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: 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.

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.

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.