In India a woman dies during childbirth every 8 minutes with a majority of these deaths occurring in remote and rural communities. A significant proportion of these deaths occur in Assam a state defined by ethnic conflict, economic underdevelopment and a huge body of untamed water in the Brahmaputra. The state in India, which leads the world in having the highest number of maternal deaths (defined as maternal mortality ratio – MMR), has a public health focus upon reducing maternal deaths through programmes within the National Rural Health Mission. While maternal-death is decidedly a medical and, in remote communities, a public health issue there are location on this planet that frustrate both the government and the medical profession as a purely medical solution fails to solve the problem of maternal deaths effectively. The Fifth Goal Project, a design project focussed upon product service systems in remote rural contexts in Assam, privileges provider plurality and the sustainability of health eco-system to construct a campaign project in the maternal health space. The paper describes the project programme and the process of visualisation of new cultural practices and of the development of new artefacts embedded in new or old cultural practices.