Problem solving

Navigating the challenges of humanitarian-academic collaborations

Image credit: International Committee of the Red Cross/Jacob Zocherman.

In the quest for innovation and progress, partnerships between humanitarian and development organisations (HDOs) and academia have become increasingly common. However, a recent article published in the Proceedings of the National Academy of Sciences (PNAS) sheds light on the practical challenges faced by such collaborations. Authored by Louis Potter — Managing Partner at Outsight — and a group of seasoned innovation practitioners, the article critically analyses the dynamics of partnerships between HDOs and academia, emphasising the need for a more strategic and efficient approach.

Link to the Article: Read the Full Article

Understanding the Landscape

The article delves into the motivations behind collaborations between HDOs and academic institutions. Highlighting the involvement of prominent organizations such as the International Committee of the Red Cross (ICRC) and Doctors Without Borders (MSF), the authors acknowledge the noble intentions of these partnerships—to leverage academic research and scientific expertise to address real-world problems in challenging environments.

Identifying Pain Points

Through a critical analysis informed by workshops and interviews, the authors identify three main categories of pain points along the technology development timeline: resources, deployment strategies, and roles and responsibilities. Each category poses unique challenges that, if not addressed proactively, can hinder the success of collaborative efforts.

  1. Funding and Human Resources:

    • The article emphasizes the importance of securing adequate funding throughout the project duration.

    • Challenges arise from differing expectations between HDOs and academia regarding funding sources and project scopes.

    • A lack of commitment of human resources from both sides hampers the initial stages of project development.

  2. Deployment and Sustainability:

    • The success of a technology is measured by its deployment on a wide scale, yet this remains a rare outcome.

    • The article highlights the lack of profit motivation, leading to neglect in maintenance, improvement, and training for deployed technologies.

    • Questions of self-sustainability and market outreach are critical considerations often overlooked in early project stages.

  3. Roles, Responsibilities, and Expectations:

    • Clear definition of roles and responsibilities is identified as crucial for successful partnerships.

    • The authors argue that the classic academic approach to technology development may not perfectly align with the requirements of HDOs.

    • Expectations play a significant role in determining the success of partnerships, emphasizing the need for transparent communication.

Moving Forward

The authors advocate for a more strategic and informed approach to collaborations between humanitarian and academic sectors. They stress the importance of comprehensive planning, clear communication, and a critical partner selection process. The article concludes by calling for a literacy in technology innovation and development processes within HDOs to ensure a more nuanced understanding of the challenges and opportunities presented by collaborative initiatives.

Conclusion

As we navigate the complex terrain of humanitarian-academic collaborations, the insights provided by this PNAS article serve as a valuable guide. Acknowledging the inherent challenges and proposing solutions, the authors encourage stakeholders to approach partnerships with a strategic mindset, fostering a more efficient and impactful collaboration that addresses real-world challenges in a holistic manner.

Launching drone (UAS) deliveries for health operations: Five learnings from real-world projects

In recent years, Outsight International’s Drone Team has worked with development organisations and national civil aviation agencies (CAAs) across Africa and Asia to advance health solutions using drone technology.

Health supply chains in many developing countries face important challenges, like insufficient cold storage and road infrastructure and in rural areas, fragmented management, safety concerns or limited availability of trained staff. Furthermore, each medical product has its own characteristics, making it difficult to find a solution that works for all items. For example, vaccines require a reliable cold-chain, and have a fairly predictable demand, while blood or anti-venoms have a much harder to predict demand as sudden peaks of demand may occur in any particular location.

Drones – also referred to as uncrewed aerial systems or UAS – can help address some of these supply challenges by quickly reaching remote locations from well-equipped warehouse facilities. There are many experiences of these uses across the world; drones have been used to deliver emergency medical supplies or tests in Malawi, vaccines have been delivered in Vanuatu, and extensive drone delivery networks for blood and other health products on a regular basis have been operating in Rwanda and Ghana for a few years. However, drones are not a magical solution for all health supply issues in any location. In this post, we share five key learnings emerging from our practice:


1. Understand the challenges of the health supply chain

Prior to developing a drone medical delivery system, it is important to understand what works well and what can improve in the existing supply chain of health items. Drones may be suitable to cover some gaps, but not all. A comprehensive supply chain assessment with a systems-thinking lens will avoid common pitfalls derived from a lack of understanding of the ecosystem in which medical transportation happens.


2. Assess the feasibility of drone deliveries

Even if some identified gaps of the health supply could improve by using drones, they may still not be a feasible solution. Drone suitability also depends on many non-health related factors, such as the drone parts supply chain, technical feasibility, maintenance, workforce available, or community engagement. One of the hardest issues to assess in advance are costs and cost-effectiveness of drone operations with respect to alternative means of transportation.


3. Regulation is a key enabler of drone operations

The regulatory environment is an essential factor to analyze when launching any drone program. However, as health deliveries involve relevant risks and operational complexities, regulatory requirements are more strict than other drone use cases.

In recent years many countries have approved regulations that include provisions on how drones can be operated, what authorizations are needed, what uses are forbidden or what are the requirements to prevent harmful uses. For health operations, some relevant rules to consider typically include limitations on cargo drops, weight limits, operations beyond visual line of sight or transportation of dangerous goods.

On the other hand, some countries do not yet have drone regulations in place. In these cases, some governments have allowed certain ad-hoc drone operations, but the lack of legal certainty is an important barrier for the development of the civil drone ecosystem. As the international drone regulatory ecosystem has been maturing, countries that plan to adopt drone regulations may benefit from comparative expertise including International Civil Aviation Organization model regulations, best practices from other countries in their region, or technical assistance from drone policy experts.


4. Procedures and supporting materials are essential to put legislation into practice

Drone regulations are a basic enabler for health operations, but not enough. National civil aviation agencies need complementary procedures that link abstract regulations with day-to-day practices in order to run drone operations safely, securely, and efficiently. Relevant procedures include drone operator registration, drone registration, type certificate acceptance, airworthiness verification or operations manuals.


5. Capacity building facilitates implementation

Capacity building and training of personnel involved in drone projects is essential for a successful implementation of healthcare drone operations. Limited capacity is a common challenge that often introduces significant delays and higher risks in operations.

To support local capacity, ICAO and drone experts provide technical assistance to civil aviation agencies at the country level. Additionally, initiatives like UNICEF’s African Drone and Data Academy also contribute to the development of local capacity to build, use and maintain drone technology.

The drone team at Outsight International supports NGOs, businesses and governments on their journey to leverage drones. We offer omni comprehensive services from piloting a small scale UAS program to developing a national drone policy, including market research, cargo and supply chain integration, or our own methodology 360 feasibility studies.

Bonus tip: As with any innovations, is it important to incorporate monitoring, evaluation and learning (MEL) to programming. Emerging technologies and pilot projects often have limited data on their impact so a solid MEL system can provide evidence for decision making and support a case to scale, allowing organisations to maximise their impact, accountability and learning.


