PATHOS: A Human-Centered Design Toolkit for Engaging Frontline Health Care Providers

"A young, bored and demoralized health care worker needs a way of breaking up his daily monotonous immunization routine....If only he could know what to do to increase his interest and motivation, he would change how he does his work."

Human-centred design (HCD) is a creative problem-solving approach that involves developing a deep understanding of the people with/for whom an organisation is designing something. This toolkit highlights how PATH's Living Labs initiative uses a 4D HCD approach - Discover, Define, Dream, and Design - to engage frontline immunisation healthcare workers (HCWs) to understand factors that affect their motivation and engagement in providing services.

Those working together on HCD undertake the following actions: empathise; collaborate; include; inquire; trust; and iterate. Living Labs starts by identifying and understanding a problem and iterating through a series of co-creation steps to design and test prototype solutions for the problem. For each of the 4 phases, the resource explains how to prepare and what activities to conduct (with which tools), and it provides tips and examples from PATH's user engagement. (Living Labs promotes the development of low- to no-cost solutions that leverage resources available to users within their own context or environment. The idea behind this is to encourage HCWs to reduce their reliance on external actors in addressing the challenges they face in their work.)

The tools in this methodology are geared toward co-creating solutions that are in what Living Labs calls "the innovation sweet spot", which is the point at which the three innovation attributes (desirability, feasibility, and viability) overlap. The tools seek to accelerate innovation and foster rapid testing and evaluation.

The final portion of the resource features learnings from Living Labs' HCD engagement with frontline healthcare providers. A key aspect is to frame the problem that is, to identify and understand the user, their needs, and their context and then co-create solutions that respond to those needs. One lesson learned: Establishing relationships with a network of providers nurtures engagement. A few enthusiastic HCWs can give much richer insights than a large group of HCWs. Continuity can be fruitful, and maintaining contact with the same users over time can be productive. However, it is important to periodically add new providers to invite new perspectives, if any.

Although these learned experiences largely involved frontline immunisation workers, this toolkit has also been applied with community members, caregivers, community health workers, and ministry of health decision makers, as well as global development stakeholders, to address the system-wide complexities of a health challenge.