Human-centered design (HCD) — a problem-solving approach that places human experience at the core — is a term that has become so popular, it borders on being overused. But at Noora Health, we’ve found that when practiced as a way of working, HCD plays a crucial role in delivering better healthcare outcomes. It anchors everything we do.
So what does that actually mean in practice? And, how does HCD show up in the real world, especially in low-resource settings?
In April, Noora Health hosted a panel titled Human-Centered Design in Health Interventions: Realities, Challenges, and Impact at the World Health Summit (WHS) Regional Meeting in New Delhi, India. The panel brought together a diverse group of leaders across public health and design: Dr. Manoj Jhalani, Director of Health Systems Development at the WHO South-East Asia Regional Office; Mohammed Shahnawaz, Co-founder and COO of Khushi Baby; Shrirupa Sengupta, Director at Swasti’s Center for Strategic Communications for Public Health; and Samina Rahman, Director, Shared Program Design and Development at Noora Health, and the co-author of this piece. The conversation was moderated by Prerak Mehta, Partner at Dalberg Design.
Together, we unpacked answers to familiar questions, like the ones we mentioned earlier. In this piece, we reflect on the panel and share real examples of HCD in use, which speak to the critical role it can play in healthcare, even with resource constraints.
Isn’t healthcare people-centered by default?
Healthcare deals directly with human lives, emotions, fears, and needs. So, at first glance, it may seem like it should be people-centered by default. However, the systems, structures, and decisions that shape healthcare delivery often feel, or can be, far removed from the lived realities of those they intend to serve.
That’s where HCD becomes essential, not just as a method but as a way of working. HCD is about designing with people, not for them. Healthcare and health behaviours cannot be viewed only through a systemic lens. What shapes healthcare realities in one’s everyday life are motivations, aspirations, and beliefs that make the core of what it means to be human.
So, in healthcare, where outcomes hinge on trust, behavior, and context, HCD is not optional; it’s foundational.
We’ve seen countless methodologies — design thinking, service design, systems design — used in public health. But HCD’s relevance lies in its intimacy. It prioritizes deep listening over assuming, empathy over authority, and co-creating over prescribing. This makes all the difference in healthcare, where every ‘user’ is a person navigating deeply human, and challenging experiences.
Take an example shared during the panel by Dr. Jhalani from the WHO. When he was at a hospital in Hyderabad, he noticed a pregnant woman who had come to the facility being pushed up a ramp on a stretcher. This, he knew, could cause the baby to press against her chest and add to her discomfort. He shared his concern with the hospital administration who, later, decided to move the labor ward to the ground floor.
“When I look at human-centered design I am thinking about people-centeredness. I am thinking of keeping people, their needs, their aspirations, their cultural preferences, their caregivers’ preferences, and the healthcare providers’ (preferences in mind) and trying to optimize and harmonize their needs, and addressing them in order of priority,” Dr. Jhalani added.
Designing interventions that actually work
One of the most common misconceptions about HCD — given it has the word design in it — is that it’s a resource-intensive luxury that needs specialized skill sets, time, and possibly even specialized funding. But in reality, it’s the opposite. A key insight we arrived at during the panel was that rather than worrying about how to practice HCD in low-resource settings, we should practice HCD because we are in low-resource settings.
At Noora Health, that’s exactly what we strive for. Like most nonprofits, we work with finite resources — limited time, funding, and capacity. In such resource-constrained settings, the HCD focus helps us test assumptions early on, invite feedback and then effectively co-create iterative solutions that work in the longer run.
While it could potentially feel like an unnecessary divergence, in practice it’s a way that helps us fail forward and learn fast.
A recent example from our new maternal and newborn health program in Nepal comes to mind. As part of the design process, we co-created multiple artefacts like flip charts and posters for nurses to use when sharing important health information with expectant and new mothers at hospitals. Even though these were designed collaboratively, with critical inputs by both the nurses and patients and their families, we still decided to ‘test’ the almost final versions in the real context before locking the designs.
We printed simple colored mock-ups in the right sizes and listed key assumptions to validate: Could nurses and mothers understand the content? Was it easy to use? Did it fit into daily routines? Was it placed in the right spot? The testing surfaced exactly what needed refinement. Some visuals were confusing, some placements impractical, and a few instructions too complex, even for the nurses.
Ultimately, half the artefacts proved to be inconsequential. And these quick tests helped us make critical decisions that helped manage the subsequent launch and implementation in a more resource-effective manner. Simple, but radical.
During the discussion, Khushi Baby’s Shahnawaz also spoke about applying a human-centered lens in the organization’s early days, despite operating with limited resources. “We didn’t have enough resources or the bandwidth, but we did paper prototyping. We made rough sketches on paper and took them to the field to get feedback,” he shared.
The common thread across these examples is a deliberate focus on identifying who we are designing for and ensuring their needs remain central throughout the process. In environments where people are stretched thin and overworked, keeping the real human — whether a health worker, patient, family member, or administrator — at the heart of our approach is critical to building solutions that are both practical and enduring. This is where HCD keeps us grounded in what truly matters, helping us avoid unnecessary complexity and waste.
“We have to remember that even in human-centered design, who is the human is a major question, which human is a major question,” Swasti’s Sengupta said.
Balancing ethics, politics, and human realities
Systems are complex. And any system with this level of human interaction and dependency is not without its share of political and ethical realities. When we anchor our work with the principles of HCD, it becomes important to even ask the core question: Whose voice are we actually highlighting? And who decides this?
“One of the first questions you should ask yourself — and this isn’t a prescription, just a suggestion — is not ‘Are we including everyone?’ but rather, ‘Are we excluding someone?’ And then design for that. Because the moment you ask, ‘Am I including everyone?’ the instinctive answer is usually yes,” added Sengupta
HCD reminds us to keep asking these questions upfront, and continue to repeat them at every step.
Yes, it is not always possible to design for all, but the least this process helps us to do is to highlight who we are actively choosing to exclude from this group, and why. It can be hard, but acknowledgement keeps us accountable.
For us at Noora Health, this is a critical step in our design process. When we build a messaging-based digital service, we need to know the actual realities of phone usage or gendered access. When we are recommending nutritious diet charts to families, it is extremely important to acknowledge that caste, access, rituals, and customs are too deep rooted into these behaviors for us to make an easy impact. And so we have to continue to learn. For example, when talking about maternal diet, Noora Health’s messaging just adds a simple sentence: “Practice your customs, but don’t restrict the mother’s diet.” It doesn’t seem like much, but we’ve seen that this small act of acknowledgment goes a long way in building trust.
No matter what we do, there will be gaps. So we must be humble enough to acknowledge them, and intentional enough to develop mechanisms to keep learning forward — returning to the human again and again, keeping an open mind about being proved wrong, and continuously improving what we’re building with and for the people we aim to support.
HCD is important, and one thing we’ve learnt over the years is that it is also very hard to practice. Not because it is complicated or resource intensive, but because it needs a different kind of rigor, rooted in empathy, deep listening, and constant iteration. And when done with intent and care, HCD is what makes all the difference between good design, and an impactful, sustainable solution for behavior change.
Samina Rahman
Director, Program Design and Development
Deepti Govind
Communications Lead