ABOUT THE AUTHORS

Denise Soesilo
Denise is an expert in unmanned aerial system (UAS) use in humanitarian and development settings. She has worked with donor agencies and development organizations, humanitarian and United Nations organisations, advising on the application and implementation of drone technologies. Denise served as the director of flight in the African Drone Forum - Lake Kivu Flying Competitions and implemented numerous other drone operations. Through her work, Denise has enabled the safe operations of nearly a dozen cargo drone companies. In addition, Denise has led the implementation of the European Union Humanitarian Aid innovation grant on drones in humanitarian action. Denise has authored several publications on UAS in development and humanitarian action.

Pablo Busto Caviedes
Pablo specialises in monitoring and evaluation (M&E), policy research, qualitative and quantitative data analysis. His experience includes a diverse range of social and economic development topics such as rural development, agriculture, or social inclusion. He currently primarily works as an Impact Analyst for evaluation studies at another non-profit organisation.

Prevention of adolescent mental health conditions: is technology a possible source for good?

In 2021, in a bid to explore the transformative potential of technology in adolescent mental health, the Data for Children Collaborative with UNICEF embarked on a groundbreaking project with Outsight International, in collaboration with UCIPT and ElevateU. The first phase of this initiative, divided into seven investigative areas, laid the groundwork for understanding existing systems and landscapes crucial for developing effective programs. These areas were:

  1. Systems View of Digital Health Ecosystems (Outsight International)
    This work package delved into the complex digital health ecosystem, creating system models that serve as tools to identify relationships and patterns. By adopting a holistic approach, the team aimed to avoid narrow solutions and recognize the diverse elements of a digital health solution.

  2. Overview of Available Data Types (UCIPT)
    The project explored a myriad of public and private data resources, from social and health data to consumer and satellite data. This early exploration provided insights into the possibilities for moving towards an implementable project.

  3. Review of Digital MHPSS Tools Literature (ElevateU)
    Recognizing the growing importance of adolescent mental health, a literature review was conducted to understand the impact of technological interventions. The review, encompassing 38 articles and 14 from grey literature, highlighted the overwhelmingly positive impact (98%) of technology on adolescent mental health.

  4. Technology Landscaping of MHPSS Digital Tools (Outsight International)
    An effort to understand relevant digital health solutions was initiated to act as a reference point for ongoing evaluation and context-specific needs.

  5. Data Landscaping and Key Informant Interviews (Outsight International)
    Interviews with mental health researchers, funders, and service providers revealed a broad consensus that technology's impact on adolescent mental health is nuanced and context-dependent.

  6. Workshop Sessions (Outsight International)
    Two workshops focused on compounding factors influencing mental health outcomes, leading to the identification of three key research questions. These questions aimed to understand platform usage, adolescent interactions with online technologies, and the potential for existing platforms to adapt for better services.

  7. Phase 2 Conception
    Integrating UNICEF's Measurement of Mental Health Among Adolescents at the Population Level (MMAP) approach with digital mental health interventions was proposed for Phase 2. This approach offers an opportunity for a multi-cohort longitudinal study in Jamaica, testing the effectiveness of digital tools and improving data collection methods.

In conclusion, the collaborative and human-centered approach of the project, grounded in a systems perspective, has paved the way for a comprehensive Phase 2. This ambitious next step aims to improve access to services, enhance data collection systems, and provide valuable insights for UNICEF's programming not only in Jamaica but also as a comparative study across other focus countries. As the project advances, collaboration between the Data for Children Collaborative and UNICEF will define the scope, identify partners, and secure funding, marking a significant stride towards better adolescent mental health worldwide.

ChatGPT: the risks and opportunities for organisations in the humanitarian and development sector

ChatGPT, a large language model (LLM) developed by OpenAI, has emerged as a viable tool for improving the speed and cost of information-related work. It can help automate services, products, and processes by performing human-level information querying and synthesis instantaneously. This technology is rapidly being adopted by organisations in various sectors, including humanitarian and development organisations. However, the adoption of ChatGPT is not without risks. It is important to think about the opportunities and risks of using ChatGPT in the operations of large organisations in the humanitarian and development sector.

Some opportunities

  1. Crisis management and communication: ChatGPT can be used to monitor and respond to global emergencies in real-time, providing a centralised communication channel for updates, guidelines, and strategies, while also addressing queries from both internal and external stakeholders.

    But how?
    AI assistants like Jarvis inside Whatsapp and Telegram make it possible to consult quickly on the go. It’s also possible to generate content, such as videos, faster than ever, just with text inputs.

  2. Training and capacity building: ChatGPT can serve as an interactive learning platform, providing tailored training materials, simulations, and assessments to help build capacity within the organisation and improve the knowledge and skills of professionals.

    But how?
    Education platforms like Duolingo and Khan Academy now have AI-powered tutors for learners, and assistants for teachers.

  3. Internal knowledge management: ChatGPT can be used to query an organisation's knowledge resources, allowing staff to quickly access information and expertise, and facilitating knowledge sharing across departments and regions. 

    But how?
    Organisations train GPT-4 on their knowledge base, to have their own AI-powered workplace search (with AskNotion, Glean, or UseFini). 

    Your knowledge base can become an asset, like Bloomberg are doing by training their own GPT on their financial data.

    Documentation is being automatically created (e.g. for a codebase), and data entry and data cleaning can be increasingly automated with workflow tools like Bardeen.   

  4. Emergency surveillance: ChatGPT can monitor global crises as an early warning system, combining information from various sources (social media, news, and health reports) to provide a comprehensive and real-time picture of global threats, enabling swift response and containment.

    But how?
    It’s becoming easier and more effective than ever to scan large data streams, using models like HuggingGPT to create your own pipeline for data analytics. 

  5. Public health campaigns: ChatGPT can assist in designing and implementing highly personalised effective public health campaigns by analysing target audience demographics, behaviour, and preferences, and creating customised content to maximise engagement and impact. 

    But how?
    The founder of the world’s leading marketing platform, Hubspot, has pivoted to focusing on Chatspot, where AI helps create personalised content and marketing campaigns at scale.

  6. Policy research: ChatGPT can aid in policy research by synthesising relevant papers, data, and best practices, allowing organisations to make informed decisions and create evidence-based health policies and guidelines.

    But how?
    ChatGPT is excelling at summarising academic articles, blogs and podcasts
    Further still, it can elevate the capabilities of staff - no barrier to knowing data visualization languages or SQL queries by just using text commands.

  7. Grant management: ChatGPT can streamline the grant application, review, and reporting processes, ensuring that funding is allocated efficiently and transparently, and reducing the administrative burden on staff. It could also be used to raise the quality and level the playing field for applicants. Inevitably, it will be used by applicants and funded projects for reporting. 

