Refine, Evaluate & Adapt Solutions to Different Contexts

Community Health Workers meeting
(USAID/ThinkPlace)

Learning Objectives

After completing this session, you will be able to:

Understand the value of adapting solutions to different contexts

Apply the Adaptation Canvas to the Nourishing Connections tools so that they can be used in other country contexts

Where are we in the process?

Diagram showing Stage IV. Solutions are refined, evaluated, and adapted during this final stage.

Refine, Evaluate & Adapt

In the spirit of continuous improvement, the process of refining and evaluating can continue indefinitely as innovations scale across different contexts. Whether testing, piloting, or evaluating a solution in a new context or setting, some degree of adaptation is usually necessary – this holds true regardless of whether the solution was originally generated using HCD or not.

Who is involved?

Key local stakeholders and potential users of the adapted solution in the new context – similar to who would be involved in co-design (see Session 5).

Starting the Adaptation Process

decision tree
Step 1. Decide as a team

Whether you are bringing the new HCD-generated solution or a pre-existing solution to your context, the starting point is the same:

  1. You must have a thorough and shared understanding of the problem you are trying to solve.
  2. You must work as a team with key stakeholders and potential users to adapt the solution.

Nigeria Case Study

In Nigeria our adaptation was adjacent, since we intended to adapt the chosen solution to a different health area, in a different country, and we understood that there was a need for a change of format.

Inovation

Although modifying something that already exists may not seem innovative or exciting, these types of adaptations are precisely what drive innovation! Innovation is often thought of as being entirely brand new and disruptive, or what is known as transformational innovation. However, there are multiple forms of innovation:

Incremental innovation

  • Typically involves bringing a solution to a broader audience, often with little adaptation. For example, expanding a tool that was designed to achieve a specific purpose among a specific audience to reach more of that same intended audience

Adjacent innovation

  • Typically involves adapting an existing solution to a new audience or for a slightly different purpose. For example, Empathways, which was originally designed for providers and young people to build empathy during family planning consultations, was adapted for use in Nigeria between CHWs and caregivers to build empathy around complementary feeding. The goal and mechanism to build empathy is the same, but the audience and content are different. Adjacent innovation is a great starting point, especially for teams that are time constrained. Later in this session we will explore quick ways to innovate using the Adaptation Canvas. In this lesson we will explore this type of innovation through the Adaptation Canvas.
Step 2. Scan for solutions that solve a similar problem

When the time came for the Breakthrough ACTION Nigeria team to ideate, the team decided that in addition to ideating afresh, they would also consider existing solutions to see if anything could be adapted. Given this decision, the team looked within the Breakthrough ACTION portfolio of solutions and found inspiration in Empathways, a tool designed to build empathy between two groups of people in a 1:1 setting.

Empathways in Nigeria

Empathways Challenge

Empathways cover
The challenge

Lack of empathetic care from health providers is a well-known issue. Empathways was an innovation created by Breakthrough ACTION, to address this problem.

What is it?

Empathways is a card activity designed to take youth clientele and their family planning service providers on a dynamic, engaging journey from awareness, to empathy, to action. The objective is to forge greater empathy between these groups, and then for providers to apply this empathy to improve youth family planning service delivery (Breakthrough ACTION, n.d.).

Nigeria Challenge

Nigerian flag
The challenge

The research revealed that there is a lack of compassion and empathy when CHWs provide counseling sessions and in-home consultations. Therefore, the team decided to focus on innovating to elicit more empathetic behaviors from CHWs and more cooperative behaviors from caregivers.

What is it?

Empathways was identified as a possible solution because it addresses the same core challenge: lack of empathy. Once this decision was made and an existing solution was identified for adaptation, the team worked through a series of questions, which have been consolidated and refined in the form of the Adaptation Canvas.

Step 3. Complete the Adaptation Canvas

Adaption Canvas

Inspired by the Business Model Canvas, the Adaptation Canvas is a one-page framework intended to help nutrition and SBC practitioners think through what changes might need to be made when adapting a solution.

1. Key Actors

Who are the key actors (target audience, influencers, systems, organizations, institutions, etc.) in the original concept? Are they the same or different in the new context? Do they play similar or different roles? (e.g., grandmothers existing in both settings but play different roles).

Tip: Map out the key actors and their relationships across the socio-ecological model.

2. Setting & Environment

Review existing data or evidence from the country or context you are adapting to. What stands out? Consider changes in setting in the new context. Is it urban or rural? What is the socioeconomic profile of the target population?

3. Key Resources & Costs

What are the key resources needed for the original concept? Are they also needed in the new context?

Tip: Consider the five S’s: “staff, stuff,
space. systems, and social support” (Zhang, 2021). Are the following resources the same or different in this new context? What are the associated costs?

  • Human resources
  • Materials and supplies
  • Physical space needs
  • System(s) access, integration or
    institutional buy-in
  • Social supports (i.e., transportation and meal vouchers)

4. Value Proposition & TOC

What change are you trying to make by
adapting this concept? Does the Theory of
Change (TOC) still hold true?

Tip: Conduct this fill in the blank exercise:
“If we [NAME OF ACTIVITY] with [TARGET AUDIENCE] then [DESIRED RESULT].

5. Constraints

What constraints are present in the new
context that may need to be factored
into the adaptation?

Tip: Consider these factors but do not
limit yourself to them.

6. Proposed Changes

Given the previous steps, what key
changes do you propose making to the
concept?

Tip: List the changes and prioritize them
using an importance/ difficulty matrix or
another matrix of your choosing. For
example, translation would be “important” and “not difficult”, whereas adapting a digital video so that the characters more closely resemble the local population would be “difficult.” The importance may be unknown but can potentially be validated during testing!“

7. Validation & Refinement

Which of the changes need to be validated? How will you know if the
changes are “successful?” With whom do you need to validate and how will you do that?

Tip: Focus on assessing desirability and
feasibility.

Each component of the canvas includes probing questions and tips to help think through possible adaptations. You may find that you do not need to fill out each component, and that is ok. Each solution, adaptation and context is unique. 

Aim to complete the first draft of the canvas relatively quickly (within an hour). If you complete it alone, share it with other key stakeholders to get their input. Or if you have the opportunity to fill this out as a team, then conduct individual brainstorming for each section, share back, and build off of each person’s input. 

Here is an example of how the Nourishing Connections Team utilized the Adaptation Canvas.

Step 4. Build your adapted prototype

Now that the specific changes have been identified, it is time to turn them into a prototype. Refer to Session 5, Prototype & Test for specific guidance about building a prototype.

Component Original EmpathwaysAdapted Empathways for Nourishing Connections in Nigeria 
TopicOriginal EmpathwaysAdapted Empathways
Rounds or categories of cards– Open up
– Awareness
– Understand
– Empathy
– Compassion
– Action		– Awareness
– Understand
– Empathy
– Compassion

The other categories were left out because Nourishing Connections have other activities that are responsible for building this piece of the relationship.
AudienceFamily planning providers and young peopleCHWs and caregivers of 6-24 month-old children 
FormatCard deckOne page handout with 5 questions
MethodOne-on-one interactionOne-on-one interaction
How to use itTo be used in training sessionsTo be used during counseling sessions
UniquenessFirst application in a safe space/training setting.“Share Just Enough” concept: CHWs should share with caregivers just enough and not expose themselves.

