Plagued by chronic drought, prolonged violence and complex population movements, Somalia has sometimes been referred to as “the most difficult context in the world.”
Unsurprisingly, many health interventions in the country have failed and there is little evidence for what works. PSI was recently funded by the UK Department for International Development (DFID) to address access to skilled delivery, modern family planning methods and maternal nutrition in a new way – by applying human centered design (HCD) in Somalia/Somaliland.
Piloting this new approach, along with tight deadlines, resource and security challenges, as well as difficulties in generating support for the new HCD process, was an immense challenge. However, the PSI Somaliland team navigated the space and found success in solid prototypes that resonate not only with users, but also the Health Ministry.
Here are some of the key learnings, as shared by Rachel James, Social Behavior Change Advisor, East Africa at PSI for the project:
- High levels of adaptability and flexibility were required to undertake HCD in Somaliland, taking a pragmatic approach to HCD in a context with low literacy, reliance on oral formats, sensitive cultural issues and limitations in both deadlines and locations that the design firm could go to.
- It is difficult for users (particularly low-income women) to think innovatively of interventions beyond those which they have already experienced. Expecting users to drive the prototyping process and invent new and innovative solutions is unrealistic.
- Prototyping was found to be an excellent way of gaining genuine user insights. As users contributed to the development and testing of prototypes, their reactions could be observed, providing new insights beyond those previously gathered through more structured research methods.
- Prototyping is a highly labor-intensive process, requiring significant commitment from both PSI staff and design teams. It can also be challenging to the social norms and deeply held beliefs of staff as well as users, which requires sensitivity in navigating on the part of the design firm. Embracing “fast failure” and no-fault learning was critical to enable the process to advance.
For more insights and details on the program, visit PSI’s Somaliland country page.