    But how?
    AI-powered writing tools are speeding up the process, increasing formal writing quality and helping generate ideas (Lex, WriteSonic).

  8. Stakeholder engagement: ChatGPT can facilitate engagement with key stakeholders, such as governments, NGOs, and the private sector, by providing timely and accurate information, and enabling efficient collaboration and coordination.

    But how?
    Effort is saved on internal communications by automatic meeting summaries, which could extend further into any type of updates. 

    AI assistants are emerging as a way to make advice more engaging and accessible for external service users, such as this AI-powered agriculture advice for farmers.

  9. Multilingual communication: ChatGPT can be used to automatically translate communications, guidelines, and documents into multiple languages at zero cost and time, ensuring that vital information is accessible to a global audience and enhancing the organisation's ability to collaborate effectively across diverse regions.

    But how?
    Whisper AI has dramatically increased the quality of speech recognition of audio-to-text.
    Tech giants Meta, Amazon and Mozilla have all made translation advances, including under-represented languages, which are becoming productized.

  10. Virtual Assistants: ChatGPT can reduce staff workload, by summarising meeting notes, triaging emails, and creating intelligent alerts that connect new information with the current priorities of staff. 

    But how?
    Enabling tools like LangChain are making it possible to string multiple actions together, and AutoGPT is making it possible for Chatgpt to prompt itself to come up with and execute a plan of action. These are resulting in first assistants like Milo, an assistant for busy parents.

What are the risks?

With any technology, there are risks that need to be assessed and with ChatGPT, those risks could be more than most. The Outsight Team can help you navigate these in the way that ensures it’s possible to improve efficiency without taking unacceptable risks. Some of the common risks associated with the use of ChatGPT are as follows:

  1. Organisational Misinformation: The potential for ChatGPT to provide inaccurate information is a risk that organisations need to consider. It is important to ensure that the data fed into ChatGPT is accurate and reliable, and that the model is regularly updated and retrained to reflect changes in the data.

  2. Inherent Bias: ChatGPT may inadvertently reinforce existing biases in the data it is trained on. It is important to ensure that the data fed into the model is diverse and representative.

  3. Privacy Risks: ChatGPT has access to sensitive information and needs to be trained with data that respects the privacy of individuals. It is important to establish clear policies and procedures to protect the privacy of individuals.

  4. Legal Risks: The use of ChatGPT needs to comply with the relevant laws and regulations, including data protection laws.

  5. Reputational Risks: If ChatGPT is used to produce content or communicate with stakeholders, there is a risk that the communication may not reflect the values and tone of the organization, potentially leading to reputational damage.

How Outsight can help

To ensure safe and effective adoption, we must map the optimal use cases for the organisational level, and empower bottom-up understanding and best practices at the individual level. Outsight can support and accompany organisations on their journey to leverage this game-changing technology, and has developed a stepwise program, including:

  1. Mapping use cases relevant to the organisation's operations.

  2. Evaluating the limitations and risks associated with the identified use cases, along with a generalised framework.

  3. Prioritising innovation opportunities based on short, medium, and long-term impact.

  4. Developing education and capacity building content, workshops and trainings to have a repeatable and scalable impact on the safe adoption of ChatGPT from an end-user perspective..

  5. Supporting the implementation of capacity building programs to take advantage of cost and time savings effectively.

The ultimate goal is to support organisations to take up the dramatic time and cost-saving opportunities made possible by this technology, while protecting against the risks and limitations amidst the hype.

ABOUT the author and OUTSIGHT INTERNATIONAL

Harry Wilson
Harry is a product person and consultant on applying technology for impact. He has led teams which have built products used by the WHO, World Bank, UNICEF, Inter-American Development Bank, as well as acted as a consultant to companies like Facebook for Good, Microsoft and Intel. His specialist areas are AI & data, blockchain and communities.

ChatGPT
ChatGPT is a sophisticated language model powered by OpenAI's state-of-the-art GPT-3.5 architecture. With a vast knowledge base spanning a wide range of topics, ChatGPT is an expert in answering questions and generating natural language responses that are both informative and engaging.

Outsight International
Outsight International provides services to the humanitarian and development sector in an efficient and agile way. Outsight International builds on the range of expertise offered by a network of Associates in order to deliver quality results adapted to the specific tasks at hand. If you’d like to discuss working with the Outsight team, please get in touch or follow us on
LinkedIn for regular updates.

How can behavioural economics help us understand decision-making during COVID-19?

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Behavioural economics offers an insight into why people make the decisions they do. In a pandemic — when even apparently small decisions may involve high stakes — the discipline can provide an insight into how such choices are made, and critically asses the emotional vs logical. In this blog, we offer an overview of some of the basic concepts of behavioural economics and how these apply to the current COVID-19 outbreak…

Many countries are moving forward and easing lockdown restrictions while there are still many unknowns about the virus and how it spreads. They are proceeding with varying degrees of caution in the face of unknowns related to both where and when the virus will flare-up as well as economic uncertainty. For example, EU countries anticipating the summer tourism season have focused on easing travel restrictions and opening up the leisure sector. But already, reports from several countries highlight the reality of recurring flare-ups of the disease.

There is widespread reluctance to re-impose lockdowns, and to incur further risks to economies as well as general morale. But in economies that are driven by consumer spending, how individuals make decisions in the face of such uncertainty will have profound impacts on both the path of economic recovery as well as the course of the pandemic. Previously mundane decisions such as whether and when to go clothes shopping, visit the mall, or to go out to a restaurant or pub, now have to take into consideration risks associated with COVID-19.

The field of behavioural economics could have much to offer as policy makers face difficult choices and trade-offs in the months ahead as the world adapts to the reality that COVID-19 is not going away soon. In the UK, the government use of behavioural insights has already been widely trailed, though not without some controversy. Behavioural economics studies the influence of psychological factors on how humans make economic decisions. It extends traditional economics to better account for real people’s beliefs and biases. Nobel prize-winner Richard Thaler summarises these extensions in terms of three 'bounds' on the behaviour economists have tended to assume:

Bounded rationality reflects the limited cognitive abilities that constrain human problem solving. Bounded willpower captures the fact that people sometimes make choices that are not in their long-run interest. Bounded self-interest incorporates the comforting fact that humans are often willing to sacrifice their own interests to help others.”

As countries and communities move from an initial phase of tight lockdown and the associated restrictions on activity — which were necessary to “flatten the curve”, slow the spread of the virus, and avoid overloading health facilities — behavioural economics can teach us, first, about how people assess risks and, second, about how they then go on to make decisions based on the risks that they’ve assessed.