Download the Empathways for Nutrition prototype (PDF) that was tested in Nigeria. See Session 5 for more details on testing the prototype in Nigeria.

Key Tips for Adaptation

Encourage your team to consider adapting existing solutions to your new context in addition to ideating new solutions.

Work with a similar group of diverse stakeholders.

Revisit your desk review to see if any potential solutions surfaced, or conduct a rapid search for potential solutions.

Step 5. Finalize the concept

Once the testing concluded and the results were synthesized, a version of Empathways for Nutrition was finalized for the Nigerian context, which includes a one-page tool composed of five questions divided into sections between relationship building and emotional state of the mother. The final Empathways for Nutrition tool was integrated with other activities of the Nourishing Connections package, thus making the tool an element of something bigger. You can find Empathways for Nutrition on pages 3 and 4 of the CHW Job Aid.

Connections graphic

Why the final version was consolidated

  1. Due to the intended group (CHW) strengths and weaknesses – Most CHW in Nigeria have a low level of literacy, so they usually memorize content. Therefore, memorizing 50 cards wouldn’t work. For this reason, we need to work with what is essential to make it possible for them.
  2. The original Empathway was made for a training context while the Nigeria version for a counseling session. It was necessary to concise it to the reality of a 30min counseling session.
  3. In Nigeria culture people are talkative, for this reason they just needed a starting point to set up an empathetic conversation and space to make the magic happen.
  4. Since many CHWs in the target group are not literate, they needed to be able to memorize the questions and reading cards would not have worked.
  5. Nigeria is a very open country, so participants just needed something to start the conversation. 
  6. Feasibility – printing thousands of card decks was not financially feasible, the single-page layout enabled the implementing partners to make the objective feasible.

Prototype

Community Health Worker meets with two care givers and their toddlers
(USAID/ThinkPlace)

Learning Objectives

After completing this session, you will be able to:

Understand the value and rationale for prototyping and iteration

Recognize different possible prototype formats and learn how to build them

Create and execute a testing plan

Apply testing methods, including those used in the Nigeria case study

Evaluate testing results and making recommendations

Where are we in the process?

Diagram showing Stage III. Devise occurs once the problem is know and ideas diverge to consider "What are the solutions?"

Devise II

To reach the second part of the Devise phase, you should have 4-6 concepts ready to be developed into prototypes which will then be tested with users.

Who is involved?

At this stage, you should involve the Core Design Team and the testing audience/users (people you will test with).

Prototyping

What is it? Why do we do it?

A prototype is an experimental model of an idea. It is a way to give our ideas a presence that we can put in front of someone else to see if our idea adds value.

Recall from Session 1 that HCD helps us arrive at solutions that are desirable, feasible, and scalable. Prototyping is the specific practice that helps us build, test, and iterate solutions that meet those three criteria. Flip each card to learn more about each criteria.

Desirability

Is it likely to lead to uptake from the target group?

Feasibility

How can it be effectively and efficiently operationalized?

Scalability

How can we ensure that it is easily replicable?

How many end users can our solution reach?

Venn diagram showing Desirability (What do people need?), Scalability (What is financially and technically scalable?), and Feasibility (What is technically feasible?) overlapping to form Innovation (the successful solution).

What can prototypes look like?

Prototyping is about bringing ideas to life quickly. It allows us to experiment with our ideas and concepts, and to test, learn, and improve them in a low-cost, low-risk way. When thinking about how to create a prototype, ask yourself “How can I get people to interact with my concept as quickly as possible?”

Prototypes can take many different forms, so the following is not an exhaustive list. Nonetheless, explore each option to learn what prototype might best meet the design need.

Creating a physical product?

Physical models

Try creating one with cheap materials first.

Creating a new process or experience?

Role play

Make a script that users can act out to test the experience you’re trying to create…

Storyboard

…or draw it out through a storyboard. 

Creating a digital product?

Sketches and paper prototypes

Use sketches to display a mock-up of your concept.

Designing an event, experience, or new space?

Physical spaces

Make a mock-up of your space that reflects the flow, orientation, and spacing. 

How do I build a prototype?

Before building your prototype, work with your Core Design Team to fill out the Prototype Canvas. Doing so helps clarify key aspects of your concept, including what it is supposed to do, what assumptions you are testing, what it will look like, etc.  It is best to complete these in small groups.

In general, prototypes should be made quickly and relatively cheaply using readily available materials. Think about a craft project you did in primary school. What materials did you use? Those are the types of materials you want to use here. Examples are paper, cardboard boxes, fabric, markers, tape, empty water bottles, poster board, magazines, clay…  You get the idea. Think: what is readily available? What is inexpensive?

What is the prototyping process?

The general process is as follows: create, validate, iterate, and revalidate. Flip each card to see a definition.

Create

Make a prototype from the idea or concept.

Validate

Test and seek feedback from users to validate whether they think it will work.

Iterate

Refine and adapt the prototype based on user feedback, changing and replacing items that do not work.

Revalidate

Did changes lead to the desired results? Is it easy to use? Can it work in different contexts?

sketch of prototype cycle

What level of complexity is needed?

The prototyping process can be repeated within the same or across different levels of complexity, ou level of fidelity. The fidelity of a prototype refers to its level of completeness, detail, and different testing phases. The degree of completeness of the prototypes depends on the stages of fidelity, which are low, medium, and high. Flip each card to learn more.

Low-fidelity example of sketches on paper

Low fidelity prototype

Low cost, rough, and quick to build

Medium-fidelity example of black and white photocopies

Medium fidelity prototype

Slightly more detailed, still rough but closer to the solution

High-fidelity example of professional color prints

High fidelity prototype

Much closer to final, very detailed, and much more time-consuming

As you can imagine, prototypes look different for every project, so do not expect your prototypes to look exactly like these examples. The important thing is that they are tangible and allow users to interact with them.

Depending on your project, you may be able to conduct multiple rounds of testing at different stages of fidelity.

Nigeria Case Study
Nourishing Connections

Prototypes in Action

In Nigeria, eight prototypes were developed to address the six challenges identified during the formative research stage. (Links to each Nourishing Connections prototype are available under the Materials tab at the top of this lesson.) Click each challenge to reveal the prototype(s) used to address them.

Challenge 1: Lack of compassionate care in counseling sessions

Prototype 1

Your Own Adventure is a prototype inspired by the Choose Your Own Adventure style stories and games. In this version, the clients select options that best represent their past experiences so that at the end of the game, the community health worker can determine at which stage of behavior change the client is: the knowledge, attitude, or practice stage.

Prototype 2

Empathways takes CHWs and users on a journey from thinking about their own experiences and needs, to understanding users’ real needs. The solution is a card deck composed of 4 categories of QUESTIONS and TACTICS.

