We have all seen or heard of an organization developing and implementing an innovative solution and then one or two months later the product is in the corner of the health clinic. It has not been used since the organization finished its initial training. While the outsiders who came in saw it as innovative, it clearly did not resonant as a solution to the users. But why? It seemed so obvious to the developers that this product would solve a glaring problem. Why wouldn’t these health workers want to use this application?

But not to worry. This is something that all organizations and companies deal with. Do you remember Windows Vista, Nokia’s N-Gage, and HP’s TouchPad? Well, each company would hope that you do not. There is an endless list of failed technology products and services. With the movement of leveraging high tech products in international development, especially in global health, failure has become a part of the dialogue in the sector. So much so that MobileActive began hosting FailFaire, where organizations utilizing technology in their projects can come and speak about their “failures.” The idea is to learn from mistakes that others have made. In the most recent FailFaire in New York, many of the stories were focused around design and collaboration issues. Not simply physical design issues (like there were too many buttons on the device), but multiple issues that the designers and implementers did not take into account.

While design has been on the forefront minds in the corporate world for many years (see iPhone and IDEO), design in the social sector is a relatively new idea. In order to decrease the number of failures, organizations have created partnerships with design firms. They are bringing user-centered design to the social sector. Below are some examples:

• Reboot has worked with United Bank Limited (UBL) in Pakistan and the Gates Foundation to expand branchless banking via mobile phones.

• IDEO.org is assisting Evotech in the further development of their low-cost endoscopy device. It is used during obstetric fistula procedures in developing countries.

• Frog Design teamed with the Aricent Group, PopTech, iTeach, the Praekelt Foundation, and Nokia Siemens to design programs to support HIV/AIDS patients as well as expand awareness and knowledge about the disease.

Design Strategy                                      

By focusing on the human-centered design, the product/service takes into account the culture and needs of the targeted consumer. As the pioneer in human-centered design, IDEO wrote a paper in 2010 for the Stanford Social Innovation Review entitled “Design Thinking for Social Innovation.” In the paper, they discuss some of the issues with design in social projects. Along with looking into the culture and needs of the end-users, they mentioned that the project failed because the intervention had not been properly prototyped with the users and receive direct feedback from them.  Human-centered design also sees a need to have the intervention fit into the infrastructure of the communities. The overall idea is to have the product/service that solves a problem that the user or community has. In order for this to occur, IDEO sees the solutions coming from focusing on those on the ground instead of the design process occur from outside the targeted community. Along with the design, they also believe that there must be a well thought out distribution and implementation strategy because that can kill a project too. Their most important strategy to the human-centered design process is observing people in their experiences and behaviors. This will tell the designers more than any survey because it can be difficult for people to explain what they need, especially if they do not know what that really is.

Collaboration

In order for the human-centered design to occur, there is a need for greater collaboration in mHealth. mHealth is a complex web of networks as it includes individuals from all areas affected in the sector – mobile operators, ministries of health, telecommunications regulators, community health workers, doctors, technology developers, global health NGOs, etc. As mentioned before, by understanding the problem and how a solution would be used in the field, the technology is more likely to be adopted. The creation process needs to understand all the aspects involved in the usage of the product/service. By creating a collaborating environment, no matter who the end user is (a mother, family, community health workers), the team has the experience and knowledge to look deeply into all the internal and external issues that are causing the problem. Once those are understood, then the group can start to see how the intervention can be both designed and implemented in the field with the end-user in mind. With this focus, there will be a clear incentive for the end-user to utilize the technology. Without understanding how a technology will improve their lives, there will be a low adoption rate. And then the technology becomes useless and another wasted investment.

The process of creating greater collaboration and utilizing a design strategy is easier said than done. Clearly money is an issue when including a design firm in the development of a mHealth product. It would be beneficial to include extra funds in budgets for the design process. The funds should be used to design the look, functionality, and business plan of the mHealth intervention as well as allow for greater collaboration. The end goal of developing a design strategy and increasing collaboration is to create products/services that will solve a problem but also that will be used by the indented users.