Assessing risks

Fundamentally, human beings are not always good at assessing risks. To take just three examples (though there are many more):

  1. Probability weighting is a key element of Daniel Kahneman and Amos Tversky's Prospect Theory, introduced in one of the most cited social science papers of all time. Probability weighting tells us that we systematically overestimate small risks and systematically underestimate large ones. But we generally get certainty and impossibility right, which means there's a discontinuity or certainty effect at the extremes. As long as the risk to individuals of catching COVID-19 remains low, we might expect this effect, on its own, to lead to an abundance of caution.

  2. We make mistakes about the independence of events. One manifestation of this is in the gambler's fallacy, through which people create imaginary dependencies between independent events. For example, the gambler’s fallacy predicts a strong intuition that a black is 'due' on the roulette wheel if we’ve just witnessed a long sequence of reds. Or that, in relation to Covid-19, we’ll feel that an individual risky behaviour becomes that bit riskier with each successive occasion that we get away with it (the total risk does increase, of course, but not the risk per occasion).

  3. We easily confuse the probability of seeing some piece of evidence given that a hypothesis is true (e.g. the chance that I get a positive test result, given that I have COVID-19) and the probability that a hypothesis is true given that I see some piece of evidence (e.g. the chance I have COVID-19, given that I get a positive test result), when in fact these quantities are often very different. For instance, say that there's a 0.1% rate of the disease in a population, and a test for the disease gives the right answer 99% of the time. Most people who get a positive test result during a routine screening will think it is now 99% certain they have the disease. But because the rate of infection in the population is low, the true probability in this case (which statisticians can calculate with Bayes’ Rule) is actually still under 10%.

Making decisions under risk

Behavioural economics tells us a wide range of ways in which our probability judgments tend to go awry. But even given correct probabilities, the way we use those probabilities to arrive at choices often seem to lack any immediate sense.

A key influence here is framing and, in particular, whether changes are presented in terms of gains or losses. As it happens, an illustration given in a paper by Tversky & Kahneman in Science hits rather close to home. The setup is as follows:

Imagine that the U.S. is preparing for the outbreak of an unusual Asian disease, which is expected to kill 600 people. Two alternative programs to combat the disease have been proposed. Assume that the exact scientific estimate of the consequences of the programs are as follows:

- If Program A is adopted, 200 people will be saved.

- If Program B is adopted, there is 1/3 probability that 600 people will be saved, and 2/3 probability that no people will be saved.

Which of the two programs would you favour?

On the average, programs A and B will save the same expected number of people (200), but A is a safe bet on saving exactly that number, while B is a gamble that may or may not save them all.

A big majority of respondents in the study (72%) favoured the safe option, program A. But then the researchers polled a second group, making a simple tweak to the language they used:

- If Program C is adopted 400 people will die.

- If Program D is adopted there is 1/3 probability that nobody will die, and 2/3 probability that 600 people will die.

These new programs do nothing but reframe the first set: C is identical to A, and D is identical to B. But, strikingly, this reframing utterly reversed the majority preference. Now, 78% of respondents preferred the risky program, D.

This is no fluke. One of us (GM) has replicated the result seven years in a row with students on a behavioural economics course. The reasons have to do with our diminishing sensitivity to both gains and losses relative to a reference point, which Prospect Theory captures with something called the Value Function (a replacement for economists’ usual workhorse, the utility function).

The upshot is that we’re generally risk-averse in relation to prospective gains but risk-seeking in attempts to avoid losses. The effect is extremely deep-seated: it has even been demonstrated, through some rather ingenious experiments, in capuchin monkeys by Chen & Santos.

Communicating risk

These sorts of effects are of clear relevance to leaders and governments responsible for formulating guidance and communicating to the wide public during times of uncertainty. The words and behaviour of a leader will strongly influence how a large majority of the population will make individual decisions that will have major economic and human impacts in consumer-driven societies.

With what we know from behavioural economics, how individuals actually decide what is gain and what is loss will influence these decisions.

For example, a political leader that states. “We’re open again for business”, and who accompanies that with a relaxation of social distancing measures may set an expectation that social activities such as congregating in bars, in parks, or beaches is again the norm. Thus, individuals could see not resuming these activities as a loss; and therefore, according to behavioural economics, engage in risk-seeing behaviour, not wearing masks and not respecting social distancing. The spike in cases we’re seeing in some US states, could potentially be due to this phenomenon.

On the other hand, a leader who leans too much towards caution — out of fear of seeing even a handful of new cases — may lead to people hesitant to venture out of their homes even for lower risk situations, such as going out to the park for a walk. There has been a lot of criticism of public health leaders: from their perspective, a high degree of caution will continue to be needed until the threshold of herd immunity is reached; which could be 1-2 years away. However, our economies will struggle to continue in suspended animation until then.

Therefore it is advisable for leaders to use wording and to communicate in ways that are balanced: it’s possible to be “open for business” while also assuring the population that “we’re going to double the number of testing centres” to retain the sense of caution. 

Getting this right is crucial over the months ahead as we all manage health and economic risks.

About the authors and Outsight International

Dr George MacKerron
George is a Senior Lecturer in Economics at the University of Sussex. His research is in subjective wellbeing, behaviour and the environment. He runs Mappiness, the world's largest experience sampling study, and is a co-founder of startup Psychological Technologies. George gained his PhD at the LSE, and prior degrees from Imperial College London and the University of Cambridge.

Dr Evan Lee
Evan is a trained MD and MBA with degrees from Harvard and MIT, he has dedicated his career to improving access to health. Initially practicing medicine in community health centers; for the past 20 years, he has worked across the private sector, NGO sector, and collaborated closely with UN partners to address access issues related to medicines, diagnostics, and other health technologies.

Louis Potter
Louis is one of the Co-founders of Outsight. He has a wide range of experience covering development, health, innovation, technology and research. Having worked in the field, he is well acquainted with the practical realities of delivering impact. In recent years, he has been helping organisations to improve innovation processes and outcomes. He is an experienced facilitator and has been closely involved in efforts to improve collaborations between the nonprofit, academic and commercial sectors. He is based in Lausanne, Switzerland, and received his MSc in Global Health from the Karolinska Institute, Sweden.

We believe that understanding the motivations behind behaviour is an essential part of quality strategy planning. This can apply to governments, industry or the third sector. As Outsight, we are happy to consult Outsight International provides services to its clients in an efficient and agile way using the ‘Hollywood Model’. Outsight International builds on the range of expertise offered by a network of Associates in order to deliver quality results adapted to the specific tasks at hand. If you’d like to discuss working with the Outsight team, please get in touch or follow us on LinkedIn for regular updates.

Decrypting human-centred design: Why it is important for the third sector

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What role can human-centred design practically play in development and humanitarian work? As a researcher and designer, Gunes Kocabag — an Outsight Associate — is often asked this question. Sometimes with scepticism — but more often with genuine interest.

Human-centred design has become a respected practice in certain parts of the humanitarian and development sectors (aka the third sector). However, while many people may have seen references to its techniques, it may not be obvious how it is applied in practice. In this article, she outlines: what is human-centred design; why it is necessary; and how to apply it in humanitarian and development contexts.