Challenge 2: Diet diversity

Prototype

Meal planner game is a card game that educates players about 4-star meals. Each card has a picture of locally available food from one of the categories with an icon identifying which category it belongs to. The game’s objective is for players to create 4-star meals for complementary feeding out of the playing cards by combining a card from each of the four categories of foods that are available to them.

Challenge 3: Uncertainty and fear of harming the child

Prototype

Les Trivia Game is a question & answer game similar to the Trivial Pursuit board game. The questions relate to facts and myths about nutrition, as well as facilitators that support or inhibit dietary diversity and complementary feelings.

Challenge 4: Previous experiences with child feeding

Prototype

Assumptions Busting is a simplified counseling session guide that makes the counseling process more empathetic and efficient in identifying the real causes of certain behaviors.

Example from the "Assumptions Busting" simplified counseling session guide
Challenge 5: Affordability and accessibility

Prototype

Price comparison is a visual table used by the CHWs to compare the price of healthy foods with the price of other things, and the preparation time of healthy meals versus meals not recommended.

Challenge 6: Food preparation self-efficacy

Prototype 1

Tips & Tricks Booklet is a fully visual recipe book containing three healthy Nigerian recipes using low cost largely locally available foods to most and 4-star meals to encourage nutritious complementary feeding.

Prototype 2

Weekly meal planner is a family meal planner that considers what the family has available. This tool has a section dedicated especially to complementary feeding for infants and young children and another for the rest of the family.

Session 6 Recap & Knowledge Check

Community Health Workers meeting
(USAID/ThinkPlace)

Key Takeaways

Refine, Evaluate & Adapt

Theoretically, adaptation is continuous and will always be part of implementation. It is a key driver of scaling solutions.

Adaptation drives innovation. Innovation does not always have to be brand new and transformational but can take other forms like incremental and adjacent innovations. Taking inspiration from what already exists is a perfectly acceptable practice and should be encouraged!

The Adaptation Canvas is intended to guide nutrition SBC practitioners in thinking through what needs to change in order to bring a solution to a new context.

Check Your Understanding

Thank you for completing the sixth session of Applying Human-Centered Design to Improve Nutrition Programming. Next is an ungraded quiz to test your understanding of Session 6.
Click the Knowledge Check button to get started.

Knowledge Check

Session 5 Recap & Knowledge Check

Community Health Worker meets with two care givers and their toddlers
(USAID/ThinkPlace)

Key Takeaways

Prototype & Test

The purpose of prototyping is to understand quickly if your idea has value by testing it, breaking it, and evolving it through various rounds of user testing.

It is essential to have a clear testing plan that includes not only the logistical requirements (who, what, where, when) but also the why and how: what is your hypothesis? What do you expect your prototype to result in? How will you test that? And how will you know if the prototype has achieved its objective?

When seeking feedback on your prototypes, it is important to remain objective. It is easy to become attached to our own ideas, but the very point of prototyping is to break your idea to get to something that will actually work.

Check Your Understanding

Thank you for completing the fifth session of Applying Human-Centered Design to Improve Nutrition Programming. Next is an ungraded quiz to test your understanding of Session 5.
Click the Knowledge Check button to get started.

Knowledge Check

Session 4 Recap & Knowledge Check

Community Health Workers learn about the tools
(USAID/ThinkPlace)

Key Takeaways

Co-design & Ideation

Co-design convenes multiple perspectives and stakeholders in the actual design of your solutions to build something that aims to be desirable, feasible, and scalable. It helps reduce the risk of developing ineffective solutions and increases buy-in for the solutions developed using this process.

Ideation is step in the co-design process of coming up with new, unconstrained ideas – and follows the general divergence and convergence pattern:

  • Diverge: Initial rapid ideation
  • Diverge: Mix and merge
  • Converge: Prioritize

Building concepts brings more clarity and detail to your ideas. It is the first “stress test” that helps develop and assess your hypothesis: What change will this make? For whom? How?

Check Your Understanding

Thank you for completing the fourth session of Applying Human-Centered Design to Improve Nutrition Programming. Next is an ungraded quiz to test your understanding of Session 4.
Click the Knowledge Check button to get started.

Knowledge Check

Co-design & Ideation

Community Health Workers learn about the tools
(USAID/ThinkPlace)

Learning Objectives

After completing this session, you will be able to:

Apply co-design is, its value, and understand who to involve

Understand the ideation process and methods and how to apply them

To able to create ideas and learn how to turn it into concepts

Where are we in the process?

Diagram showing Stage III. Devise occurs when ideas diverge to consider "What are the solutions?"

What is next?

You have completed the first diamond in the double diamond framework – congratulations! Now, it is time to practice some more divergent thinking as we begin the first part of the Devise phase, which includes co-design and ideation.

Who is involved?

At this stage, you should involve the Core Design Team and additional stakeholders related to your insights and How Might We questions.

What is co-design?

As mentioned in Session 1, co-design is an approach to design that actively engages multiple and diverse perspectives in the design process to ensure that the end result meets user needs. It is about convening these perspectives to build something that is truly desirable, feasible, and scalable to key stakeholders.

Typically, an engineer, a product manager, or business owner might work on a product or idea,  for long periods of time, before bringing it to users. If the product flops once it is launched, it is usually too late, too tiring, or too expensive to make changes, and the solution dies.

Co-design aims to prevent this from happening by designing solutions with users and other key stakeholders, and by balancing all perspectives. Although the user voice is central, it must be balanced with the know-how of the other voices in the Core Design Team. Only together  they can arrive at a solution that is desirable, feasible, and scalable.

Co-design in Action

Nourishing Connections

The first step is to identify the key stakeholders which should be involved. The following stakeholders were involved in co-design for the Nourishing Connections project:

  • Mothers
  • Fathers
  • Caregivers
  • Community leaders
  • Implementing partners
  • Core Design Team

Once your co-designers have been identified, it is time to bring them together for ideation.

Ideation

What is an idea?

“Ideas are initial thoughts. They lack detail. They do not need to be reasonable or achievable. They must break the sound barrier of reason.”

– ThinkPlace Global Institute of Regenerative Design & Terry, 2022

What is ideation?

Ideation is the process of generating new ideas. It is all about rapid, divergent thinking that is anchored in the research insights.

The key to ideation is to aim for quantity over quality or feasibility, and being open to everyone’s ideas– regardless of their positions. There are no discussions around the quality or feasibility of an idea, there are only further suggestions.”

– Breakthrough ACTION, n.d.

How do we ideate?

Who is involved?

  • The Core Design Team
  • Your intended users
  • Any other key stakeholders including for example, representatives from the Ministry of Health who could not commit to being a Core Design Team member, but bring technical experience and an understanding of the challenge

An ideal number is between 20-25 participants, who can then break into 4-5 groups of 4-5 people.

