Delivering real health equity means more than reaching most people with the care and services they need. It means understanding, and meeting, the needs of everyone. The challenges of human health are complex, as are the social dynamics that impact health care delivery. Brilliant innovations are worthless if they are not adopted or don’t get to the people for whom they are intended.
Social design offers a methodology for understanding issues from the users’ point of view; for seeing people as individuals with agency; for identifying needs as defined by them; and for developing ideas for delivering health in ways that people want to receive it. The design process provides tools for engaging stakeholders in the research process, developing multiple solutions and de-risking implementation through rapid prototyping, identifying upstream causes, and framing challenges in ways that inspire new approaches.
Often, social design is not a substitute for other methods of health care innovation and delivery but can be used to enhance relevance and adoption, either for creative inspiration at a point in the overall program (used as a spark), for certain phases of the program (used as an ingredient), or integrated throughout the initiative (used end to end).
By Michelle Risinger, Innovation Director, PACT
This myth often rears its head for nonprofit organizations with a rich history of community engagement. Many of the tools and techniques utilized throughout the social design process look familiar to staff who frequently engage with beneficiaries. Sometimes this gives rise to the misperception that design is no more than basic participatory approaches, packaged in a new way.
It’s not true. The difference, and the effectiveness of social design, is in the iterative nature of the process — its goal of testing assumptions and its authentic search for user need. Social design brings together the best tools of ethnographic research but then asks designers to challenge their expert mindsets and to sincerely question what they think they know and continuously experiment around a hypothesis.
“This process makes me uncomfortable! It’s really hard to begin research and embrace the fact that I can’t control the outcome. It also feels unpredictable, messy, and a little like I don’t know what I’m doing when, in fact, I have a decade of experience in the topic area.”
Ahhh, but becoming familiar with the process and having faith in the end-user becomes more comfortable and is required to navigate uncertainty. The social design is clear and simple:
Sometimes the design process can be so simple and common sensical that researchers try to over-complicate what is truly basic. What can feel unusual, though, is the circular nature of social design. Many researchers crave a linear process, a checklist of tick boxes that concludes with a final report. We use social design as a tool for problem-solving, perhaps when other approaches have already failed.
The social design process can’t be learned in a classroom. It is mastered by practicing it repeatedly. But you inevitably will become more comfortable once you’ve practiced the process in a few different contexts.
Not so. In many cases, social design will actually make it clear how to improve and/or maximize an existing solution. Chances are, unless existing solutions are currently failing (in which case you should change them anyway), the design process will reveal why challenges are plaguing the existing solution. Additionally, keep in mind that as the designer, you have control of the direction your process takes. An iterative approach does not mean you lack purpose. As long as the design process continues to reveal data relevant to your problem statement, you can safely continue to solve your original problem.
This is deeply connected to an entrenched and sometimes unconscious mindset about problem-solving.
However, surfacing more information shouldn’t be regarded as a negative thing –- all relevant data is good data.
Fundamentally, social design identifies needs and the underlying drivers and motivators of a user’s decision-making. When we solve for complex health and poverty related problems, we will likely surface a host of interconnected root causes that are exacerbating the symptoms of the problem. It is up to the design team to evaluate which causes can be realistically addressed while still achieving a positive outcome. Social design is actually a form of risk mitigation. It’s better to invest in a design process to quickly uncover which solutions work before millions of dollars are spent on a solution that hasn’t been tested. It’s just good business.
The truth is that implementing the design process can be as inexpensive and convenient as you choose to make it. If this is your first design process, you will probably perceive it as more time-consuming, because you’re spending extra time both learning and doing. It’s a double whammy. But as is true with all participatory approaches, more practice is the only requirement for mastery.
Also, prototyping can be simple role play or a paper cut-out. Organizations that treat a prototype more like a pilot can watch costs pile up, but those costs can be saved for implementation when there is evidence that the solution works.
As is true of all social issues, true outcomes and behavior change are rarely a quick fix.
The value of the design process is in the depth of insights generated about end-users (as compared to previous research) and the success of tested prototypes. A gentle reminder to key stakeholders that social design is about ethnography and experimentation, not generating five years of behavior change in one run of a prototype.
Prototyping is a powerful learning and de-risking tool, but it should never be expected to generate outcomes.
The design process has been used for decades in the private sector as a tool to design more intuitive and empathetic consumer products and services. The turn of the 21st century saw the rise of a dialogue about how to apply business strategy and lean innovation principles to the social sector, catalyzing an industry trend in formally adopting design principles to tackle poverty. For example, in 2011, the design giant IDEO incorporated a nonprofit organization called IDEO.org whose mandate was to focus on fusing design principles to improve the lives of people in poor and vulnerable communities. What has followed has been an uptick in design firms, tools, and resources all looking to encourage the adoption of social design in the social sector.