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Rose Matthews
Co-Designing Across
Cultural Boundaries
INTERDISCIPLINARY APPROACH
Technical Public Health, Development,
Clinical, Emergency Response
Co-ordination Project Management, Monitoring
& Evaluation, Partnerships
Comms Campaigns, Behaviour,
Engagement & Advocacy
System, Service, Product, Space,
Experience, Interaction
Research Social Sciences, Mixed Method,
Participatory, Creative
Futures
Policy, Trends, Scenarios
Creative Strategy, Concept, Visual / Art,
Storytelling
Design
Design
Research
Creative
Co-ordination
Futures
Comms
Technical
OUTCOMES
• New knowledge
• New service models
• System strengthening
strategies
• Product, space innovation
• Behaviour change
initiatives
• Campaigning, advocacy
• Capacity building and
organisational change
What is co-design?
ExpertDesigner
”Asking the end users to
design their own solution.”
”Asking the end users to
design their own solution.”
”Crafting activities that
uncover their needs.”
Designer
Expert
ExpertExpert
Expert Expert
OPEN
EXPLORATION
COLLABORATIVE
SYNTHESIS &
IDEATION
PILOTINGPROTOTYPING &
ITERATION
CO-DESIGN IS CONTINUOUS
Replicating desired
outcomes through rapid,
iterative prototyping.
DISCOVER UNDERSTAND IMPLEMENTCREATE
EXAMPLE METHODS
Focus Groups
Contextual Interviews
Group Exercises (journey mapping, card sorting etc)
Ideation Cards
Concept Test (e.g. roleplay)
Prototyping
Piloting
Etc
CULTURAL DIFFERENCES
Language & dialect
Level of education / literacy
Religious beliefs
Gender, age and marital status
Customs and etiquette
Legal and moral views
Arts and music
Food and drink
Men need to
give permission
Age =
status
Homosexuality
is illegal and
immoral
An unmarried
woman shouldn’t
hear certain things
Work is
strictly
hierarchical
Free to talk about anything,
openly and honestly
Observations over
conversations
Who leads the activities?
Who can / should be there?
Pictorial tools
Local materials
Incentivisation
Informed consent
TACTICS
Pictorial instruments
Local ’guide’ (e.g. community healthcare worker)
Continual iteration of tools
Observations over descriptions
Local materials, familiarity
Careful team selection – who should run and attend sessions
What we offer in return – polaroids, food etc
OPEN
EXPLORATION
COLLABORATIVE
SYNTHESIS &
IDEATION
PILOTINGPROTOTYPING &
ITERATION
CO-DESIGN IN DISCOVER PHASE
Replicating desired
outcomes through rapid,
iterative prototyping.
DISCOVER UNDERSTAND IMPLEMENTCREATE
Focus	group	discussion	with	17-20	year	old	women	in	Bihar,	India
DISCOVER
Exploring	a	male	perspective	on	women’s	health	in	Agege,	Nigeria
DISCOVER
Meeting	a	man	who	performs	circumcisions	and	other	rituals	in	a	Hausa	community
DISCOVER
Joining	a	medical	team	in	Kenya
DISCOVER
LESSONS IN THE DISCOVER PHASE
The first set of instruments is only a starting point
Translations and transcripts take time
Cultural immersion and mapping
Right place, right time – go with the flow!
OPEN
EXPLORATION
COLLABORATIVE
SYNTHESIS &
IDEATION
PILOTINGPROTOTYPING &
ITERATION
CO-DESIGN IN UNDERSTAND PHASE
Replicating desired
outcomes through rapid,
iterative prototyping.
DISCOVER UNDERSTAND IMPLEMENTCREATE
Thorough analysis of	data,	tagging sources with reference numbers
UNDERSTAND
Mapping	out	solution	concepts	according	to	where	they	sit	in	a	service	ecosystem
UNDERSTAND
Design	Sprint	with	experts	from	around	the	globe,	meeting	here	in	Helsinki
UNDERSTAND
Mapping	out	progression	of	a	woman’s	labour in	Kilgoris,	Kenya
UNDERSTAND
Developing	new	concepts	and	evaluating	them	against	chosen	criteria
UNDERSTAND
LESSONS IN THE UNDERSTAND PHASE
The value of thorough data analysis and synthesis
Bringing in the voice of the end user
Guiding the process of ideation
Clarity of ’what next?’
OPEN
EXPLORATION
COLLABORATIVE
SYNTHESIS&
IDEATION
PILOTING PROTOTYPING&
ITERATION
CO-DESIGNINCREATEPHASE
Replicatingdesired
outcomesthroughrapid,
iterativeprototyping.
DISCOVERUNDERSTANDIMPLEMENT CREATE
Activity	title
Activity	description
1.
2.
3.
4.
5.
Outputs Plan	for	
synthesis
Learnings
Data	from	other	sources
Tracking changes over time
Existing trackers
Date & time
Symbol mapping
Calendar choice
Pilot of calendar
Other projects around tracking
Expert interviews
Religious events based on date
Current
mechanisms
Selection of
symbols
Usage results
Affinity map
of symbols
Collection of
successful and
unsuccessful
mechanisms
Health
trackers to
prototype
and test
Organising co-design	activities	in	a	way	that	allows	us	to	rigorously	test	and	evaluate	the	concepts
Sketching	out	tools	that	can	line	up	with	our	requirements
CREATE
Prototyping	product	ideas
CREATE
Health	tracking	calendar
CREATE
CREATE
CREATE
LESSONS IN THE CREATE PHASE
Be ready to abandon your favourite idea
Bring implementers in from the start
Look for local production opportunities
Consider wider impact on the community
OPEN
EXPLORATION
COLLABORATIVE
SYNTHESIS &
IDEATION
PILOTINGPROTOTYPING &
ITERATION
CO-DESIGN IN IMPLEMENT PHASE
Replicating desired
outcomes through rapid,
iterative prototyping.
DISCOVER UNDERSTAND IMPLEMENTCREATE
Prototyping and testing
IMPLEMENT
ODISHA PILOT - BALASORE & BASTA
LESSONS IN THE IMPLEMENT PHASE
Multiple partners required – bring them in early
Clear measurement and evaluation plan
Definition of success
Thank you!

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Rose Matthews, M4ID // Co-design for cultural barriers