What you will need

  • Post-its or small pieces of paper that can be placed in clear view among small groups 
  • Markers or pens
  • A wall or flip-chart paper to place post-its on
  • Tables and chairs to accommodate small groups 
  • One Insight/How Might We worksheet per small group (from Session 3)

The Process

The ideation process follows the general divergence and convergence pattern:

  • Diverge: Initial rapid ideation
  • Diverge: Mix and merge ideas
  • Converge: Prioritize

Click each step to learn more

Step 1: Rapid ideation

Step 1

This step is anchored in the Insight/HMW worksheets from Session 3.

  • Separate into smaller groups – aim to have representatives of different voices in the same group and begin quick fire brainstorming.
  • Teams have discussions and contribute ideas. It is advised for each individual to write their idea on a small piece of paper and place it in clear view for the other participants. This way, participants become inspired by the increasing number of ideas and themes in front of them.
  • Try to write only one idea per post-it, and aim to generate as many ideas as possible! This can be done initially as an individual activity in silence for 5-10 minutes. After individual brainstorming, share back within small groups and place each paper in full view of the rest of the group.

Rapid Ideation Tips

  • Quantity is more important than quality or detail right now. Encourage friendly competition between small groups!
  • Do not dampen wild ideas – encourage them!
  • Draw your ideas, use short sentences, just make them as clear and simple as possible.
  • Do not negatively judge or dismiss ideas early on.
  • Try to have one conversation at a time.
  • Do not discuss too many details of any one idea; opt for breadth of ideas over depth.
  • Take some risks – build on what is there and explore new territory.
  • Go fast! Keep it fast paced to avoid overthinking.
Step 2: Mix and merge

Step 2

Now that you have a high quantity of individual ideas, start clustering them, still within small groups. Are there similar ideas? Group them together and give them a name. Are there certain groups that could be combined to create a “mega” idea? Draw links between them. This step is a chance to expand upon and add more details to the initial ideation round.

(Image credit: Yagazie Emezi/Getty Images/Images of Empowerment)

Step 3: Prioritize

Step 3

With your ideas a bit more formed, it is time to prioritize them since they cannot all be developed. A favorite way to prioritize ideas is to use a simple importance/difficulty matrix, or effort/impact matrix.

  • Money pit: low effort and low impact
  • Incremental: high effort and low impact
  • Easy wins: low effort and high impact
  • Big bets: high effort and high impact
Incremental = low impact and low effort, Money pit = Low impact and high effort, Easy wins = high impact and low effort, Big bets = high impact and high effort

At the end of ideation, you should have at least 2 strong ideas per small groups that are ready to be developed into concepts. See the examples below from the Nourishing Connections Project.

Nigeria Case Study
Nourishing Connections

Ideation in Action

The Nourishing Connections team worked through the 3 steps of ideation. What began as 50 different ideas ultimately became 8 ideas prioritized as the team progressed from Rapid Ideation to Mix & Merge to Prioritize.

How Might We statements → Rapid Ideation → Mix & Merge → Prioritize
1. How might we promote awareness around locally available and inexpensive healthy food options while positioning locally available foods as higher value and more desirable and appropriate for young children?

2. How might we improve food preparation and transformation capacity in mothers and caregivers to facilitate safe, nutritious, and digestible meals for children 6 to 24 months?

3. How might we strategically alleviate the cost, time, and energy burden placed on mothers and caregivers to prepare nutritious meals for their children 6 to 24 months in addition to their other household and community responsibilities?		~50 ideas! Idea 1 – Local food cultivation, purchasing, and preparation training for CHWs
Idea 2 – Cooking experience group sharing
Idea 3 – Active sensitizing towards men to support mothers & caregivers
Idea 4 – Community drama displaying benefits of well nourished children
Idea 5 – Influencer leveraging
Idea 6 – Cooking demonstration and advice through radio and community dramas
Idea 7 – Community town hall sensitization
Idea 8 – Entertainment activities for the community
Idea 9 – Game for community meetings
Idea 10 – Tools for community health workers
Idea 11 – Activity to prompt empathy between caregivers and community health workers		Idea 1 – A set of questions to help community health workers to understand caregivers’ current state

Idea 2 – A tool/activity to prompt empathy

Idea 3 – A game that works as a cook demonstration and increase families knowledge

Idea 4 – A questions and answers game

Idea 5 – A counseling session optimized guide, faster, better, helpful and empathetic

Idea 6 – Price comparison tool

Idea 7 – Tips and tricks booklet

Idea 8 – Weekly meal planner
With the prioritized ideas, the members of the core design team based in Nigeria built them into concepts.

Turning Ideas into Concepts

What is a concept?

A concept is a more fully formed idea or mash-up of ideas. It goes beyond any individual idea and is a thinking step where designers aim to frame a more holistic solution (ThinkPlace Global Institute of Regenerative Design & Terry, 2022).  It contains more details that help answer key “who, what, when, where, why, how” questions.

Why and how to build concepts

Flip each card to learn about the benefits of building a concept.

Clarity and Focus

Refine and narrow down your ideas, providing clarity and focus.

Assess Feasibility

Assess various factors such as demand, technical feasibility, resource requirements, and potential challenges.

Enhance Differentiation

Refine and tailor to users needs, incorporating innovative features, approaches, and value proposition.

Guidance for building a concept

  • Establish small groups that are interested in developing the idea into a more detailed concept. These can be, but are not limited to, the same small groups used during ideation.
  • Explore the concept and build up the features. Use the Concept Canvas as a guide. You do not have to limit yourself to these questions, but at a minimum they should be answerable at this stage.
Screenshot of Concept Canvas

Nigeria Case Study
Nourishing Connections

Concepts in Action

Review three examples of concepts from the Nourishing Connections case study.

Concept 1: Choose your own adventure

Hypothesis

Helping CHWs understand caregivers’ current state helps them provide personalized, relevant guidance more efficiently and effectively.

Describe your concept in detail

What are the objectives of this idea? How will this idea work in detail?

Inspired by “choose your own adventure” style games, in this version clients will select options that best represent their past experiences so that at the end of the game, their current state will be determined. The past experiences will be divided into 3 categories:

  • Knowledge
  • Attitude
  • Practice

This game will have a version for mothers/caregivers and influencers.

What problem does this concept solve? For whom?

This concept aims to address the lack of empathetic care during counseling sessions.

Where will this take place? What is the setting?

During household visits or at a health facility.

Does something like this already exist? If so, how is this different?

Nothing like this exists in Nigeria to our knowledge.

Who needs to be involved and what are their roles and responsibilities?

Supervisors need to learn how to use the tool and orient CHWs to the tool. 

CHWs need to learn how to use the tool during their counseling sessions.

Concept 2: Nutrition Card Game

Hypothesis

The fictional practice of diversified eating, copying the decision making process and constraints of everyday life, will lead to a better understanding and change of attitude.

Describe your concept in detail

What are the objectives of this idea? How will this idea work in detail?

This is a card game that educates players about 4-star meals. Each card has a picture of locally available food from one of the categories with an icon identifying the category. The game’s objective is for players to create 4-star meals for complementary feeding out of the playing cards by combining a card from each of the four categories.

