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The Stitch

Issue 4: May 15, 2018

Putting people at the centre of public health
Dear <<First Name>>,

We’re still recovering from a jam-packed week at the  Social and Behaviour Change Communication Summit in Bali (Summit presentations just released!). Credit to the organizers, it was a busy and stimulating week. We spent most of it sprinting from room-to-room trying to catch the best in behaviour change theory and practice, while staring longingly in the general direction of the beach.

In the process, we met some great people and future partners that we’re really excited about working with (you know who you are.)

One term seemed to permeate the agenda and the sideline chit-chat: Human Centred Design. HCD was simultaneously dismissed as just a new word for participatory development, and championed as a game changer for how to design nimble and effective tools and programs.

So for this month’s Spotlight, we decided to dig in to demystify it a bit.

In our audio feature this month, we also asked a few patient Summit-goers to help define it for us. Let's just say, we're not all in agreement. Have a listen here.

And thanks to everyone who came out to our packed session on behavioural surveillance, Preparing for Disease X. It was a great discussion, which we’re happy to say is continuing beyond the Summit. Watch this space.

And how do you like our new look? With help from the beautiful people at Yummy Colours, we recently unveiled our new visual identity, just in time for Spring. For us, it’s a reflection of our core value of seeking connection between constantly changing and complex things.

This month we're on the road, packing our freshly-minted business cards to start field work in Tajikistan, and to support the national communication review for polio in Pakistan. Follow our adventures on Twitter and Instagram (@gocommonthread).
 
See you next month(ish)!

Sherine, Tom and Mike
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SPOTLIGHT ON HCD

HCD: Designing for People not Problems
Human Centred Design, User Centred Design, design thinking, doodling for development… whatever you call it, it’s a participatory problem solving process that takes people into account at each step. Skeptics call it a fad; that by focussing on individuals, it fails to adequately take into account the complexity and systems in which these sometimes, short-term solutions are being designed.

 

In our view, HCD can add an invaluable infusion of new ideas to complex problems, and the best examples complement existing participatory approaches and qualitative research in the social sector. It’s not a threat, it’s another tool in the toolbox.
 

Here’s our 3 big takeaways on Human Centered Design.

  1. It’s about asking the right questions. Too often we seek answers from the point of view of our project and program goals, not from the needs and values of the people we are working for. So instead of asking how do we decrease drop-out vaccination rates, an HCD approach might ask, how can we encourage families to return to the clinic?
  2. Leave the shackles of your desk. Step into the world and the shoes of someone else with a diverse team to better understand the constraints, and the reality in which the work must live. Speak to people, watch the complexity of how decisions are really made and in what environments.
  3. Prototype, test, prototype again. Building small-scale, low cost, imperfect versions of your approach can provide greater clarity and create space for realistic feedback from those we seek to help. This might be a physical representation of a solution, it might be an A/B test, it might mean role-plays and testing messages out. But this building to learn approach is all about failing fast and failing early, potentially turning months of perfection-seeking into weeks of tangible learning about what does work.


Back at SBCC, the  “Where’s our Proofsession tackled another critique of HCD:  How do we measure the impact of these design efforts?
 

Interested in this stuff? Here’s a few of our favourite resources:

  1. No HCD list would be complete without mentioning ideo.org’s Designkit
  2. Though still in beta, UNICEF’s Demand for Health Services walks users through HCD steps to crack persistent demand problems in immunization and other health services
  3. Stanford’s dschool is a pioneer in bringing HCD to the masses. Check out their reading list and their online Crash Course.
Ready to tackle your next problem with a, "how might we..."?
The Stories We Can't Stop Talking About

Watch your back Dr Seuss, you may be next

Anti-vax reviewers are leaving negative and misleading reviews for children’s books on Amazon that promote or otherwise help children prepare for and understand vaccination. Meanwhile, this children’s book seems to offer a how-to manual for using your kids to create a measles outbreak. Serious stuff, but the truly hilarious comments from the pro-science side should give you hope, or at least a laugh.

 

Just what the doctor (didn’t!) order

One of the most common reasons people don’t receive their flu shot is because their local physician has never recommended it. (80% of patients say they would be more likely to get a vaccination if a health care provider recommended it.) But with a small prompt attached to each electronic patient record forcing doctors to accept or cancel a flu vaccine order, vaccination went up by 37% over a two year period. Cheap nudges like these are increasing vaccination rates.

 

Winter is coming - Prepare for war

When someone tells you that a coming disease could kill up to 30 million people in a period as short as six months you sit up and listen. When that person is Bill Gates and he tells you that the world is not ready or prepared to respond effectively, you sit up and listen very carefully. The current Ebola outbreak in DRC may be the next front where the world’s global outbreak response is tested.
The Research We're Curious About

Big data leaves room for big error

Despite the undeniable power of big data this article is a timely reminder that all data sets are the product of imperfect human design and inevitably reflect the experiences, expectations and biases we all carry. Despite the 2.5 quintillion bytes of data we now generate every single day, there is also a serious data divide. From 2002 to 2011, a World Bank analysis found that 57 countries had zero or only one measure of poverty. Put another way, for a third of the world’s developing or middle income countries there is no meaningful way to monitor poverty or prosperity. But are big sample sizes the answer? Is what’s measurable the same as what’s valuable?

 

Wasting food is bad. They don’t waste food. Doggy bag?

In an effort to reduce food waste, researchers tested different prompts on restaurant diners.  Some were encouraged to take food home through informative prompts, others were given both information and normative prompts about what others were doing.  Overall, greasy plates of leftovers were taken home more often by those exposed to any prompt. But surprisingly, there was no discernible difference in adding the normative message to the informative one. Now about the plastics that probably came with it...

The Lessons That Are Sticking With Us

We need to talk about our *&I!-ups

We all make mistakes, but using the permanent marker on the whiteboard again pales in comparison to the life and death decisions medical practitioners make every day. And mistakes happen more than we think: an estimated 98,000 people die every year as a result of medical errors in hospitals in America alone. But admitting to errors is tough, particularly in a field that expects perfection. So what does work? Peer accountability, creating a supportive environment for reporting mistakes, and promoting discussions between institutions and individuals on how to do better. Read more.

Why do we do that? The Brain knows...

With all the invaluable insights lately from the fields of behavioural science, it’s easy to forget the 3lb gelatinous mass in our skulls mysteriously pulling the strings. This author argues that understanding the brain is essential to get beyond the predictive power of BE, to the why. Predictive coding for example may help explain confirmation bias. Important insight on how age and poverty affects brain development and changes in its structure and function could be the next frontier in our field.

 

Happy anniversary smallpox eradication!

Three hundred million people died from smallpox in the 20th century and for the past 38 years the number has held at zero, zilch, nada. As we are on the cusp of eliminating polio and guinea worm from the planet, there is room for more optimism, argues William Foege one of the architects of small pox eradication. Want more? Read Foege’s book about what it took to get to smallpox eradication: House on Fire.
What's Distracting Us From Our Work

Take 4 minutes to get excited again

It’s about eight years old now, but nothing beats the late, great Hans Rosling in visualizing data and communicating about progress, disparity and the relationship between health and wealth. Jumpstart your day with his contagious energy and optimism.

We’re also pretty proud of this little animation.

This Issue Was Produced While...
Mike dusted off his kurta and Sherine and Tom got ready to tuck into some delicious qurutrob.
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