FROM DESIGN AS A CRAFT TO DESIGN AS A MINDSET, and FROM USER-CENTERED TO HUMAN-CENTERED

Design has historically been categorised as an art, a craft, or as a way to improve the look and functionality of products. However, from the 80s onwards a new perspective on design has progressively taken hold – an approach that defines design as a process and a mindset that can be applied to solve diverse problems. The term ‘Design Thinking’ was popularised by the design firm IDEO in the early 90s and today has gained increasing popularity in the business world as a methodology to approach complex problems.

A key principle of the design mindset is its emphasis on placing user needs and expectations at the centre of the process. As users (aka customers) in the commercial context are more and more empowered with their decision making, companies are racing to understand their users and identify their innermost unmet needs to create the next winning product in the market. That is why user-centred design is increasingly popular in corporate innovation circles.

Global development work often happens within complex systems made up of multiple partners, people on the ground, multiple end beneficiaries and various contextual factors. So it is not only about creating solutions that work for the end-user but also for all key stakeholders within the system. It requires an approach that is not only user-centred, but human-centred, which takes into account the complexity of all stakeholders. Thus, in humanitarian and development innovation, the term that is predominantly adopted is human-centred design (HCD).

WHY HUMAN-CENTRED DESIGN?

Although human centred-design is becoming increasingly recognised and embraced by leading third sector actors such as the Bill & Melinda Gates Foundation, UNICEF and WHO working regularly with innovation, there remains lack of clarity on how human-centred design can be properly harnessed to ensure better interventions for a greater range of projects.

Here are three key reasons why human-centred design can greatly improve the success of humanitarian and development projects.

Reason 1: HCD complements system thinking to reveal differences between how the system works in theory and how people actually engage with it

Systems thinking is often referred to as a go-to approach to solve complex problems — and rightfully so — as it provides a great way to break down and make sense of the parts of a system and the relationships between them.

The systems thinking pioneer Donella Meadows defines social systems as “the external manifestations of cultural thinking patterns and of profound human needs, emotions, strengths and weaknesses.” Human-centred design can help dig deeper into those external manifestations to get to the core of human behaviours, needs and expectations behind them.

By placing the focus on the human actors within the system, HCD helps bring abstract concepts such as beneficiaries, government officials or private sector initiatives to life.

By placing the focus on the human actors within the system, HCD helps bring abstract concepts such as beneficiaries, government officials or private sector initiatives to life.

By placing the focus on the human actors within the system, HCD helps bring abstract concepts such as ‘beneficiaries’, ‘government officials’ or ‘private sector initiatives’ to life: identifying the human stories behind each, with their unique needs, motivations and goals. HCD’s emphasis on qualitative data helps us move beyond an understanding of what people do to an understanding of the social, cultural, and psychological patterns that reveal why people behave the way they do.

Understanding not only how the system theoretically works, but also how people live and breathe within the system, we can create effective solutions that meet needs and expectations at both functional and emotional levels.

Case study: Improving the adoption of home-based immunisation records (HBRs) in Africa

Home-based records are medical documents issued by a health authority, and provide a record of an individual’s history of primary healthcare services (e.g. vaccinations) received. They are maintained in the household by an individual or their caregiver. Since the beginning of the Expanded Programme on Immunization (EPI) in 1974, home-based records have served an important role in increasing the effectiveness and efficiency of immunisation programs around the world. However, retention rates in many countries remain significantly low, which is particularly worrying in countries with a high birth cohort.

To tackle this problem, we first need to understand the system and the actors within the system. A systems-thinking approach focuses on understanding the key parts of the system and how they interact with each other. Adding human-centred design to that, we glean a better understanding of the human actors behind the institutions and the human actors that affect and get affected by the system.

When I worked on this challenge in collaboration with WHO and multiple other development partners, focusing on six African countries, our first task was to understand the system map and identify the key stakeholders. Then we applied HCD to dig deeper. Through ethnographic, immersive research on the ground with health workers and caregivers as well as officials in the Ministries of Health, we were able to challenge the big picture.

During pilot research, we brought together Ministry of Health officials, caregivers and health workers to compare their knowledge of how the system should be working, with an understanding of how it is actually working. Being able to observe what was actually happening, the physical and emotional burdens on the ground, what unofficial, makeshift solutions were put in place by those who had to solve problems on the ground helped us all view the system under a different light and helped shift priorities at the institutional level. Through this nuanced understanding, we were able to align key stakeholders on prioritising the needs of the end beneficiaries and health workers on the ground, as well as creating a roadmap for successful implementation that balanced the different priorities of the stakeholders involved.

Reason 2: HCD goes beyond creating solutions to creating end-to-end experiences that drive adoption

For successful adoption of a developed solution, a functional framework focusing on efficient delivery is not enough. To deliver a solution that is efficient and effective, we need to ensure it fits into the lives of those who will be using it. The main premise of HCD is to frame the whole challenge from the perspectives of the human actors, be this the end beneficiary, a specific actor in the value chain, or a key decision maker. We then design interactions and experiences tailored for the specific context and expectations of those who will be interacting with the particular product or service.

When designing services, HCD addresses these interactions not only at one point in time but through the whole journey of service delivery: before, during and after. This helps us understand the functional and emotional highs and lows of the experience, developing fixes to mitigate the lows and catalysers to enhance the highs. Through this methodological approach we can identify potential pitfalls early on and design solutions that work end-to-end.

A service journey maps out the user’s experience step by step, as well as the people, processes, policies, and systems behind the service delivery.

A service journey maps out the user’s experience step by step, as well as the people, processes, policies, and systems behind the service delivery.

Case study: Improving the quality of data in humanitarian emergencies

Access to high quality and timely data can be a life and death-defining factor when monitoring humanitarian emergencies. The MSF REACH project, coordinated by my colleague, Lucie Gueuning, is an initiative addressing exactly this problem through creating a web-based platform to support MSF staff on the ground. The platform combines institutional data with crowd-sourced information from various sources.

While all are working towards a common goal, the platform needs to be used by different types of users with different levels of familiarity with the technology, different environments of use, culture and legal context, different skill sets and mental models. The quality of the data, which is key to the platform’s success, depends on providing an inclusive experience to all its different users.

A human-centred approach to solution development in such a context, can ensure that the user experience of the platform is designed to maximise its effective use by different users, taking into account all steps of the experience from accessing the service to data entry to making sense of the data. To give one specific example, the design of the user interface can have a significant impact on the quality of the data as well as how users perceive and prioritise data.

By putting users at the centre, human-centred design ensures that the interactions fit the users’ different mental models and drives the adoption and successful use of the platform. For MSF REACH this means high quality data, which is critical for saving lives.