What problem does this concept solve? For whom?

This concept aims to address the lack of knowledge among caregivers about diverse diets, the lack of mental space to test new recipes, and the different roles key family members can play in complementary feeding for children aged 6-24 months.

Where will this take place? What is the setting?

This game can be played during our outside of CHW-led counseling sessions.

Does something like this already exist? If so, how is this different?

There is a similar game, but it does not add complexities such as real characters, bigger spaces for mistakes that provoke reflection and force different decision making, thus driving attitude change. So, it is not able to imitate real life.

Who needs to be involved and what are their roles and responsibilities?

Supervisors need to learn how to use the tool and orient CHWs to the tool. 

CHWs need to learn how to use the tool during their counseling sessions.

Concept 3: Assumption busting

Hypothesis

Streamlining the counseling protocol to focus on understanding the specific situation will help the CHWs counsel caregivers more efficiently and effectively.

Describe your concept in detail

What are the objectives of this idea? How will this idea work in detail?

Simplifying the session protocol to make the session more empathetic and more effective in identifying the root causes of certain behaviors. 

The CHW should always begin with a statement about past experiences, myths or common challenges. The mother will respond and the CHW will ask WHYs at least 3 times until the root cause is understood.

What problem does this concept solve? For whom?

This concept aims to help CHWs:

  • Understand caregivers’ past experiences with complementary feeding
  • Understand the conditions under which caregivers attempt to follow recommendations
  • Gather relevant inputs to provide a feasible and effective recommendation

Where will this take place? What is the setting?

During household visits

Does something like this already exist? If so, how is this different?

Nothing like this exists in Nigeria to our knowledge.

Who needs to be involved and what are their roles and responsibilities?

Supervisors need to learn how to use the tool and orient CHWs to the tool. 

CHWs need to learn how to use the tool during their counseling sessions.

Session 3 Recap & Knowledge Check

Community Health Workers meeting
(USAID/ThinkPlace)

Key Takeaways

Insights & Identifying Design Opportunities

Revealing insights are composed of non-obvious learnings, are actionable, and offer a rich empathetic picture of the issue.

A good synthesis process generates good insights. That is why validation of the learnings is as essential as validation of the insight itself.

Validating insights before turning them into an opportunity is essential. This ensures that the project is going in the right direction.

HMW questions help teams focus on user needs and problems, rather than just jumping into solutions.

Check Your Understanding

Thank you for completing the third session of Applying Human-Centered Design to Improve Nutrition Programming. Next is an ungraded quiz to test your understanding of Session 3.
Click the Knowledge Check button to get started.

Knowledge Check

Identifying Design Opportunities

How Might We…

Turning insights into opportunity spaces

You may be thinking, “but we started the entire design process with a HMW question!” That may be true, but that HMW question was likely a broad question that was formulated prior to conducting research and formulating insights. Now is the time to formulate a more specific HMW question that links your research-informed insights to clear and actionable opportunity spaces. In doing so, teams and stakeholders are better able to imagine how the insights might be addressed without converging too quickly or without making decisions based on biases and assumptions, rather than on the insights themselves.

How Might We Basics

There is no prescriptive formula for the perfect How Might We question. Below are a few guiding tips to help you and your team turn your insights into HMWs:

Start by looking at the insight statements that you’ve created. Try rephrasing them as questions by adding “How might we?” at the beginning.

Now take a look at your HMW question and ask yourself if it allows for a variety of solutions. If it doesn’t, broaden it. Your HMW should generate a number of possible answers and will become a launchpad for your brainstorms.

Also make sure the HMW questions aren’t too broad. They should give you a good frame that allows you both to know where to start to brainstorm and enough room to explore wild ideas.

Repeat this process until you have several viable HMWs.

Once the HMWs have been generated, select those that resonate most with your users and your Core Design Team. You can use these HMWs, based on your insights, as your guides as you develop potential prototypes.

Consider using the following template to help you write your HMWs:

HMW Template

How might we _____________ [ACTION / WHAT] for ________ [INTENDED AUDIENCE] ____________ in order to _________ [DESIRED CHANGE]?

Finally, consider using this Actionable Insights Template to help you consolidate your linked insight(s) and HMW question into a single document.

Nigeria Case Study
Nourishing Connections

Putting How Might We (HMW) into Practice

Insights translate into HMW statements

Directing towards accessible foods

How might we…promote awareness around locally available and inexpensive healthy food options while positioning locally available foods as higher value and more desirable and appropriate for young children?

Food preparation confidence

How might we…improve food preparation and transformation capacity in mothers and caregivers to facilitate safe, nutritious, and digestible meals for children 6 to 24 months?

Reducing burden on mothers

How might we…strategically alleviate the cost, time, and energy burden placed on mothers and caregivers to prepare nutritious meals for their children 6 to 24 months in addition to their other household and community responsibilities?

Learn More

Consider using the Actionable Insights (Template) to help you consolidate your linked insight(s) and HMW question into a single document.

Actionable Insights (Template)

Test

Testing

What does it involve?

Now that you have identified prototypes, you need to share them with users to assess their functionality and performance, and to gauge the user experience to see if the prototype should be further developed or dropped.

A testing sprint is a round of testing at a particular level of fidelity, depending on what a design team intends to learn.

Testing Sprint

Flip the sprint cards to reveal what can be learned at each stage of the process.

Low-fidelity sprint

Concept validation/ desirability, early problem identification, and value proposition.

Medium-fidelity sprint

Usability, feasibility user flows, functionalities, interface, interaction patterns, navigation, and stakeholders communication.

High-fidelity sprint

Scalability, visual design, branding, refinement of value proposition, usability refinements, and functionalities.

Keep in mind that if you do not have the resources to conduct all the steps, you should check which learnings are most important for your team and focus on one sprint.

Iteration

Iteration is the act of making incremental improvements to prototypes based on feedback from testing. Iteration can be done within a single round of testing, and is always done between testing rounds (i.e., as you move from low- to medium-fidelity testing, your prototypes evolve based on what you learned). 

For example, imagine you test a prototype in a community forum that requires users to show up, but no one shows up. Perhaps the next day of testing, you change the location and test the prototype in homes during CHW consults, and you reach the intended. That is a simple example of iterative testing – making modifications as you go according to real-time feedback. This can be done within a round of testing, and is certainly done across rounds of testing.

How to prepare for a successful test?

It is finally time to test your prototypes! This is an exciting part of the design process as it is the first time you will get real-world feedback on your prototypes. Your mindset at this stage is more important than ever.

Ensure an open mindset

Remaining detached from “your ” prototype ideas can be so difficult, but is critical to the testing phase. It is natural to want to see prototypes succeed, but to get there we often have to learn what does not work first. Remember, the goal of prototyping is to break your idea, not to validate it. This is one of those times when failure really does mean success. Each learning is important and if one of the prototypes isn’t working, you want to know early so that you can adapt it or drop it altogether. The most important feedback is from the end users and if it doesn’t work for them, you have to honor that.

