generation, providing greater context when assessing labor progression.

The device has also been designed for the realities of busy maternity wards, with an IP55 rating for water and dust protection, USB-C charging, an improved transducer design, and adjustable Doppler audio volume to suit different clinical environments.

Individually, many of these improvements seem small, but together they make the device more intuitive, durable, and dependable in everyday use.

Designing Around Real Clinical Work

Our process was deliberately iterative. Early concepts began as simple physical mock-ups – sometimes nothing more than a cardboard model paired with a phone interface – before evolving into increasingly refined physical and digital prototypes.

Each iteration was tested with clinicians, documented thoroughly, and refined based on what we learned. Throughout the project, every design decision had to balance usability, technical capability, and clinical guidelines.

Supporting Safer Births

The updated Moyo is more than a standalone product. It is a key clinical innovation within the Safer Births Bundle of Care (SBBC), an evidence-based program that combines clinical innovations, simulation-based training, continuous quality improvement, and sustainability initiatives to improve the quality of care for mothers and newborns around the time of birth.

Within the program, Moyo allows for fast and reliable fetal heart rate monitoring, helping healthcare professionals identify babies at risk earlier and enabling a more timely response when intervention is needed.

Progress That Builds Confidence

This project reinforced an important lesson for me: Innovation isn't measured by the number of features you add. It's measured by whether people can use a product correctly, confidently, and consistently when it matters most.

By listening to healthcare workers, testing with users, and refining small details, we strengthened guidance, reduced opportunities for misuse, and improved clarity without adding unnecessary complexity.

The result is an updated Moyo that builds on the strengths of the original while offering a more intuitive user experience, greater durability, and better support for clinical decision-making.

Developed and field-tested with partners in Tanzania, the name “Moyo” means “heart” in Swahili. It can also be used metaphorically, as in, “He put his moyo into this project.”

And I can certainly say that I did.

Because ultimately, the best innovation isn't about doing more.

It's about helping people do better.