Almost 50 years of engaging users in global health innovation

January 29, 2024 by Helen Storey, Levis Nderitu, and Brian Taliesin

PATH’s first project centered equity and user inclusion long before the terms human-centered design and DEI were coined.

Living labs

At PATH’s Living Lab in Nairobi, Kenya, participants at a human-centered design workshop create an empathy map charting what a health worker thinks, sees, says, hears, and does in their work environment. Photo: PATH/Faith Mbai.

In 1977, PATH was founded by a group of researchers who were on a mission to accelerate health equity, but they knew they needed to do things differently.

These researchers put equity and inclusion at the forefront of their innovative public health approach, working side by side with people to better understand their communities’ health care needs. And they named this company, “Program for Appropriate Technologies in Health,” which was shortened to PATH.

Most health care innovation happening by and for high-income countries depended on existing infrastructure (reliable electricity and supply chain) and an available market to make those innovations profitable. This meant that innovations didn’t always translate globally, and as a result, most people (including those in greatest need of technologies and medicines) were left out.

To create medical products for the people left behind by existing health innovation, PATH researchers knew these products needed to be less expensive—but that wasn’t all. With input from the users themselves, PATH helped develop health technologies that could actually be used and even manufactured by the people and communities who would ultimately use them. And importantly, they made sure the people and communities wanted the products in the first place.

To do this, PATH engaged with the communities and local health care professionals to design solutions that worked for them within their unique contexts. This approach—now called human-centered design (HCD)—has been core to PATH since its inception.

PATH’s collective 45-year history of global health innovation has proven that working alongside communities and individuals results in solutions that are appropriate, equitable, and inclusive.

Prioritizing users from day one

One of PATH’s earliest projects started with a simple question: How can low- and middle-income countries raise awareness of the existing contraceptive options?

“We were trying to fix a problem: the tools that were available for health that we were familiar with in the US and the Western World were not suitable for people in [low infrastructure, low-resource] environments,” PATH Senior Advisor Emeritus and one of its founding employees, Michael Free, said in a 2016 interview.

At the time, contraceptives were becoming more widely available in the United States and Europe, but there was a growing need for educational materials designed for women in other regions.

Rather than assuming translated versions of existing health information would do the job, PATH worked with women to understand their needs and developed tools that would be most useful to them.

PATH partnered with women in communities with strong oral communication traditions. We learned that the materials and instructions used in the United States and Europe would not resonate with people with these communication styles, so we worked with advisory councils and key stakeholders to develop a guide that allowed community influencers to become advocates for these technologies and included illustrations to help support explanations.

As a result, PATH developed educational tools that used culturally relevant illustrations and produced a guide on delivering health and family planning materials for low-literate audiences.

PATH also introduced the use of HCD in contraceptive technology development, working with users as co-designers for an innovative female condom.

This idea—that end-users and communities are central to the innovation process—is a hallmark of PATH’s brand of innovation.

“In order to fully understand those needs, you have to invite the users of those products to be co-designers of those products.”
— Michael Free, Senior Advisor Emeritus and founding employee

Human-centered design, inclusive innovation, and health equity

Today, more than ever, co-creation and HCD are particularly critical elements to the development of cutting-edge technologies like digital and artificial intelligence products for health. However, HCD is just one approach that PATH uses to advance inclusive innovation and health equity.

Though it may look different from project to project, all PATH work has two critical components in common: every project identifies stakeholders and partners in collaboration with the affected countries and communities, and every project requires this level of inclusion from conceptualization through completion.

For instance, in 2007, the PATH Safe Water Project worked to increase access to safe drinking water solutions. PATH used an HCD approach, listening and responding to users’ needs, to identify affordable, appropriate, sustainable products reflective of local priorities and the appropriate price point for the market in this community.

We have also expanded our HCD approach to address diverse and growing health challenges, established in multiple countries. Living Labs is PATH’s team of in-house HCD and innovation specialists who work closely with governments and a diverse network of more than 2,000 users partnering in countries where PATH does not have a physical presence.

The Living Labs team rapidly engages with key stakeholders, leveraging PATH’s collective experience to design and scale health interventions and products that improve access, use, and uptake. From evaluating new prototype products to evaluating the integration of emerging health technologies into existing care management practices, PATH engages with communities and local health care professionals to design locally appropriate solutions.

PATH’s Living Labs has partnered with health care providers to explore the potential of using multimodal devices and smartphones for pediatric screening and triage in primary care settings, supported the development of a Diabetes CarePak to improve access to safe insulin administration and self-care, and worked with health care workers to optimize COVID-19 vaccine rollout, among many other projects.

Diversity, equity, and inclusion

Over decades of partnership and collaboration, PATH’s global health experts have forged deep relationships with key local stakeholders in the countries where we work. Together, we are still developing and implementing solutions that are inclusive, scalable, and aligned with local priorities.

At the same time, we continue to examine, renew, and refine this commitment. In 2021 PATH launched our Diversity, Equity, and Inclusion Strategy, reiterating the need to include equity in every aspect of our institution, from who we are and where we are to how we operate our business and how we approach public health in communities around the world. Equity at the heart of everything we do means designing our products and programs with, not just for, the communities we serve, embedding equity (including gender) in our public health programs and partnerships, and becoming a catalyst for change in the sector.

The individuals and communities we work with as partners and co-creators are helping PATH strive toward these lofty, important goals of becoming more inclusive and equitable. Ultimately, we hope leading by example will contribute to a better, more equitable global health sector.

Learn more about PATH’s HCD approach here.