Keep Edison’s spirit of experimentation at the heart of your prototyping and testing.

“I have not failed. I’ve just found 10,000 ways that won’t work.”

– Thomas A. Edison

Testing checklist

Testing typically comes immediately after building prototypes and is conducted in a sprint fashion. In a low-fidelity setting, you would ideally have about 4-5 days over which to test your prototypes and get meaningful results though less time testing is also fine.

Review this testing checklist and make sure you and your team have a clear and shared understanding of what needs to be done for each prototype in preparation for testing.

Consider common design indicators

There are a variety of indicators that can be used during each sprint. It is critical to have consensus among your team about what you aim to learn. Use the example of indicators (below) to assess during each round of testing whether your prototypes work or not.

DesirabilityFeasibilityScalability
Driven by user preferencesDriven by internal, programmatic constraintsDriven by contextual factors & partnerships
Indicators (Predictors of Adoption)Indicators (Predictors of Efficient Operationalization)Indicators (Predictors of Replicability with the Same Success)
Relative Advantage
To what extent does it innovate upon current practices or precedents? If the innovation is perceived as an extreme change, then it will not be compatible with past experiences and is less likely to be adopted.		Risk and Positioning
Using the Risk Matrix/Innovation Portfolio, to what extent is this innovation similar to what PSI/DFID has seen before? To what extent, therefore, does it pose a risk in terms of ROI?		Replicability
To what extent can this innovation be efficiently replicated across contexts?
Trialability
To what extent is the user able to experiment with or practice the new behavior before it is adopted?		Technical Feasibility
To what extent is the innovation able to be efficiently produced within the programme’s resource constraints? 		Plaidoyer
To what extent are we already seeing signs of users promoting, detracting, and/or being passive about this innovation?
Observability
To what extent are the results (the change) of the innovation visible to others? If the observed effects are perceived to be small or non-existent, then the likelihood of adoption is reduced.		Logistical Feasibility
To what extent is the innovation able to be efficiently implemented within the programme’s resource constraints? 
Simplicity
To what extent is it perceived to be relatively easy to understand and use? Innovations that are perceived as complex are less likely to be adopted.		Financial Feasibility
To what extent is the innovation financially feasible within the programme’s resource constraints?		Long-term Financial Sustainability
Does the innovation need to be supported financially? To what extent do we have a plan for a self-sustaining mechanism for this?
Value (to user)
To what extent does it offer simplicity, efficiency, effectiveness or meaning for the user?
Value (to health facility/staff)
To what extent does it offer simplicity, efficiency, effectiveness or meaning for the health facility and/or staff?		Scientific Validity
To what extent does the innovation have the potential to directly lead to the desired behavior change?		Readiness
To what extent is the innovation appropriate for the broader market or user base?
Willingness to pay (if applicable)
To what extent is the user willing to pay for this product/service/offering?

Guidance for conducting successful rapid testing

Set clear objectives for your testing sprint, focus is essential.

Test with intended users. These are people who will be the final users so their feedback and insights are valuable.

Conduct iterative testing. Plan for several rounds of testing throughout the sprint rather than relying on a single testing session.

Use a realistic testing environment. Make sure you test in a real environment or mimic the real-world environment.

Test key hypotheses and your assumptions.

Facilitate cross-functional collaboration by building a multidisciplinary field team that is composed of not only designers, but also represents the voice of experience.

Mix qualitative and quantitative methods to capture proof of whether your prototype works or not. (This is described in further detail below.)

Time: Ideally you would have about 3-5 days to conduct a round of low- or medium-fidelity testing. High-fidelity testing takes 4-6 weeks. 

Team: Ideally the whole Core Design Team is conducting testing. Dividing into teams and splitting up the prototypes among teams helps create a manageable workload. 

Nigeria Case Study
Nourishing Connections

Testing in action

Breakthrough ACTION with USAID Advancing Nutrition tested a series of prototypes that consisted of three different audiences: Community Health Workers, caregivers, and family influencers (partners, midwives, mothers-in-law, and community leaders). The team tested the extent to which the prototypes helped each audience achieve specific goals. 

Before starting our tests, we created a model in which we defined what were the objectives to be achieved with each audience. As a result, our prototypes fostered the behaviors described in the scheme below.

Outcomes Assessed During Testing

Learning objectives and outcomes graphic

1. Community Health Worker

The tools help me: Gain trust, understand and address mothers’ needs regarding Feed children a more diverse diet from six months.

2. Mother

The tools help me to: Gain knowledge about, Better communicate my needs about, and Develop agency to provide: Feed my child a more diverse diet from six months.

3. Influencers

The tools help me to: Empower, motivate, and enable an environment for CHWs to support mothers to: Feed children a more diverse diet from 6 months.

Testing Methods

Simulation, Real-life environment, Focus groups & One-on-one

There are a variety of testing methods to assess user interaction with your prototypes. Some of the most commonly used methods include: Simulation, Real-life environment, Focus group discussion, and One-on-one. Click each method to see a description and examples

Simulation

Description

A simulation test goes beyond talking about the process and actually has teams to carry out the scenario.

Who to involve?

  • Primary users (in Nigeria, CHWs)
  • Testing team acting as end users

Examples

A counseling session is simulated using the prototype to see how a caregiver might react to the new content or approach.

Nourishing Connections Prototypes tested with this method:

  • Tips & Tricks
  • Meal Planner Game
  • Price Comparison Assumption Busting

Possible formats:

  • Roleplay
  • Storyboard
Real-life environment

Description

Expose the user(s) to the prototype in the real environment where the final solution is to be used.

Who to involve?

  • Primary user
  • End-user

Duration: Minimum of 60 minutes

Examples

Introduce the prototype into the routine of the CHW who might use it in the future with caregivers or families, in a real environment.

Nourishing Connections Prototypes tested with this method:

  • Assumption Busting during household visits.

Possible formats:

  • Physical spaces
  • Event or experience
Focus group discussion

Description

This method is used to demonstrate how the prototype should work and collect the users’ perceptions, feedback, and suggestions.

Who to involve?

  • Primary user
  • End-user

Duration: Minimum of 30 minutes

Examples

This method is usually suitable for testing policy solutions or a new strategy or process.

This method was not used during Nourishing Connections but is still worthy of mention.

Possible format:

  • Community gathering
One-on-one

Description

In this method, an individual is shown the prototype in a controlled session as they are exposed to the prototype.

Who to involve?

  • Primary user
  • End-user

Duration: Minimum of 60 minutes

Examples

Nourishing Connections Prototypes tested with this method:

  • Empathways
  • Your Own Adventure

Users were individually exposed to the prototype, and their feedback was collected to support prototype changes.

Possible formats:

  • Physical model
  • Products

Within a round of testing, be it low, medium, or high-fidelity, test each prototype a few times until you start to see saturation or are not learning new information with each new test. While there is no set number, but try for 3 tests for each prototype so you can start to develop a trend line. Iteration between tests is encouraged!

