Exploring Subsets of Design

Human-centered design (HCD) continues to evolve as a methodology as designers continue to develop their own practices and think critically about the value and role of design in the context of health programming. Speakers from Dalberg Design (Kenya), Noora Health (India), and ThinkPlace (Singapore) joined us for a webinar on April 30, 2024 to speak about the diverse subsets of design they use to achieve the best experiences for their program participants. This rich discussion provided  perspectives on re-imagining community-centered design(CCD), the use of service design for participants and internal learning, facilitation approaches to ensure that both facilitators and participants are equipped for design activities, and co-creation with governments. 

Read on for a summary of the key points, and don’t forget to watch the recording for the full experience.

Community-Centered Design (CCD)

The speakers from Dalberg defined HCD as an interdisciplinary problem-solving and facilitation methodology that engages stakeholders across a system, with the objective to help people design products, services, programs, policies, and strategies for positive social impact. This is a methodology they have been employing for the last ten years. When the COVID-19 pandemic forced their team into remote design research, they used it as an opportunity to ask questions about how to better engage members of the community in their approach to design. They started integrating local researchers in their projects, exploring tools like WhatsApp to facilitate extended conversations over a longer period of time.

The Dalberg team recognized that while HCD provides a strong problem-solving framework,  power is still being held by the donors and the designers working on behalf of the people, and that communities are still largely being engaged as research subjects. This led them to explore ways to address power and equity challenges within their work.

Envisioning Community-Centered Design 

In an exercise to envision the future of equity-centered community design, and an understanding of the work that Dalberg and the larger design community would need to do in order to achieve this future – including the understanding that designers will need to embrace humility in learning through this process of ‘undesigning design’ – a re-imagined definition of CCD was curated as a north star to guide Dalberg’s practice:

Community-centered design prioritizes the active involvement of community members in all stages of the design, development and implementation process of solutions that directly affect their lives. This approach inverts the needs-based approach and focuses on the assets that a community already has. CCD fosters connection and collaboration between community members, local organizations, and institutions, and design skills and capabilities are shared with the community.

The pursuit of genuine CCD has challenged Dalberg to evolve their practices in five key ways:

• For designers to embrace dialogue and introspection to recognize biases and power imbalances. This involves a team culture that is intentional about the role of the designer and how personal perspectives influence work.

• Identifying and establishing community advisory councils to inform and advise the project team. These councils are made up of experts and community members to provide diverse insights, expertise, and richer contextual understanding within a project, and ensure that the community can influence project direction and outcomes.

• Developing ethical incentive models in collaboration with community partners to ensure equity and fairness. These incentives need to be valuable while not perpetuating power imbalances between researchers and community members. 

• Transferring ownership to communities to run the research post-capacity embedding. This involves knowledge-sharing, shadowing, and conducting research in parallel so that the activities and responsibilities can be owned and sustained by communities. 

• Sharing back research insights to increase transparency and build trust with communities. This involves ongoing dialogue to ensure community members can validate the findings and insights and can see how their contributions have shaped the work to create a shared sense of ownership.

Service Design

The Noora Health team have a unique perspective on service design as they apply it both to their health programs to equip families as care-givers, and their internal team to create a seamless experience with their delivery teams.

They define service design as;

An approach that applies human-centered design principles in order to design services, experiences and programs in particular, to advance care practices. It guides the process to co-create cohesive, seamless experiences for patients, caregivers, healthcare workers and internal delivery teams, by regularly learning and understanding their needs.

Service design is particularly appropriate for the type of programming that they do because of the multiple points of interaction that people have within health systems. Service design helps to think about an entire experience holistically, connecting the dots between touchpoints, rather than approaching touchpoints separately. It helps to break down the complexity of the big picture and ensure that a human-centered lens is consistently being applied.

