November 13, 2020

Putting the Community in the Driver’s Seat

In early November, Concern Worldwide and John Snow, Inc. (JSI) hosted Think Differently, a conference focused on evidence-based health innovations for women, newborns, and children. Throughout the day, speakers ranging from intervention designers to international funders shared insights on project challenges and achievements, and one topic rose as the unifying key to success: user-centered design.

Intervention design and testing can feel like an emotional rollercoaster. Within a span of 30 seconds, a design team can shift from pure excitement and promise for success to a discouraged room of individuals, confused on what went wrong. If this storyline sounds all too familiar, take 10 seconds to answer this question: Is your intervention a user-centered design?

Jean Christophe Fotso, Associate Director of Research, Monitoring & Evaluation for Innovations at Concern Worldwide, initiated the conversation on user-centered design when speaking about Concern’s Essential Newborn Care Corps program in Sierra Leone. The two-year pilot project explored the potential of training traditional birth attendants (TBAs) to take on new roles as Maternal and Newborn Health Promoters (MNHPs), capable of checking for health complications and referring women to health facilities rather than assisting in home deliveries. As part of this project, a mobile application was designed to assist the MNHPs in providing maternal health diagnoses to patients. After multiple in-house iterations of the application, the design team released the product to be implemented on the ground. With no hesitations came the community input. 

The MNHPs began to drive the design process once they had their hands on the prototype. They finally had the opportunity to voice concerns over the look, feel, and use of the application. With this valuable feedback, the Concern team was able to mold the application into a product that was driven by the users, for the users. Placing the community at the center of the design team resulted in a stronger, better fitted product and allowed the MNHPs to feel appreciated, heard, and validated as partners in the project.

Beth Skorochod, Deputy Director for HIV/TB at Population Services International (PSI), echoed Fosto on the importance of design feedback loops. She underlined the value in providing the user with tangible prototypes to which they can respond and with which they can interact. Skorochod and her team took this approach when developing Adolescent 360, an initiative that aims to increase voluntary, modern contraceptive use and reduce unintended pregnancy among adolescent girls in developing countries. Throughout this project, young people were at the center of the design process, co-creating with the PSI team to ensure that solutions were tailored to the needs of the community. Skorochod emphasized that this user-centered design generated vital insights into country and culture specific contexts that the design team would have never guessed.

While these community inputs and prototypes are essential to the development of successful interventions, the reality is that these “fail fast” approaches of little experiments can strain even the broadest of budgets. Ledia Andrawes, a designer from ThinkPlace and consultant for Adolescent 360, highlighted that user-centered design requires funders to provide more money and time dedicated to testing and identifying solutions. Without this freedom to experiment and evaluate what works in a community, designers are trapped in funding contracts to develop a full plan and solution for an intervention before they are even in the field. According to Andrawes, international funders must create this space for risk-taking if they want to see tailored and appropriate interventions come to life. 

For designers who can make it work, putting the user in the driver’s seat has the potential to elevate an intervention from good to great. Whether the time or money will be available for this style of design is up to funders to decide.