Collect User Feedback

HCD primarily uses qualitative methods to systematically collect, analyze, and evaluate data, though quantitative methods can also be used. Below are commonly used data collection methods. Methods should be selected based on the reality of your testing situation. Common methods include: think-aloud protocol, post-task or exit interview, Observation, and Net Promoter Score. Click each method to learn more.

Think-Aloud Protocol

A method where participants work through the flow of a specific experience (can be digital) while verbally describing what it is that they are doing and what they are expecting from each action.

This method was used during the Nigeria testing combined with one-on-one testing and focus group discussions. This allowed the team to improve the usability of the prototypes after each session before further testing.

Post-task or Exit Interview

In this method, the user or a group of users is interviewed at the end of the experience to capture perceptions, behaviors, feelings, and suggestions. 

This method was used in testing all of Nigeria’s prototypes because it allows the team to capture user input immediately.

Observation

In this method the tester observes and documents how the user interacts with the prototype to identify the implications for desirability, feasibility, and scalability. This does not involve directly asking questions to the users but instead involves paying close attention to what happened during the test followed by an objective interpretation of those observations. 

Observation was also used as a method in the Nigeria example in combination with simulation and real-life environment. This allowed the team to collect data without interrupting the users’ experience.

Net Promoter Score

In this method, the user will answer questions quantitatively without the interference of any tester. For example, “On a scale from 1 to 5, with 5 being the most likely, how likely are you to recommend this to a friend or family member?” 

This method can be used in combination with post-task because it is a quick and easy way to achieve the same goal.

Guidance for testing and collecting user feedback

What to doWhat to avoid
Ask them to “think out loud”
For example, if they are reading your content, ask them what they are thinking as they read it.		Avoid asking them their opinion
“Do you like my prototype?” 
“Do you think it’s a good idea to create an app?” 
Ask them what they would do
“What would you do if you wanted to find XX on this website?”
Ask them how they feel
“If you saw an app like this, what would you be feeling?” 
Ask open questions
“How would you react to this page?”
“In this section, you have three  options, which one would you click on?”		Avoid leading questions
“Is something missing from this step? 
Avoid hypotheticals
“Would you buy this app?”
Avoid asking them for the solution
“How would you design this?”
Watch their reactions Don’t just believe what they say 
Ask why
“You said you’re confused here, why is that?”		Avoid answering their questions
“The reason we have that section of the App is to….” 

Remember to document, document, document! Take notes and photographs, with permission of course. Use the daily synthesis tool to help you synthesize your daily results.

Evaluate testing results

The evaluation process in HCD is continuous and informs the improvement of the prototype over the course of the testing sprint or across rounds of testing. Here are the general steps for continuous evaluation that enable iteration throughout.

Daily debrief

At the end of each day of testing the prototypes take 30-60 minutes to connect with your team to discuss the results. This meeting is used for rapid analysis of testing results, including sharing observations, impressions of what worked and what didn’t work, and recommendations the group has to iterate and adapt prototypes and improve them. Use the daily synthesis tool to help facilitate your debriefs. 

Final synthesis

This is the final session where the team’s learnings will be analyzed to generate a final recommendation about the solution.

  • During this session, your testing results should continue to yield actionable information about the questions and assumptions you tested. This information should inform decisions about:
    • Should I recommend implementing the prototype?
    • Should I recommend abandoning the prototype? 
    • Should I recommend an additional iteration/adaptation and testing of the prototype?
  • Each recommendation should be accompanied by a clear “why” behind the recommendation.

Nigeria Case Study
Nourishing Connections

Key Learnings

Learning 1

CHWs resisted sharing their own experiences as a way to engage with mothers and caregivers. The testing team identified that this realization could ultimately compromise the “compassionate care” strategy as CHWs feared gossip, looking weak, and losing control of the process.  For this reason, the team focused on creating strategies about how to encourage CHWs to be more open with the caregivers and families they serve.

What’s the bottom line? This learning provoked changes to the Empathways prototype, such as the creation of the “Share just enough” concept that was introduced in the training.

Learning 2

Compassionate counseling requires a different skill set. Listening actively for more than 1 minute, being vulnerable, asking probing questions, writing down key points, and developing and sharing recommendations all at the same time is a drastic change in the skill set, mindset, and expectations for CHWs in their counseling interactions with caregivers and family members.

What’s the bottom line? Understanding this learning changed the flow of all of the prototypes. Based on the testing, it was decided to make the prototypes more flexible for the CHWs with Empathways and incorporate Assumption Busting as a  part of the same tool to create a logical flow  easily for the CHWs to follow. The key questions at the opening of the tool were then added to encourage CHWs to provide relevant recommendations that speak to the specific needs of the caregiver they are counseling rather than recite messages that may not be relevant.

Insights

Community Health Workers meeting
(USAID/ThinkPlace)

Learning Objectives

After completing this session, you will be able to:

Understand what an insight is, its role in SBC, and when and how to generate an insight

Recognize the key characteristics of a strong insight

Where are we in the process?

Diagram showing Stage II. Define occurs when ideas converge to determine "What are the problems?"

Who is involved?

At this stage, you should involve those conducting the research (not including the research participants) and the Core Design Team (specifically the Voice of Expertise).

Voice of Expertise

Those who have technical expertise in the subject area.

What is an insight?

While an insight can be defined in many different ways, an insight for design purposes is a succinct finding that helps you see an old problem in a new, humanistic way. It is a clear, deep, and sometimes sudden understanding of a complicated problem or situation.

“An insight helps explain why something is happening in a way that creates empathy and is respectful of the people from whom the insight was derived.”

ThinkPlace Global Institute of Regenerative Design & Terry, 2022

Insights Help Define Problems

Insights help define a problem by highlighting people’s words, behaviors, interactions, perceptions, feelings, and thoughts (ThinkPlace, 2017).

Words

What are users saying and how are they saying it? What words and tone are they using?

Behaviors

What are users currently doing with regards to the problem at hand? How are they making do within the current environment?

Interactions

What are their interactions with the service, product, or system? How do they connect?

Perceptions

What do people believe about the service, product, or system? This is often not what the service provider or client expects and might be “wrong” in their eyes; however, it is what the user believes.

Feelings

How does the users’ experience make them feel? How does interacting with the service, product, or system make them feel?

Thoughts

What do users think about the service, product, or system? What are they thinking when they use it?

What is not an insight

Data and facts

“62% of women use family planning methods.”

Observations

“The women go to the market twice a week.”

Wish & need statements

“As a community health volunteer, I would have liked to have been paid more.”

Exemplary Insights

Click each insight to see a description and to learn how it was applied in the Case Study (ThinkPlace Global Institute of Regenerative Design & Terry, 2022).

Uncover something new

Description

Les eureka moment refers to the common human experience of suddenly understanding a previously incomprehensible problem or concept.

Insights in Action: Nourishing Connections Case Study

Insight: CHW counseling sessions may provide helpful food choice and meal guidance, but do not always leave mothers and caregivers feeling sufficiently equipped or confident in their ability to prepare appropriate meals, reducing their likelihood to feed their children appropriately.

