Human-centered eradication: A social science approach

Transcription

1 Human-centered eradication: A social science approach Theresa Jones + Juliet Bedford, Anthrologica Benjamin Hickler, UNICEF SBCC Summit Nusa Dua, May 2018

2 WHAT DO WE MEAN BY HUMAN CENTERED? Increasing recognition of importance of social and behavioral determinants in disease control and public health. Different figures of the human from different traditions: - anthropology and sociology - behavioral sciences - human-centered design Despite recurring recognition of importance, why are human-centered approaches so challenging to put into practice? WHAT DO WE MEAN BY HUMAN CENTERED? 2

3 DIFFERENT FIGURES OF THE HUMAN IN HUMAN -CENTERED APPROACHES Anthropology / sociology and public health 7 Local rationality Despite how things may look at first glance, most human behavior is perfectly reasonable if you understand local experience, meaning, beliefs regarding disease. Listen first Listening to community perspectives should precede prescribing solutions. Listening helps us understand local perspectives, which drive behavior. Acting before listening can often backfire. Participation and negotiation Involving communities in the development and implementation of solutions contributes to local ownership and sustainability of more appropriate solutions. 3

4 DIFFERENT FIGURES OF THE HUMAN IN HUMAN -CENTERED APPROACHES Behavioral sciences and public health 7 ALL humans are (predictably) irrational: An abundance of evidence shows that humans are riddled with cognitive and behavioral biases. This applies to everyone. Humans do not understand themselves: People overestimate their ability to describe why they do what they do. Human brains are lazy: Human cognition requires all sorts of shortcuts to make sense of things. People easily ignore information that contradicts existing beliefs and assumptions. Many behaviors are governed by entrenched habits. 4

5 DIFFERENT FIGURES OF THE HUMAN IN HUMAN -CENTERED APPROACHES Human-Centered Design (HCD) and public health 7 Problem driven, solution agnostic does not only focus on the client or customer, but entirety of human and environmental factors. E.g., Health workers are people too! Takes insights from social and behavioral sciences and designs them into methods. Principles include: make it, test it, iterate and scale. Fail fast, learn and adjust. Encourages teamwork and co-design of solutions directly with end users. Does not stop with diagnosis. All insights are followed by prompts: how might we?

6 HOW IS HCD DIFFERENT? HCD is experimental, encouraging small trials to build scalable solutions Work in a collaborative team of 3-5 with diverse skillsets Don t outsource insights! Observe and talk to people in their home, community, or clinic Everyone is creative and can make things you learn when you break your routine Think in weeks, not months Share the richness and implications of stories showing is more powerful than telling Observe change in person prototype solutions in context 6

7 WHAT DO WE MEAN BY HUMAN CENTERED? Anthropology / Sociology Behavioral Sciences Human-Centered Design Time intensive Time intensive Rapid In the field In the lab In the field Individual Collective Collaborative Professionalized Professionalized Easily teachable Deep understanding Peer-reviewed evidence Actionable insights Ethnographic methods Experimental methods Eclectic methods Particular General Specific Local Universal Local Norms as object Norms as lever Norms as lever 7

8 WHAT DO WE MEAN BY HUMAN-CENTERED? Can these distinct approaches be synthesized? Design Thinking Swift, low-cost, multimethod research is often sufficient. Test solutions, iterate, learn and improve. Co-design solutions with communities. Evidence-based insights about human universals. People are irrational, lazy, and unreliable sources of information about why they do what they do. Proceed accordingly. Behavioral Sciences Good solutions depend on deep insights about human particulars, local beliefs and values. Empathy, understanding, and participation will improve outcomes of interventions. Can these be brought into productive alignment? Sociology and Anthropology How? 8

9 TOWARDS A SYNTHESIS OF HUMAN-CENTERED APPROACHES A Human-Centered Approach - principles 7 ALL humans are (predictably) irrational: An abundance of evidence shows that humans are riddled with cognitive and behavioral biases. This applies to everyone, not just the targets of interventions Humans do not understand themselves: People overestimate their ability to describe why they do what they do. What people say they do and believe is poorly correlated with how people actually behave. Human brains are lazy: Human cognition requires all sorts of shortcuts to make sense of things. People easily ignore information that contradict existing beliefs and assumptions. Behaviors are governed by entrenched habits. Small Is Big Knowing Is Not Enough Attention Is Elsewhere Context Comes First Truths Are Buried Intentions Are Not Actions Little things can The focus on Most people do Environment What people There is a make a big knowledge is not think about usually trumps say, believe and significant gap difference. often misplaced. the concerns of cognition and do are often between Leverage hassle Information is the health communication. three distinct intentions and factors and rarely enough to professionals. Make the desired things. We can t actions. We can little pleasures. influence They have other action the easiest rely on a single use nudges to behavior. priorities. action. method. help bridge it. 99

10 TOWARDS A SYNTHESIS OF HUMAN-CENTERED APPROACHES A Human-Centered Approach - process 7 ALL humans are (predictably) irrational: An abundance of evidence shows that humans are riddled with cognitive and behavioral biases. This applies to everyone, not just the targets of interventions Humans do not understand themselves: People overestimate their ability to describe why they do what they do. What people say they do and believe is poorly correlated with how people actually behave. Human brains are lazy: Human cognition requires all sorts of shortcuts to make sense of things. People easily ignore information that contradict existing beliefs and assumptions. Behaviors are governed by entrenched habits. Small Is Big Knowing Is Not Enough Attention Is Elsewhere Context Comes First Truths Are Buried Intentions Are Not Actions Begin with a problem rather than a solution. Simple techniques can be used to challenge biases we bring to situations. Apply multi-method approaches, mixing observation with dialogue and participation. Ask how might we? Build prototypes of solutions to be deployed, tested and adjusted. Iterate, embrace failure. Learn to scale and scale to learn. 10

11 WHAT IS HUMAN-CENTERED DESIGN? The process addresses demand by focusing on users and decision making. It requires two simple tasks: 1. Observe 2. Ask Questions INTRODUCING HUMAN-CENTERED PROCESSES 11

12 WHAT IS HUMAN-CENTERED DESIGN? The process addresses demand by focusing on users and decision making. It requires two simple tasks: 1. Observe 2. Ask Questions INTRODUCING HUMAN-CENTERED PROCESSES 12

13 Why do global disease control initiatives so consistently fail to take human-centered approaches? Why does it so often take things going wrong to take human-centered approaches seriously? 1 3

14 How might we help planning organizations learn to be learning organizations? 1 4

15 How might we stop outsourcing the generation of insights? And how might we ensure insights actually inform actions? 1 5

16 How might we encourage risk-taking and embrace of failure as an opportunity to learn? 1 6

17 Thank you! 17