Service Design Methods Across the Design Phases:

Design Research & Needs Finding

• Service Safaris help designers to understand pre-existing services offered at facilities that can help direct new program design or to iterate on existing services by stepping into the experiences of users directly
• Generative Techniques are used to identify core challenges and understand the needs of users through verbal and visual prompts while putting participants at ease through a more playful or less formal approach
• Co-creation engage participants to develop solution ideas that are desirable and viable, and are especially useful when the design direction has been well defined
• Research Blueprints are inspired by service blueprints and help to structure user sessions to ensure that all spaces, materials, risk mitigation and troubleshooting has been considered and is prepared for 

Mapping & Touchpoint Design

• Journey Mapping Workshops help to map out the touchpoints of users to help visualize their experiences and prioritize where their needs can be better met
• Design for Constraints is a mindset adopted in service design to ensure that solutions are inclusive and accessible to the participants who need the service regardless of their constraints and contexts

User Experiences & Opportunities

• Zooming into the Intervention(s) and specific touchpoints because, while service design looks at the system level, it is important to go into the details to ensure that all experiences are consistent and user-friendly once the big picture is designed for
• Community-Centered Design approaches ensure that the solutions are based on the needs and visions of stakeholders

Service Communication

• Service Walkthroughs simulate the actual experience of a service through the creation and testing of high-fidelity tools and prototypes

• Building Out Toolkits that define use cases by mapping out the different interventions against the needs of each persona or user type. These can be used as building blocks for interventions. 

Sensitive Facilitation

The ThinkPlace Singapore team has recently consolidated their learnings from engagements with vulnerable communities into a framework for conducting sensitive facilitation. This is a subset of HCD that focuses on creating safe spaces for dialogue on sensitive topics, particularly when working with vulnerable or underprivileged populations.

Sensitive facilitation is a method to make conversations easier, while actually considering the individual’s emotional baggage and past traumas. It is the planning and executing of empathy-driven discussions that build trust, and enable conversations about a certain topic with inputs from participants.

This method aims to equip designers, researchers and facilitators to navigate complex conversations with empathy, prioritizing dignity and empowering participation. It removes exclusion and gives voice to communities to shape their own futures.

Sensitive Facilitation Framework

This framework puts equal emphasis on planning (intentional phase) and post-session reflection, (reflection phase), as it does on the actual execution of the session. In preparation, important things to consider include the right environment, planning the house rules, deeply understanding the topic by engaging experts, assigning the right facilitators for the topic – and acknowledging that facilitators may have their own triggers as well – and designing the right activities to get the right response from the participants. After a session, time should be taken to reflect again with experts, unpack the conversation with the team, and also check in on the wellbeing of the facilitators.

Co-Creation with Government

The ThinkPlace Singapore team highlighted their experience of co-creating with government agencies, officials and industry partners to develop policies and solutions to address societal challenges.

Co-creation with the government requires intentional building of trust between the government agencies and citizens. The approach seeks to empower and include all stakeholders early on in the process and give them a stake in the decisions that shape their lives. Within this context, there is also a focus on innovation, and bringing together diverse perspectives to fuel creativity.

This work follows the HCD process with an added layer of complexity to ensure that the needs of the users are balanced with those of the political office holders. The team was successful in achieving this by creating spaces that ensured inclusive and representative outcomes for all stakeholders, including end-users, decision-makers, and subject matter experts.

HCD and the design subsets covered in this summary can be used together in different ways, highlighting relevant aspects of each methodology where necessary. These approaches share common themes of centering the needs and perspectives of program participants, and engaging them in co-designing solutions. However, as our practice continues to evolve, especially within the social sector and in public health, centering communities as partners more intentionally and empathetically within the process can help to have more equitable, effective, and sustainable solutions that solve some of society’s most pressing challenges.

Key Links

• Webinar recording
• Slide deck
• Stay up to date on the work of the speakers:
  • Dalberg Design
  • Noora Health (and check out the guest authored blog they wrote for the HCDExchange on putting together a design team)
  • ThinkPlace Singapore