This reveals that current methods used to teach caregivers about complementary feeding are not effective at helping them retain information and do not leave them with the skills or confidence to act.

Stimulate ideas and are actionable

Description

Les opportunity moment when the mind tips toward “How might we?” and there is natural energy that flows when the insight triggers a question that leans towards a possible solution.

Insights in Action: Nourishing Connections Case Study

This insight presents a natural opportunity moment: “How might we help caregivers feel confident in their ability to prepare appropriate meals?”

Build a rich picture of empathy

Description

Les empathy moment refers to the tipping point that once insights have been read/discussed, there is a material shift in the hearts and minds of the problem and opportunity.

Insights in Action: Nourishing Connections Case Study

The fact that caregivers feel ill-equipped and to act on this knowledge is something universally relatable. This shifts the challenge from being about didactic knowledge transfer to helping people feel prepared to do something that they are intrinsically motivated to do. Much more human-centered!

Why do insights matter for SBC nutrition work?

Insights help uncover what matters most to the people who are experiencing the problem. When done well, insights can help you see an old problem in a new way and be a launchpad for new and fresh ways to address people’s challenges.

Now that you know what an insight is and what they contain, let’s learn how to generate your own insights. This is one of the most crucial points in the design process because it directly shapes the opportunities for which solutions are designed and usually requires deep immersion into the data over a period of time.

Generating Insights

The goal of generating insights is to synthesize and transform data collected during your design research into insights. Generating insights is the transition from raw, disparate data to interpreted, meaningful information. It is the sense-making phase – making sense of all the inputs gathered during the research and transforming them into knowledge that reveals design opportunities.

Key Outputs

A set of insights that succinctly and powerfully communicate key findings from the design research.

Design opportunities in the form of How Might We statements.

Steps to Generate Insights

Generating insights is an intensive, rapid, and creative process. It starts with the raw data (i.e. observations, notes, stories, quotes, and images) gleaned from the research and leads to design opportunities that  inspire the next phase in the design process. Click each step to learn more.

Step 1: Capture data and observations

The objective is to verify as much information as possible. At this point you are interested in information that points in the direction of specific behaviors, how the intended population experience the problem, how they overcome the problem, quotes, social norms, routine, influencers, specific cultural aspects, and others.

Synthesis can feel messy and overwhelming at first. Start by documenting and organizing your data and observations with your team. As a team, share reflections and stories about the research process and your own impressions. Capture these inputs on post-its or in another way so that the information is visible and can be moved around.

Step 2: Cluster

The objective is to find initial high-level themes or groupings.

Mine the data and begin to physically group them around any recurring ideas or themes. Use different colors to help you organize. Consider organizing around different user groups or other categories. Label the clusters.

Step 3: Identify sub-themes

The objective is to dive deeper into the initial themes. 

Now that you have some high-level themes, dig into them further. What else are they trying to tell you? Are new themes emerging? These deeper sub-themes will be the kernels for generating insights. 

Here you should maximize the interaction between designers and researchers in your Core Design Team. The voice of expertise and experience will help your team to refine the insights, and together you will create a new and unique view of the problem.

Themes and sub-themes in action: Nourishing Connections Case Study 

ThemesSub-themes
Nigeria Case StudyFood behaviors
Beliefs (cultural beliefs, complementary feeding beliefs, dietary diversity beliefs)
Roles and influencers
Supportive system
Counseling services
Counseling needs
Step 4: Generate Insights

The objective is to create a first draft of insights, then review and refine them so that they reflect the following characteristics:

CharacteristicNourishing Connections Case Study Examples 
Makes an emotional connection
It connects with users on an emotional level and elicits the “you obviously get me” reaction.		“Our sessions last 45 min-1h and we have many messages to pass on. The mothers don’t feel listened” CHW, Faika.
Challenge existing thoughts
It re-examines existing conventions and challenges the status quo.		Most CHWs understand the value of being empathetic and sharing back their own experiences as mothers; however, they fear others gossiping about them.
Improves lives
It solves a real problem that improves the lives of users.		Families often share a single mobile phone, which they use to share information more often than anything else.
Inspires clear actions
It inspires actions giving you a clear goal to aim toward.		Mothers are strongly influenced by their mother-in-laws on their complementary feeding practices, especially when they live in the same household.
Produces values for users
It is a clear statement of what to do next and how to deliver value to users.		Community meetings are a space that unites mothers, fathers, grandparents, and neighbors. Therefore, it is a great space for CHWs to reinforce messages or have them validated by the community leader.
Use the Actionable Insights (Template) to help you craft a strong insight.
Step 5: Validate and refine insights

The objective is to get feedback from those involved in the process. Here you should consult not only the Core Design Team, but the intended population and their influencers as well – How strongly do these insights resonate? What is missing? 

Check the insights against the insights characteristics listed above.

Case Study
Nourishing Connections

Insights in Action

Supporting Quotes

  • CHW counseling sessions may provide helpful food choice and meal guidance, but do not always leave mothers and caregivers feeling sufficiently equipped or confident in their ability to prepare appropriate meals, reducing their likelihood to feed their children appropriately. → EMPATHY

“Some parents don’t practice what they have been taught and it makes it difficult for them to process the meals.”

– Community leader, Arewa
  • While mothers may understand which foods to introduce to their children based on counseling sessions, many expressed that they did not know how to prepare foods that are safe and digestible for their children between 6 and 24 months.

“Some [caregivers] don’t know how to prepare [nutritious foods] or where to get it in the town.”

– Community leader, Fakai
  • After counseling sessions, many parents and caregivers forgot the complementary feeding process outlined to them by the CHW and several CHWs across all 3 local government areas (LGAs) described difficulties experienced by mothers and caregivers to understand or comprehend the complementary feeding process due to language barriers or the absence of visual guides.

“The most common concern of mothers and caregivers is the knowledge on how to process food at home.”

– CHW, Fakai
  • This insight helps us empathize with caregiver needs and reveals a specific opportunity to improve caregivers’ knowledge and confidence in preparing healthy meals.

“[During counseling, I asked the CHW] why they advise that a child less than 6 months should not be given water and what type of foods [to] feed my baby after months.”

– Mother, Sura

Key tips for generating insights

Do not rush – It takes time to create an insight that is not obvious yet grounded in data.

Collaborate – Validate and refine insights according to feedback. It is normal to go through several iterations to arrive at a strong insight. This can be done within the Core Design Team and/or by creating a story that represents the insight. Always ask the audience involved in the challenge.

Stay close to the data – Strengthen insights with supporting quotes from the research that clearly illustrate your point (also known as “golden quotes”).

Step away! – After the initial synthesis work is complete, return to the insights to look at them with fresh eyes. This “incubation” period of consciously stepping away from the data is an essential step (ThinkPlace Global Institute of Regenerative Design & Terry, 2022).

Look outside – Consider looking at a parallel sector or completely different sector for inspiration or disruption.

Once your insights have emerged, start transforming them into design opportunities for your users.