Design Thinking in Global Health Systems: Understanding People to Meet Demand

Shaping health systems that effectively meet the needs of people is unfinished business. Global health practitioners still fail to fully understand the people who are expected to benefit from investments in health in low-income settings. The less we understand, the less likely it is that we will design interventions that people want, and importantly, willing to use. Human-centered design (HCD), or design thinking, is an approach that is helping us gain insights into people, their needs, desires, and the practical barriers to seeking care and improving health. As investments and interventions evolve to truly reflect people’s self-defined desires, we expect to build trust in the health system and lasting changes in demand for services, products, and new behaviors.

The desire for skills, techniques, and framing to reorient global health practice toward people is growing. At last year’s Fifth Global Symposium on Health Systems Research in Liverpool, UK, over 40 people crammed into conference room 22 for a satellite session on the use of HCD in global health led by Vikas Dwivedi and Anne LaFond of John Snow, Inc. (JSI), and Olivia Nava and Biruk Tammru from Gobee Group, an HCD firm focused on social impact projects.

Based on a brief poll taken before the session, a sizeable number of the attendees had either heard of HCD or had some level of engagement with the process in their respective fields.  The two-hour skills session was a crash course on the basic tenets, tools, and process of HCD and a demonstration via case-studies of how HCD has been used in global health settings. In a true HCD participatory fashion, most of the session engaged attendees with hands-on exercises that illustrated how the tools can help put them in the shoes of the end-users they work with.

Facilitators highlighted examples that showcase the design process in action, including current and past JSI and Gobee projects. Demonstrating the impact of the design process through concrete cases helped further solidify that this is a new and sometimes unconventional process, but one that yields results suitable for the ultimate end user.

By the end of the session, most participants, representing countries from every corner of the globe, left happy to have been exposed to the material and were very eager to apply some of the lessons and tools to their own work, particularly the journey map tool. Participants also posed questions on next steps – how to synthesize and present findings, and how to avoid getting overwhelmed with data that comes in through this somewhat unfamiliar approach.

While it was impossible to fully address these questions in the short time allotted, the fact that participants were inquisitive about the details of the process was encouraging. It indicates a need for longer forums to allow participants to meaningfully explore questions and to get their hands dirty with experiential practice to see firsthand how design interconnects people, ideas, and collaborative problem-solving. Such learning opportunities that pique the interest of practitioners are necessary first steps toward embracing a demand-driven approach in public health programming and health systems strengthening. Both JSI and Gobee look forward to the work ahead as more stakeholders add and grow HCD in their practice. Gobee will continue to collaborate with public health practitioners, lending its design expertise in research, product and service design, coaching, and conducting specialized design labs. At the same time, JSI will explore new technical areas to incorporate HCD, while investigating and refining how to measure its effectiveness and influence on program design and implementation. 

Written by Anne LaFond and Biruk Tammru