Human-centered design for global health equity

Abstract

As digital technologies play a growing role in healthcare, human-centered design is gaining traction in global health. Amid concern that this trend offers little more than buzzwords, our paper clarifies how human-centered design matters for global health equity. First, we contextualize how the design discipline differs from conventional approaches to research and innovation in global health, by emphasizing craft skills and iterative methods that reframe the relationship between design and implementation. Second, while there is no definitive agreement about what the 'human' part means, it often implies stakeholder participation, augmenting human skills, and attention to human values. Finally, we consider the practical relevance of human-centered design by reflecting on our experiences accompanying health workers through over seventy digital health initiatives. In light of this material, we describe human-centered design as a flexible yet disciplined approach to innovation that prioritizes people's needs and concrete experiences in the design of complex systems.

Keywords: Digital health; ICT4D; co-design; design thinking; eHealth; global health equity; human-centered design; implementation research; mHealth; participatory design; user-centered design.

Figure 1.

Two visuals of the design process.

Figure 2.

Sketch of an SMS-enabled antenatal care intervention. In this example mockup of the workflow or mechanism of action for an antenatal care (ANC) intervention, (1) a CHW registers a pregnant woman via SMS; (2) software installed at a hospital automatically creates a schedule of appropriately-spaced ANC visits and sends the CHW personalized notifications before each appointment; (3) the CHW re-visits the household to refer the woman for ANC; (4) typically the pregnant woman visits clinic; (5) the CHW follows up a few days later and (6) sends an SMS to confirm that the appointment was attended. If no SMS confirmation is received, the CHW's manager (the CHEW) is automatically notified. Partners often find such workflow sketches more participatory and accessible to input (especially across language, culture, and power barriers) than technical product specifications or detailed written/verbal descriptions alone. New projects involve many variations of such sketches as designs for technology and service delivery co-evolve.

Figure 3.

A Medic Mobile designer in Nepal using participatory design cards.