Reason 3: Through divergent thinking, HCD catalyses new perspectives and out-of-the-box solutions

HCD is a process that can be applied to different problem spaces. It is made up of iterative cycles of divergent and convergent thinking, following a pattern of exploring possibilities before narrowing down on one solution. This emphasis on divergent thinking allows its practitioners to ask ‘what if…’, think out of the box and imagine possibilities beyond established patterns of thinking. Divergence is then followed by a structured and criteria based process of convergence that defines what is possible.

HCD follows an iterative process where divergent thinking is followed by structural convergence, both for problem definition and for solution development.

HCD follows an iterative process where divergent thinking is followed by structural convergence, both for problem definition and for solution development.

Bringing together different mindsets and skills sets is essential for divergent thinking. This helps explore the problem space from different perspectives and create richer solutions. Thus, HCD projects rely on a combination of different topic expertise combined with the perspectives of stakeholders on the ground. Participatory design, co-creation with communities, design sprints are common methodologies that are used to catalyse divergent thinking in a structured way.

Case study: Developing a strategy for 10 years from now

Developing strategies and roadmaps in the humanitarian and development context is a complex task. It involves multitudes of stakeholder (often with very specific areas of expertise) who need to understand one another, if not reach a common understanding. Building empathy between stakeholders is key to having a meaningful conversation around priorities. HCD, with its emphasis on divergent thinking, can create a space for building empathy among stakeholders, a safe space to step into someone else’s shoes and think creatively. It is here that HCD practitioners can thrive in a facilitating role, helping structure discussions, outcomes and strategic roadmaps.

When I worked with a global foundation as a consultant on HCD, our challenge was to bring together employees to co-create a future strategy while introducing the HCD methodology. Using a HCD approach, we were able to get participants from different groups within the foundation to work together and collectively discuss how the foundation should evolve to support its global network of partners. In a workshop setting, participants stepped into the shoes of policy makers, advocates, scientists, end beneficiaries and other actors they interact with day to day. With this new perspective, they articulated how the future could impact those actors and what this could mean for the foundation’s strategy. This approach enabled participants to leave behind their roles and titles and explore the problem space from a new angle, providing a strong foundation for the definition of a new strategy.

To sum up, human-centred design can greatly improve the success of humanitarian or development projects by:

  • Revealing the nuances between how the system works in theory and how people actually engage with it.

  • Creating end-to-end experiences that drive adoption.

  • Catalysing new perspectives and out of the box solutions.

HOW CAN WE APPLY HUMAN-CENTRED DESIGN IN THE THIRD SECTOR?

Going back to my initial question, ‘What role can human-centred design practically play in development and humanitarian work?’, I would like to finish this post by providing some concrete pointers on when and how you can incorporate HCD into your work:

  • During scoping and need identification - to ensure we’re accounting for the experiences, needs, mindsets and context of the all human actors involved and not just making assumptions about what is needed.

  • During solution development - to develop solutions that fit into the lives of the target group and provide an end-to-end experience that drives adoption.

  • During implementation - to prototype and test solutions with users and stakeholders, to learn and iterate to improve the solutions.

  • During monitoring and evaluation - to complement quantitative data on what is happening with qualitative exploration of why it is happening.

  • Throughout our work - to catalyse collaboration, out of the box thinking, iterative solution development and experimentation through design sprints, co-creation workshops or methodological training.

Human-centred design is not just a high-level theory, but a practical tool that can add value over different project phases. For those who use it, it quickly becomes indispensable for achieving efficient and effective implementation. It is exciting to see its increased adoption in the global development field, yet there are still many more situations in which humanitarian or development practitioners are not taking in the whole picture, and thus missing opportunities to implement much more efficient projects and systems.

ABOUT Gunes AND OUTSIGHT INTERNATIONAL

Gunes is a researcher and service designer specialising in the development of human-centred solutions in complex stakeholder environments. She has worked as a consultant for public and private sector entities as well as global development organisations in areas including global health and financial inclusion.

Outsight International provides services to the humanitarian and development sector in an efficient and agile way. Outsight International builds on the range of expertise offered by a network of Associates in order to deliver quality results adapted to the specific tasks at hand. If you’d like to discuss working with Gunes and the Outsight team, please get in touch or follow us on LinkedIn for regular updates.

Covid-19 and mental health: An exploding global burden

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An increase in the already substantial burden of disease related to mental health will put a strain on healthcare systems at risk of collapsing under the pressure of the Covid-19 outbreak.

As the world grapples with the Covid-19 outbreak, rushing to “flatten the curve” and mitigate the risks of collapsing health systems, it is imperative we turn our attention to the mental health implications of this pandemic. Many proactive measures put in place around the world have underestimated the importance of incorporating MHPSS (mental health and psychosocial support) as an essential component of any emergency response. In a recently released report, the Inter-Agency Standing Committee (IASC) for Mental Health and Psychosocial Support in Emergency Settings advise that Mental Health and Psychosocial Support (MHPSS) “should be a core component of any public health response.” The fear of being infected can not only lead to severe anxiety, but also cause individuals to avoid seeking healthcare to prevent being exposed to the virus – or, paradoxically – to present too readily at emergency centres without medical cause. As noted in an article recently published in the British Medical journal, 

“Surges of such low risk patients are often precipitated by high levels of anxiety, leading patients to identify, catastrophise, and seek help for symptoms that might otherwise have prompted little concern, and leading clinicians to refer patients to hospital at the first sign of a mild symptom developing.”

Considering the mental health impact is essential: 

  • The baseline prevalence rates of mental health disorders – before the outbreak – already constitute a significant portion of the global burden of disease. 

  • Under the current climate of fear, enforced social isolation, and economic devastation, mental health difficulties may be expected to increase sharply.

  • This burden will have a substantial impact on already over-stretched health systems.

Baseline prevalence: the substantial global burden of mental health diseases 

The Institute for Health Metrics and Evaluation and reported in their flagship Global Burden of Disease study estimates that 970 million people lived with a mental health or substance abuse disorder in 2017. This represents a staggering 1 in 7 people (15%) globally. The ‘disease burden‘ – measured in Disability-Adjusted Life Years (DALYs) — considers not only the mortality associated with a disorder —, but also years lived with disability or health burden. Of this, mental health disorders accounted for around 5% of the global disease burden when measured in 2017 (up to 10% in several countries). We may consider these to be conservative estimates. Many difficulties go under-reported and undetected, particularly in the developing world where there is typically less awareness and more stigma around mental health issues, and fewer resources at hand to identify and treat those in need.

