Evaluating Human-Centred Design for Public Health A Case Study on Developing a Healthcare App with Refugee Communities.

Abstract

Background: Australian women from migrant and refugee communities experience reduced access to sexual and reproductive healthcare. Human-centred design is an ethical and effective approach to developing health solutions with underserved populations that are more likely to experience significant disadvantage or social marginalisation. This study aimed to evaluate how well Shifra, a small Australian-based not-for-profit, applied human-centred design when developing a web-based application that delivers local, evidence-based and culturally relevant health information to its non-English speaking users. Methods: This study undertook a document review, survey and semi-structured interviews to evaluate how well Shifra was able to achieve its objectives using a human-centred design approach. Results: A co-design process successfully led to the development of a web-based health app for refugee and migrant women. This evaluation also yielded several important recommendations for improving Shifra’s human-centred design approach moving forward. Conclusions: Improving refugees’ access to sexual and reproductive health is complex and requires innovative and thoughtful problem solving. This evaluation of Shifra’s human-centred design approach provides a helpful and rigorous guide in reporting that may encourage other organisations undertaking human-centred design work to evaluate their own implementation. Keywords: human-centred design; design thinking; refugee health; evaluation Plain language summary: Australian women from non-English speaking migrant and refugee communities face reduced access to sexual and reproductive healthcare and many then go on to experience poor health outcomes as a result. There is an urgent need for new approach to improve access to healthcare for underserved communities, one that centres these women in the process of finding, developing and disseminating the solutions themselves. Human-centred design is an ethical and effective methodology to working with communities to develop these health solutions. This study aimed to evaluate how well Shifra, a small Australian-based not-for-profit focused on improving access to healthcare for refugees and new migrants, undertook human-centred design approach when developing a Smartphone app that deliver local, safe and culturally relevant health information to non-English speaking Australians. The authors interviewed refugees, health and social sector experts and computer programmers involved in creating Shifra to evaluate how well they used human-centred design to achieve its goals. This evaluation found that Shifra’s approach was successful whilst also highlighting several important recommendations for improving collaborative efforts with refugee communities. These findings could help other projects also seeking to undertake an authentic community co-design process.

Factors Shaping Good and Poor Nurse-Client Relationships in Maternal and Child Care in Rural Tanzania

“…Ideally, to address the contributors of poor nurse-client relationship, a consideration of an innovative approach that brings nurses and MCH clients together as partners in the intervention design and evaluation process need to be made. It is for this reason, HCD approach is being embraced because it is considered to facilitate improvements in client, provider, and community satisfaction and increased e ciency and collaboration in public health intervention development and implementation process [27][28][29][30][31][32]. Furthermore, HCD is considered to result into more successful and sustainable interventions when compared to traditional problem-solving approaches in health care and public health in general [27][28][29][30][31][32].…”

“…It is for this reason, HCD approach is being embraced because it is considered to facilitate improvements in client, provider, and community satisfaction and increased e ciency and collaboration in public health intervention development and implementation process [27][28][29][30][31][32]. Furthermore, HCD is considered to result into more successful and sustainable interventions when compared to traditional problem-solving approaches in health care and public health in general [27][28][29][30][31][32]. Melles, Albayrak and Goossens [32] recently proposed that the implementation of HCD in healthcare need to focus on developing an understanding of the people facing a particular challenge and their needs and engaging the stakeholders from early on and throughout the design process and embracing a system-wide approach by considering interactions of factors at different levels and harmonizing individual interests to form collective interests when developing solutions to the identi ed challenges.…”

“…This complexity necessitates targeted contextualized innovative solutions that places nurses and clients at the forefront as agents of change in optimizing intervention designs and implementation [26][27][28]. A human centered -design (HCD) is one of the innovative approaches to problem-solving that leverages insights from the end-users of services, and experiences in order to develop best-t solutions that are rapidly prototyped and iteratively re ned [26][27][28][29][30][31][32]. The aim of this study was to explore nurses and clients' perspectives on factors shaping nurse-client relationships in MCH care.…”