Human-Centered Design and Global Health | David Milestone

Summary

In this presentation, Dave Milestone from USAID’s Center for Accelerating Innovation and Impact discusses the application of human-centered design (HCD) in global health, focusing on the challenge of scaling chlorhexidine in Nigeria to reduce neonatal mortality. Milestone emphasizes the importance of designing interventions that are not only feasible and viable but also culturally desirable. He shares a case study on using HCD to improve maternal health practices, highlighting the importance of stakeholder engagement, iteration, and context-specific solutions. Ultimately, he encourages global health professionals to embrace HCD for more effective, sustainable health solutions.

Takeaways

• 😀 Human-centered design focuses on putting users and stakeholders at the center of product development, particularly in global health initiatives.
• 😀 The gap between private sector product launches (such as in pharmaceuticals and medical devices) and global health product rollouts often spans decades, with slower uptake in lower-income countries.
• 😀 A core challenge in global health is ensuring that solutions are not only feasible and viable but also desirable to the target population.
• 😀 Human-centered design involves iterative prototyping and co-design, where feedback from end users is collected frequently to refine solutions.
• 😀 In global health, traditional methods often overlook the desirability of a solution, focusing too heavily on feasibility or cost reduction.
• 😀 By applying human-centered design principles, USAID is working to make health solutions more effective, sustainable, and relevant to the needs of diverse populations.
• 😀 An example of applying human-centered design is the project in Nigeria, where scaling up the use of chlorhexidine to prevent neonatal mortality involves overcoming cultural and practical barriers to its adoption.
• 😀 In Nigeria, traditional umbilical cord care practices are entrenched, with many mothers using outdated or ineffective substances like methylated spirit or even cow dung, creating resistance to change.
• 😀 The design process involved understanding local practices through field research, identifying key influencers (e.g., family members, health workers, chemists), and co-creating solutions with stakeholders.
• 😀 The project emphasized low-cost, practical tools and assets that can be customized for different regions, ensuring that solutions are flexible enough to accommodate diverse needs.
• 😀 A key lesson learned is the importance of doing human-centered design early in the process, as it can significantly reduce costs and improve the chances of success, with one project costing less than 0.5% of the total scaling costs.

Q & A

What is the primary focus of Dave Milestone's presentation?

Dave Milestone's presentation focuses on how USAID is applying human-centered design principles to improve global health initiatives, particularly in scaling up health solutions in countries like Nigeria.

Why does Dave Milestone emphasize the comparison between global health product launches and those in the private sector?

Dave Milestone emphasizes this comparison to highlight the significant gap between the slow uptake of health products in global health and the rapid scaling of products in the private sector. He believes there are valuable lessons to be learned from how the private sector introduces and scales products.

What are the three key areas of human-centered design as explained by Dave Milestone?

The three key areas of human-centered design, according to Dave Milestone, are feasibility, viability, and desirability. These principles aim to ensure that health interventions are practical, sustainable, and aligned with the needs and desires of the target population.

How does human-centered design contribute to the success of health interventions?

Human-centered design contributes by ensuring that products and interventions are tested early and iterated based on real-world feedback from users, leading to more successful and sustainable solutions.

What challenge is USAID addressing with chlorexidine in Nigeria?

USAID is working to scale up the use of chlorexidine, a low-cost antiseptic, to reduce neonatal mortality in Nigeria. The challenge is to convince communities, especially in rural areas, to replace traditional practices with chlorexidine, which is more effective.

Why is the introduction of chlorexidine difficult in Nigeria, according to the script?

The introduction of chlorexidine is difficult because people in Nigeria are accustomed to using traditional substances like methylated spirits or even toothpaste on the umbilical cord. Additionally, there is a lack of awareness among chemists, who are the first point of contact for women preparing for childbirth.

What role do chemists play in the adoption of chlorexidine in Nigeria?

Chemists play a crucial role as the first point of contact for women preparing for childbirth. However, they are often driven more by profit than clinical effectiveness, which can hinder the adoption of new products like chlorexidine.

How does the process of co-creation help in human-centered design?

Co-creation involves engaging all stakeholders—mothers, chemists, nurses, and community members—in the design process. By working together, the solutions are more likely to meet the practical needs and desires of the target population.

What is the significance of low-fidelity prototypes in human-centered design?

Low-fidelity prototypes allow for rapid testing and iteration. This approach helps in gathering real feedback early in the process, which can be used to refine and improve the design before final implementation.

What key lesson does Dave Milestone share about applying human-centered design in global health?

One key lesson Dave Milestone shares is that human-centered design should be applied early and often, ensuring continuous improvement based on user feedback. He also emphasizes that human-centered design is not a one-time solution but an ongoing process to adapt and optimize interventions.