LIGHT focuses on the co-creative design of cost-effective technology solutions to healthcare challenges in low- and middle-income countries and in doing so, we investigate the design processes that produce effective and usable devices. We use design ethnography to develop a deep understanding of contexts and stakeholders to inform design decisions.
Truly innovative solutions are not only creative, but also practical in the context of a culture and its people. To accomplish this, the engineering design field has expanded from a function-centered view to include a human-centered view of design processes, where the focus is on developing an experience between the user and the product. Design ethnography is a methodology by which a designer can develop a thorough understanding of a products stakeholder and context-of-use in order to inform design decisions. Design ethnography evolved from the ethnographic techniques developed by anthropologists. Adapted for use by design engineers, design ethnography attempts to understand and represent the perspectives of daily life and defines approaches for understanding the actions, words, and thoughts of users and stakeholders in order to inform design decisions. A key advantage of design ethnography methods like observations and in-depth interviews is that designers have the opportunity to discover needs and problems that are not otherwise obvious to the designer or even the user. By placing the researcher into the users’ environments and exploring the ways the users engage in daily life, design ethnography data collection methods can remove biases and pitfalls of self-reporting, because they allow direct examination of users’ potential needs. Our lab is interested in how design ethnography can be used to design medical devices in low-resource settings, how novices learn and use design ethnography, and how novice use compares to expert use of design ethnography.
Prototyping during the front-end phases of design
Prototypes play an essential role in the product design process and enable designers to specify, meet and verify design and engineering challenges. Since engineers are not typically trained in immersive methods, the solutions they develop often do not include the ethnographic foundation that is crucial to a product’s successful adoption. Expert practitioners develop ethnographic skills that they use to form a deep understanding of the design problem, with both users and stakeholders involved, and use prototypes frequently to share ideas, reiterate and elicit information essential for making design decisions. We examine how and when designers use prototypes in the development cycle and how prototypes assist during stakeholder interactions, identification of user requirements, verification of goals and their overall contribution to a successful project outcome.
Subcutaneous underarm contraceptive insertion device
Providing access to family planning services in low- and middle-income countries is a major focus of the global health community. Subcutaneous implant contraceptive methods are an effective reversible contraception methods available. Subcutaneous implants are single (or double) rods that contain etonogestrel and are inserted subdermally on the inner side of a woman's non-dominant arm. Despite the benefits, major barriers exist that prevent wider usage; namely, the training and skill required for performing insertion/removal procedures. This barrier is exacerbated in rural areas where access to health clinics, medical devices, and trained clinicians is more limited. Our lab has developed an assistive device that allows minimally trained healthcare workers (such as community health workers in rural areas) to perform Implanon insertion safely and accurately.
Task shifting medical devices
Expanding access of medical services to a larger proportion of the population is critical to improving health outcomes worldwide. However, a major barrier to access is the lack of highly trained medical personnel in most areas of low- and middle-income countries. Developing medical devices that reduce the training needed to perform medical procedures would allow medical services to be expanded to underserved populations. Development of these task-shifting or task-sharing medical devices is critical to enabling different cadres of healthcare workers to perform more medical procedures safely, and easily. LIGHT focusses on understanding what it means for a device to be task-shifting in order to be better able to purposefully develop these important devices in the future.
A tool to increase the likelihood of safe traditional adult male circumcision outcomes
The growing body of evidence attesting to the effectiveness of clinical male circumcision in the prevention of HIV/AIDS transmission is prompting the majority of sub-Saharan African governments to move towards the adoption of voluntary medical male circumcision. While clinical male circumcision has been promoted as a biomedical intervention to reduce HIV/AIDS acquisition, traditional male circumcision, a cultural ritual in parts of sub-Saharan Africa, has been practiced for centuries as a rite of passage for young men ages between 10 and 20. However, traditional adult male circumcision is associated with high adverse events rate, such as excessive bleeding, glans injury, infection, and even death. To address the need to make traditional adult male circumcision safer, we have been working on design and development of a culturally appropriate tool that allows target communities in sub-Saharan Africa to continue their tradition while ensuring safer outcomes of traditional circumcision. In this project, we have been focusing on co-creative design process to develop a tool that is not only robust based on engineering design, but is also appropriate based on feedback gathered from experts in the field in sub-Saharan Africa.
Compendium of global health medical devices
The design, development, and implementation of health-related technologies for resource limited settings require a detailed consideration of the end user and target community that goes beyond the traditional engineering design needs assessment. In a broader sense, economic, social, and cultural constraints must be considered for successful implementation of technologies. Such constraints are often difficult or impossible to ascertain a priori, necessitating significant fieldwork; there is currently no database where prospective designers for global health can review how others have fared with similar and diverse challenges. We have developed a compendium of medical devices through research of best practices in medical devices designed for diagnosis, treatment, and prevention of the World Health Organization top ten causes of death in low-income countries in addition to Millennium Development Goals 4 and 5 (maternal and infant/child mortality). The online, free, and wiki-based compendium of global health medical device allows users to search for any medical device that is designed for or used in a developing setting based on a given health challenge (ex. HIV, Malaria, etc.), or device classification (ex. diagnostic, prevention, treatment), or device stage (concept, clinical trial, market), or region. The wiki-based nature of the compendium allows users to add new device cases to the existing database.
Access the compendium here.