Four Big Insights from HCD Exchange

By Manya Dotson, Project Director, Adolescents 360

In no uncertain terms, Human Centered Design (HCD) is revolutionizing Adolescent and Youth Sexual and Reproductive Health (AYSRH).

That was my takeaway from the HCD Exchange—a weeklong summit in Tanzania that convened some of our community’s leading innovators to collectively process what we are learning, what we still need to understand and how we might work together on both of those questions.

I came away with four big insights (and a lot of juicy things to consider!):

1. HCD and Global Health are a May-December couple—and they haven’t been together for that long

HCD and AYSRH are raising eyebrows. It’s an inter-generational relationship of sorts marking only five years of a passionate relationship. Public Health is a distinguished and respected older professor and HCD is a gorgeous and brilliant younger thing brimming with spirit and optimism. HCD breathes life, energy and passion into what can be a staid (and set in its ways) community, which—frankly— has had its heart broken many times before. Public Health brings maturity, measure and caution to the exuberance of blue-sky thinking and the experiential risk-orientation of design. But while the couple is clearly infatuated, they are still just dating and figuring out whether they can communicate and complement each other well enough to go steady… for the long term. It was good for me to remember how young this relationship is as our flagship program Adolescents 360 (A360) attempts the role of committed and honest broker and objective learner.

2. HCD vs. Research is a false dichotomy

An extension of point one, A360 continually grapples with how it can best navigate some of the beautiful tension between researchers and designers to communicate HCD’s value-add while we build program data and results. HCD Exchange reinforced that presuming HCD and “insight gathering” is meant as an alternative to traditional qualitative research misses the point, and may be a false and destructive dichotomy.

Qualitative and mixed methods research are critical tools in understanding not only whether interventions are effective, but in how and why they are. Importantly, though, HCD is not attempting to replace or even moonlight as qualitative research. Its value lies elsewhere– in the opportunity it opens to us, to ensure youth-centered, youth-resonant programming in our design processes. (And let’s be honest, the majority of interventions today are the product of very lean design processes that cannot, by nature of resource constraints, embody the full extent of Meaningful Youth Engagement.)

Researchers have long lamented the lack of data in programmatic decision-making, oft assuming that implementers aren’t bothering to learn from and build on the evidence, or that they don’t know how. As Dr. Venkatraman Chandra-Mouli from the World Health Organization’s Department of Reproductive Health and Research noted, too many brilliant situational analyses have yet to be translated to impactful programs. A360’s transdisciplinary approach to HCD allows us a robust and youth-centered design process that integrates a whole spate of research evidence and theory, with youth as decision-making partners.

I left HCD Exchange hearing others, like our colleagues at Pathfinder International, echo this point, addressing how HCD eliminates the gap between young people, health care providers and implementers. HCD invites youth and provider voices into the intervention decision process, and allows implementers to experientially process and understand known evidence in a way that makes it more actionable. I even observed this shift among the participants who visited A360 activities in Dar es Salaam; they returned energized by what they had experienced. Yes, at times HCD may lead to a “rediscovery” of the evidence and appear naïve as it presents a finding as if it is completely new. But generating a new evidence-base is not the value-add of HCD (though, it can definitely discover new things and contribute new understanding). It is in the human- and youth-centeredness. Which, incidentally, has value for more than just young people.

In A360, it seems to consistently help implementers see and feel the opportunities for action within the evidence-base, with transformative experiences that enable truly empathetic implementation. This process  inspires action in ways that PowerPoints, manuscripts and reports may not. HCD Exchange convinced me, more than ever, that HCD can help to build a bridge between the data and responsive activities. It is a tool to closing the data to action gap.

3. Craving the Nitty Gritty

While naysayers are debating the conceptual value of HCD for programs, many implementers have seen its value and are already craving to get down to brass tacks with practical tips and hacks on how to actually DO THIS THING. This is where we intend to help the conversation keep moving, because it is true that HCD invites us to question many of the traditional structures we have used (and at times been confined by) to shape our work. What sorts of problems are well suited to an HCD approach? How do you know if your team is ready to do it? How much professional support will teams need? How do you procure for rapid prototyping? What sort of hours do people work? What do we safeguard for? What’s going to fall apart?

Madeleine Moore, A360’s Tanzania Innovations Team Lead, gave a presentation on this sort of “Nitty Gritty” that brought the house down. And here she was worried that it would be boring! A360 is more committed than ever to demystifying the process, and making it accessible—both conceptually and practically.

4. Transformation

I wasn’t surprised, but very glad to hear, anecdotal reports from every organization that their teams had been transformed simply by being a part of an HCD process and working alongside designers. (Our friends from Marie Stopes Kenya were particularly vocal about this.) Certainly, while nobody I spoke with felt that the experience had transformed them into professional designers, everyone said they had seen their teams becoming much more responsive to the needs of young people and willing—and able—to adapt and course correct through implementation. We’ve experienced the same throughout our A360 journey, and are working double time on using our experience to gain clarity on how this translates as projects transition to implementation and expansion.

HCD Exchange prompted us to consider how to move the HCD-AYSRH community of practice forward. What can we collectively do to deepen our connections and expertise, while advising the global health community at large? I worked with Ram Prasad from Final Mile, Tiffany Franke from Incandescent, Anabel Gomez from Avac and Mari Tikkanen from M4ID. We got inspired to build a virtual playground where the AYSRH community of practice can share and discover what is possible, inspire and be inspired to take action, and give and get practical help from peers and experts.

I personally have committed PSI and A360 to set up a prototype on Facebook, establish a small steering committee, and develop a concept note to set us on the path of launching a live platform by the end of 2018 (assuming all goes well!). For now, we remain committed to the A360 Hub, which is our attempt to share raw learning, experiences, “flubs” and resources for peers to replicate A360’s processes.

A360 is taking HCD to the next level and demonstrating that HCD and other disciplines working together can result in effective, efficient and scalable programs with pathways to sustainability. Our early pilot results are promising, and we will be sharing more about the what and how as data comes in. As A360 moves in 2018 from the HCD-informed interdisciplinary approach to implementation and expansion, we will begin working on an A360 Quick-Start Kit that brings the honest, practical and “Nitty Gritty” perspective that everyone is craving.

HCD Exchange underscored the immense value HCD has brought to the AYSRH community. It’s a partnership that’s honoring a young but meaningful relationship, and one that has delivered our community ripe opportunities to learn—and learn quickly. As we all gain clarity on the reliable value-add of HCD, get better at measuring it, and get more skilled at communicating it, I have no doubt HCD will become an indispensable resource in our collective tool kit.

Adolescents 360 (A360) is a four-and-a-half year initiative co-funded by the Bill & Melinda Gates Foundation and the Children’s Investment Fund Foundation (CIFF). The project is led by Population Services International (PSI) together with, University of California at Berkeley Center on the Developing Adolescent, the Society for Family Health Nigeria, and Triggerise. The project is being delivered in Ethiopia, Nigeria and Tanzania, in partnership with local governments, local organizations, and local technology and marketing firms. In Tanzania, A360 is building on an investment and talent from philanthropist and design thinker Pam Scott.

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