Opt me in: the process of organ donation

Sayali Bharambe
Service Design Case Studies
4 min readJul 28, 2020


The project resulted in a new onboarding journey co-developed with users and field experts

How might we increase organ pledging rates and improve the donor conversion rates in Maharashtra?

This was the design question we wanted to address through this project in collaboration with a local NGO.

The project highlighted the importance of family discussions, awareness and myth-busting by co-creating and designing a new service to trigger open-table after-death discussions.


Research Objectives and methods used to collect insights

The project was based on service design methodology and focussed on understanding main citizen motivations for opting in for the cause. Therefore, it was important to utilize conjoining methodologies based on empathy. Both desk research and in-field research were used to gain a deep understanding of the overall organ donation scenario in Maharashtra. Co-creation and participatory design methods were utilized to develop the solution together with the users and stakeholders. Quantitative research was conducted with the help of General physicians where the doctors spoke with 280 participants. For the in-depth interviews, 27 individuals were interviewed to gain specific insights about the topics discovered in quantitative results.

Each interview was a loop in itself, framing the questions for the next interviewee. The insights clubbed with observations and shadowing helped us trace the actual user journey and see the processes firsthand.

Insights from the interviews were listed down in the form of the post-its and then clustered to see patterns.

The Concept:

The service designed could be described as a “first encounter provider”, that is, it would create the right conditions to foster ice-breaking meetings between family and friends to lead the discussions of organ donations. A well-structured and coordinated system, aimed at providing people with a platform to think and ask questions regarding the cause whenever and wherever they are.

The concept revolved around the question: why would the donor carry an additional donor card with him always, how about hacking the existing touchpoint to create the same impact?

We started listing down all the mandatory documents used in India, and the list went on and on. We were arguing between the two most common identification documents used, Driver’s license and the Aadhar Card. But using a mandatory document application process as an organ registry application would take a long time to implement, so as part of our pilot version of the concept we decided to settle for a donor sticker which can be placed on your ID document easily.

A research performed by Thaler and Sunstein shows that once someone makes a conscious social choice or stand, they encounter pressures to keep that behaviour going. Taking the decision and making it public increases the chances of the person sticking to it, thus making it pro-social. Having these stickers on the ID card will act as the social stand for the pledges and thus they are likely to stick to their decision. This will also act as a discussion starter at social/ personal gatherings, which in turn would encourage other people in the group to think of the cause or even pledge their organs.

Pilot and impact:

Through the collective research, a proposal for 24x7 helpline number dedicated to the organ donation issues (989 9898 667) was presented to the State government of India by the NGO, the same was approved and the call centre went live in Dec 2018.

Following the launch, counselling protocols were revisited and re-designed, all the digital and physical touchpoints were updated with key messages and the NGO staff were briefed. Organ donor stickers with a thank you note signed by the NGO Director were to be distributed to all the organ donors, along with a “Discuss your decision with your family” brochure. The call centre assisted with not just emergency calls but also the counselling of family members.

New touchpoints and collaterals have helped to increase the awareness and bust common myths related to organ donations. The donation certificates and the donor stickers which were given to the organ pledgers worked as a conversation starters for family and friends. They resulted in more people from close circles coming on board and pledging for organ donation.

Pilot user journey


This project was a step forward in understanding the organ donation onboarding in the opt-in policy structure. Utilising these research outcomes to go more in-depth and re-design the onboarding journey not just at an NGO level, but also on a higher level would be beneficial for the community as a whole. That being said, changes like these requires joint efforts, scalability, help from government bodies and time to sink in.

To know more about me and my work, visit the website: www.sayalibharambe.com

You can also listen to me talk about the research regarding the organ donation systems here, in a podcast with fellow Service Designer.



Sayali Bharambe
Service Design Case Studies

Empathetic designer. Lazy Illustrator and avid reader. Interested in Social Innovation and Public Sector Innovations.