Toward a More Comprehensive Approach to User-Centered Design

mHealth

Caitlin Loehr

CCP | Program Officer
Uju Ofomata-Aderemi of OneWorld UK presents the Ma3looma project at the Global mHealth Forum.

Uju Ofomata-Aderemi of OneWorld UK presents the Ma3looma project at the Global mHealth Forum.

User-centered design is currently one of the most popular buzzwords in the field of information and communication technology for development (ICT4D). It is the first of the Principles for Digital Development, it can be found in most proposals and concept notes today, and it was the focus of sessions, presentations, and countless comments at the Global mHealth Forum held last month in Washington, D.C.

There was widespread agreement among presenters and participants that user-centered design (UCD) reaps many benefits, namely increased usability and relevance of a given product or service. The other predominant theme at the conference was the challenge of UCD taking more time and resources than are usually available in donor-funded, time-bound, deliverable-focused projects.

The challenge of limited time and resources may be the reason that UCD is typically focused on initial design. But just as the project doesn’t end once the product or service has been designed, UCD shouldn’t stop with initial design. Over the course of the conference, a number of presenters introduced different ways that UCD has been used in other aspects and stages of projects.

  • UCD in Promotion: Without users, it doesn’t matter if an mHealth tool has a user-friendly design or is relevant and appropriate to the users’ needs, desires, and context. This points to the importance of promotion, which can greatly benefit from UCD. When the CycleBeads app was being developed, testing with potential users helped determine the appropriate medium for the app, and beta testing was done to improve the usability and content. In addition, Cycle Technologies, along with the Institute for Reproductive Health, conducted testing to determine which channel would be most effective for promoting the app among users in Kenya. Before investing money in a promotion and distribution strategy, testing revealed that Facebook ads were significantly more cost-effective than educational meetings hosted by a local NGO.
  • UCD for Ongoing Improvement: It was mentioned multiple times during the conference that analytics and user feedback gathered for routine monitoring can serve as the basis for continual UCD, informing improvements to mHealth tools and inspiring new tools and activities. OneWorld UK first launched the Learning about Living sexual health education program in Nigeria in 2007. Following a UCD process, the program was adapted for the Egyptian context, and, upon launching in 2012, it was instantly popular among young adults in Egypt and throughout the Middle East. The Egypt project, called Ma3looma, was built around social media; however, analytics showed that most users were accessing the social media content from their mobile phones. This realization spurred the development of a phone app to meet users’ desires for more personalized information, and the much-anticipated app is set to launch soon.
  • UCD with All Users: mHealth tools function within a broader system of other services, sources of information, social networks, and changing conditions. While UCD typically examines how these other elements affect the end user, what is often ignored is how the tool will affect other people and processes. Perhaps a family planning app refers users to visit their local clinic to find out more information; however, nurses at the clinic feel uncomfortable talking to young women about such topics. Or a mobile data collection tool actually doubles the amount of work for community health workers since the district health office requires paper records, and the national ministry is going digital. Without consulting all “users,” mHealth tools can end up being impractical, ineffective, or even problematic.

These ideas and activities presented at the Global mHealth Forum are hardly radical or complex and are already being included to some extent in many projects. At the Johns Hopkins Center for Communication Programs, in both technology- and non-technology-based projects, we follow the “P-Process,” which incorporates these ideas of inclusive and continual involvement of users in our activities. Regardless of what it is called or how long a specific process has been followed, there is always room to be more intentional about taking a comprehensive approach to design for, by, and with our users.