Mental health from a socio-ecological perspective 

Mental health disorders are complex. They take many forms. Difficulties may range from depression, anxiety, PTSD, and schizophrenia — through to substance abuse disorders. They are not only located at the level of the individual. They are increasingly understood as unfolding within the context of systems of relationships which constitute our socio-cultural environment. They are exacerbated by harsh living conditions, the erosion of mutual social support mechanisms, limited access to basic needs and services and lack of opportunities for maintaining livelihoods and education. In recent years, there has indeed been a burgeoning of theoretical models for understanding mental health disorders that situates individuals’ mental health sequelae and recovery within interpersonal, political, and social context. This ecological perspective similarly incorporates a “resource perspective”, which assumes that human communities evolve adaptively. We are deeply embedded in complex and dynamic social contexts. Equally, symptom severity is not static but fluid and changes according to a continuum of pathological reactions. 

Simply put, the social and economic environment has a fundamental role to play in mental health. We need to pay attention to the various, context-dependent, long-term, and complex social, political, and economic measures affecting the mental health of populations. Given the importance of the socio-cultural and economic environment on mental health, the anxiety, economic impact, and social isolation brought about by the Covid-19 pandemic can only exacerbate the burden. 

The mental health impact of Covid-19

Some of the key factors related to the Covid-19 outbreak and its influence on mental health include:

  • Boredom linked to quarantine: risks exacerbating most mental health difficulties, including substance use disorders, anxiety, and depression.

  • Frustration, anger, and powerlessness linked to quarantine: risks exacerbating domestic violence, sexual abuse and violence and childhood abuse – further linked to the increased risk of substance use disorders as a maladaptive coping mechanism. In China and Italy, cases of domestic violence have increased. Several organisations preventing violence against women and feminist collectives are sounding the alarm.   

  • Social isolation and loneliness: risks exacerbating most mental health conditions, notably depression, anxiety, and substance use.

  • Fear: risks exacerbating anxiety disorders, including Obsessive Compulsive Disorder and PTSD. Feeling overwhelmed by anxiety can make it difficult to cope with the new lifestyle changes that are required, or may lead to people using unhealthy ways of coping, such as substance use. Another risk related to fear is an increase in psychosomatic reactions, in other words, physical manifestations of psychological suffering (sometimes understood as conversion disorder). This again could result in an increased number of patients attending emergency centres. 

  • Financial loss: risks exacerbating most mental health difficulties, including substance use disorders, anxiety, and depression. 

We have little evidence on the mental health impact of quarantine on individuals. We have even less on the impact of a global enforced quarantine on entire communities. However, this rapid review recently published in the Lancet “suggests that the psychological impact of quarantine is wide-ranging, substantial, and can be long-lasting.” Most of the studies examined in this meta-review reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors highlighted across studies included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. 

We need to be concerned for the individuals affected and for their families and communities. Importantly, we also need to be concerned for the healthcare systems at risk of collapse globally in the face of increased mental health difficulties. 

The impact on frontline workers 

A recent article published in the Lancet, exploring the lessons learnt on MHPSS in China, stated that:

“Under strict infection measures, non-essential personnel such as clinical psychiatrists, psychologists, and mental health social workers, are strongly discouraged from entering isolation wards for patients with COVID-19. Therefore, frontline health-care workers become the main personnel providing psychological interventions to patients in hospitals.”

This is a triple burden, with negatively reinforcing feedback mechanisms: 

  • Healthcare workers “on the frontline” of the outbreak are particularly at risk of experiencing mental health difficulties themselves. The large body of literature on medical emergency workers in general attests to the high prevalence rates of mental health difficulties related to the stress of the job. This refers both to the nature and the amount of work, as well as the exposure to human tragedy, increasing the risk of secondary or vicarious trauma. A recently published article in Brain, Behaviour and Immunity confirms the significantly high levels of vicarious trauma among frontline workers facing the Covid-19 outbreak in China.   

  • Healthcare workers are also asked to take on the double task of acting as both medical AND mental health care workers. Not necessarily within their scope of practice, they may not be equipped with the necessary tools and resources, both professional and psychological, to handle this extra load.

  • Healthcare workers may see an increase in the number of people presenting with mental health difficulties. There is a significant risk of the global burden of disease related to mental health difficulties increasing. This is not only necessary in relation to the virus itself (for example, anxieties and fears around contracting the illness), but more generally related to mental health conditions globally being exacerbated by current conditions.

Physical distancing, social solidarity: moving forward together 

The crisis has catalysed countless creative examples of social solidarity, mutual aid, encouragement, and support. As global mental health experts have noted in a recent report:

“We need to encourage physical distancing along with social solidarity. And any MHPSS intervention during this time needs to include key psychosocial principles, including hope, safety, calm, social connectedness and self- and community efficacy.”

  • Healthcare workers need to be armed with adequate MHPSS strategy integrated into their response activities and the systems in which they work

  • Patients in quarantine should have access to mental healthcare 

  • Mental health professionals should be resourced and equipped to offer support online/via tele-therapy – and paraprofessionals (such as community healthcare workers) should be trained and equipped to join them in picking up this load. Online mental health services have been successfully implemented in response to the outbreak in China, as confirmed in this report in the Lancet. 

By mapping existing MHPSS service providers and institutions, efforts can be pooled to address the global burden of mental health disorders: a substantial burden projected only to increase.

About Gail Womersley and Outsight International

Gail Womersley is based at the University of Neuchâtel, where she lectures BA and MA students in sociocultural psychology. She has worked for over ten years as a clinical psychologist and researcher with displaced communities in the Central African Republic, the Democratic Republic of Congo, Greece, Iraq, Israel, the Philippines, South Africa, South Sudan, the Ukraine, and Zimbabwe. Her recent publications include the book: “Trauma Without Borders: Working with Adversity and Resilience Among Displaced Populations” (to be published by Springer in 2021).

Outsight International provides services to the humanitarian and development sector in an efficient and agile way. Outsight International builds on the range of expertise offered by a network of Associates in order to deliver quality results adapted to the specific tasks at hand. If you’d like to discuss working with Gail and the Outsight team, please get in touch or follow us on LinkedIn for regular updates.

Mastering the art of hard problems (and avoiding the rush to easy solutions)

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Forward looking organisations take the need for innovation seriously, seeking original ideas that help avoid disruptive threats and pursue original opportunities. Unfortunately, these much needed initiatives often fail to deliver on their promise of impactful change.

There are a number of common stumbling blocks. Good ideas may fail to earn the required investment, while even those that are funded find that they are unable to muster on-the-ground support necessary to drive adoption. Unexpected barriers, tangled dependencies, and ongoing change in the surrounding environment can also derail the innovator’s plans. Perhaps the most disappointing projects, are those that succeed only by staking out a small vision, taking incremental steps that make little impact on future success.

Surprisingly, these varied failures are seldom driven by a team’s incompetence or lack of creative imagination. Instead, they are more often tied to a specific, but crucial, step that is missed in the creative process. In a team’s rush to embrace a solution, they fail to first immerse themselves in the full messiness of the problem that underlies an important challenges.

