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COMMENTARY
Open Access

Design Is an Essential Medicine

Pragya Mishra and Jaspal S. Sandhu
Global Health: Science and Practice November 2021, 9(Supplement 2):S195-S208; https://doi.org/10.9745/GHSP-D-21-00332
Pragya Mishra
aDalberg Design, Seattle, WA, USA.
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  • For correspondence: pragyamishra7@gmail.com
Jaspal S. Sandhu
bGobee Group, Oakland, CA, USA.
cSchool of Public Health, University of California, Berkeley, Berkeley, CA, USA.
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  • FIGURE 1
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    FIGURE 1

    Documents by Year Containing the Phrase “Human-Centered Design” From the U.S. Agency for International Development’s Development Experience Clearinghousea

    a This represents approximately 625 documents or about 0.5% of the documents between 2008 and 2020. The decrease in 2020 may be due to the effects of COVID-19, bias in the dataset (documents from 2020 may not yet been included in the same intensity as prior years), or (less likely) a decrease in design-related activities at the U.S. Agency for International Development.

  • FIGURE 2
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    FIGURE 2

    Comparison and Synthesis of Selected Design Processesa

    a Many other prominent models of design exist. We have chosen these 6 illustrative models to represent a breadth of organization types, and we have intentionally oversampled models from health care, global health, and global development. These models are from Hasso Plattner Institute of Design,10 Mayo Clinic Center for Innovation,11 EngageHCD,12 Medic Mobile,13 and Design for Health.3 The authors are contributors to both EngageHCD (PM) and Design for Health (PM, JS).

  • FIGURE 3
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    FIGURE 3

    Common Phases Seen in the Design Processes Mapped to the Advantages of Design

  • FIGURE 4
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    FIGURE 4

    The Design Process in Global Healtha

    a As described by Design for Health.3 The first cycle, which helps design the right things, starts with discovering the challenges and needs of the people and systems to design for and converge on opportunities to overcome these challenges and address these needs. The second cycle helps design things right by developing and testing ideas based on the opportunities identified in the first cycle and then converging on and delivering a solution. The model emphasizes testing and iteration, which helps weed out ineffective ideas and prioritize impactful, desirable, and sustainable ideas.

  • FIGURE 5
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    FIGURE 5

    Nine Benefits of Design Organized by the 3 Defining Advantages of Framing, Intention, and Collaborationa

    aThese questions are derived from common questions about design that we and our colleagues have fielded from global health practitioners. Together, these benefits describe the value of design.

  • FIGURE 6
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    FIGURE 6

    Document Frequency of Key Approaches in the U.S. Agency for International Development’s Development Experience Clearinghouse, 1975–2020a

    a For each approach, we conducted a keyword search over all the text of all documents, including synonyms, unique abbreviations, or adjacent approaches when appropriate.

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    Design is an essential medicine. © Vector Point Studio/Shutterstock (modified)

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    TABLE.

    Design Compared to 3 Approaches in Global Health

    Participatory ResearchQISociobehavioral ResearchDesign
    Related terms and approaches
    • CBPR

    • Participatory action research

    • Youth participatory action research

    • Lean

    • QI

    • Continuous QI

    • Performance improvement

    • TQM

    • PDSA

    • Six Sigma

    • Qualitative research

    • Social-behavioral research

    • Formative research

    • Cultural anthropology

    • HCD

    • Design thinking

    • User-centered design

    FramingPartner with communities to define the problems that matter to themUnderstand problems in context of existing systems and subsystemsUse qualitative research methods, sometimes ethnographic approaches; formally approach sampling, recruitment, data collection, analysisUnderstand problems in context; use methods from qualitative research, with flexibility to adapt approaches
    IntentionGenerate research for future action; develop localized ownership and solutionsImprove existing systems using a continuous approach to testing and measurementProvide inputs to program design or general knowledgeFundamentally innovate, through creative processes and prototyping; sometimes improve existing systems
    CollaborationPartner with community members, establish long-term relationshipsIdentify teams within an existing organization or systemCreate qualitative research teams, who sometimes immerse in a group or cultureUsers may be partners, participants, or subjects in design; engagements are days or weeks, not months or years
    OutputsResearch; community ownership of research; community capacity buildingMeasurably improved processes within existing systemsPeer-reviewed research; ethnographic accounts; program recommendationsInnovation in form of service, product, strategy
    Citations and further readingChen et al.32
    Kia-Keating et al.33
    Kachirskaia et al.34
    Ahn et al.35
    Tolley36
    Design for Health, 2019 Complementary Approaches37
    -
    • Abbreviations: CBPR, community-based participatory research; HCD, human-centered design; PDSA, plan-do-study-act; QI, quality improvement; TQM, total quality management.

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Global Health: Science and Practice: 9 (Supplement 2)
Global Health: Science and Practice
Vol. 9, No. Supplement 2
November 29, 2021
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Design Is an Essential Medicine
Pragya Mishra, Jaspal S. Sandhu
Global Health: Science and Practice Nov 2021, 9 (Supplement 2) S195-S208; DOI: 10.9745/GHSP-D-21-00332

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Design Is an Essential Medicine
Pragya Mishra, Jaspal S. Sandhu
Global Health: Science and Practice Nov 2021, 9 (Supplement 2) S195-S208; DOI: 10.9745/GHSP-D-21-00332
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  • Article
    • INTRODUCTION
    • DEFINING DESIGN
    • UNDERSTANDING THE DESIGN PROCESS
    • THREE ADVANTAGES OF DESIGN
    • THE VALUE OF DESIGN IN GLOBAL HEALTH
    • COMPARING PROBLEM-SOLVING APPROACHES
    • THE PATH FORWARD: INTEGRATING APPROACHES
    • CONCLUSION
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