Rushing to Design

Innovation typically begins with lots of energy. Well trained innovators listen attentively to those who are immersed in the area where change is needed. They use these insights to identify a good idea and then quickly move forward with design decisions that are informed by user engagement (option #1 on the diagram). They fail fast and learn quickly.

This approach drives directly to a usable solution, yet a strong case must be made for inserting an additional step early in the process. Even a fast moving innovator can benefit from taking time to understand the root cause of the problem that is behind their User’s need (option #2 on the diagram). This insight helps inform good design decisions. Still, there are limits to this targeted look back. Focusing only on the specific problem behind a user’s need often leaves the original vision unchallenged. The innovator may do a slightly better job in design, but still rushes ahead with the same fundamental solution.

Innovation teams may justifiably feel that they are doing a good job when they use these first two strategies. Yet, these seemingly well tested practices still fall short.

The unrecognised challenge is that neither genuinely important problems nor truly impactful solutions are as simple as they appear in this rush to design. In real world systems, diverse individuals and organisations are tangled together, so that even simple activities are the result of dynamic collaborations involving varied skills, resources, and motivations.

Seeing Beyond the Keyhole

This fact requires a non-trivial addition to conventional fast moving innovation methodologies. Before rushing forward to solution design, there is a need to pause and intentionally look back at the messy systems that are at the heart of the problem. (#3 on the diagram)

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Understanding these systems demands a fundamentally different way of thinking. While a User’s specific challenge may be quite real, it is just a fraction of a much bigger picture. When an innovator focuses only on a specific need, it is as if they stare at the world through a keyhole. What they see is true, but it is hardly a complete view of what is inside the room.

This small actionable view comes at a cost. The unobserved complexity and challenges that lie outside the User’s and the innovator’s immediate view become stumbling blocks. Unrecognised complexity undermines business cases, casts doubt among potential stakeholders and leaves innovators surprised and unprepared for barriers and setbacks.

Innovators fail when they assume the world is simpler than it is. Of course this isn’t always the case. If an idea is small enough, or already thoroughly understood, it is possible to confidently make a small tweak or addition based on a narrow view of a problem and solution.

Yet, when innovators ambitiously seek to drive more substantive and sustainable change, it is no longer possible to assume that important problems can be addressed with simple ideas. To be truly impactful, the solution must embrace the true complexity of the problem and be suited to the scale of the challenge.

The embrace of the real world’s messiness begins by letting go of the original idea. Instead of supporting a preordained path to addressing a challenge, the user’s need can be treated as a symptom of the challenges found in complex real world systems. This broad-based, systems perspective looks at the diverse actors involved and seeks to understand how the world works. In real world systems, if something good or bad happens it is because of the way these tangled webs of actors, interactions and incentives connect. Understanding the rich complexity of these systems opens the door to a far more sophisticated view of the challenges and possible solutions.

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The Power of Embracing Hard Problems

Investing time and effort in building a big picture view of a problem requires significant investment. This can be difficult to embrace. Just at the moment when everyone is excited to drive forward with realising the solution, the journey seems to take an about-face. Sponsors and participants in the creative effort may worry that the project is becoming mired in “analysis paralysis”. Fortunately, this thinking does not have to be bogged down in a never ending swamp of details. Rather, the effort should look down from above, doing just enough big picture work to see the important patterns of the system and its actors. This big picture systems view is broad but not necessarily deep.

With a top down view of the systems behind the problem, it possible to leverage four powerful creative capabilities:

  1. Claim Bigger Problems – A bigger picture of the challenge naturally encourages broader thinking about the nature of the challenge and the scope of the solution. A particular User may have identified a specific issue, but it is far more likely that making a substantial change that impacts the future will require addressing a more substantial version of the problem.

    Stretching the problem can help the innovator to strengthen their case for change. Smart organisational leaders naturally guide their investments to big urgent problems. Stepping back and understanding the full scope of the challenge allows the innovator to claim a bigger more compelling problem.

  2. Design More Sophisticated Solutions – It’s easy for an Innovator to look naive when they propose a simple solution to genuinely hard problems. Seasoned experts in the field quickly identify shortcomings, challenge the idea, and withdraw their support, often taking others with them.

    While an individual User may see a particular aspect of a challenge, working with system’s view makes it possible to see the many interconnected elements that are in play. Understanding the complexity of the problem makes it possible to recognise dependencies, trade-offs, and barriers that are only apparent when the entire system is considered. The innovator can then propose a sophisticated solution that rises to those challenges.

  3. Tap Complexity’s Bigger Toolkit – There are many moving parts and dynamic interactions in a real-world system. Understanding this complexity can be a challenge, but it also offers a creative gold mine of resources and capabilities that can be used to build solutions.

    Seeing a broad-systems view offers the use of a big toolkit that includes varied actors, capabilities, technologies, and existing resources. These resources can be reassembled in new and creative ways, building powerful solutions without starting from scratch. Shaping solutions with this holistic view also allows innovators to take advantage of synergies and emergent behaviours which are only visible at a systems level.

  4. Enable Creative Agility – The final advantage of beginning with a systems view of the problem is tied to the actual development of the idea. As innovations become bigger and more ambitious, the more they face unknowns and uncertainty. It’s simply not possible to plan a large creative change in advance.

    Powerful solutions are not just about coding a piece of technology and releasing it. High impact innovations require a wide variety of people, institutions, and technologies to evolve together, progressively transforming the current real-world systems.

    At any point on this journey an unexpected barrier may rise up to derail the effort. The best way for innovators to respond is to pivot and adjust as they go. Rooting an innovation in a broad understanding of the problem, rather than a specific solution, gives the innovator the flexibility to nimbly adjust their vision. When necessary, they can take a significantly different approach the solution, because they can see alternative ways to solve the underlying problem.

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A Worthwhile Creative Discipline

Because a systems understanding of the problem is so useful throughout the innovation lifecycle, it is important to begin thinking about it early in the creative effort. This is not a bit of busy work that delays the real job of the innovator. While rushing forward into detailed design and implementation may feel tangible and productive, it is in fact an indulgence that borders on creative negligence.

Taking the time to think deeply about the messiness and deeper challenges, when everyone is anxious to drive quickly forward, can be a hard sell. Nonetheless the creative payoff is substantial. Building an early understanding of the system behind the problem makes it far more likely that the idea will eventually be big enough to matter and will survive the winding journey to adoption.

About Dan and Outsight International

Dan McClure has spent over three decades working on the challenge of disruptive systems innovation. He has advised global commercial firms, public sector agencies, and international non-profits in support of their ambitious efforts to imagine and execute agile systems level innovation.

Outsight International is an organisation specialised in providing services to the humanitarian and development sector in an efficient and agile way. Outsight International builds on the range of expertise offered by a network of Associates in order to deliver quality results adapted to the specific tasks at hand. If you’d like to discuss working with Dan and the Outsight team, please get in touch or follow us on LinkedIn for regular updates.