The Course for Human-Centered Design

Class 1: An Introduction to Human-Centered Design

What Is Human-Centered Design?

Human-centered design is a creative approach to problem solving and the backbone of our work
at IDEO.org. It’s a process that starts with the people you’re designing for and ends with new
solutions that are tailor-made to suit their needs. Human-centered design is all about building a
deep empathy with the people you’re designing for; generating tons of ideas; building a bunch of
prototypes; sharing what you’ve made with the people you’re designing for; and eventually
putting your innovative new solution out in the world.

What Can the Approach Be Used For?

Human-centered design is a process that can be used across industries and sectors to approach
any number of challenges—from product and service design to space or systems design, to name
just a few.

Products
When people think of design, they often first think about expensive, stylish products. But
thoughtful product design is just as important in social innovation. Not only are all people
deserving of well-designed products, but challenges that arise when there are limited resources,
services, or infrastructure require new approaches and elegant solutions.

• How might we design a cookstove that reduces the amount of smoke inhaled by a person
while cooking?

• How might we build an irrigation pump that can run without the electricity grid?

• How might we design a toilet for families living in areas with no sanitation
infrastructure?

Services
For a service to be effective, it needs to be considered from end-to-end: from how it’s advertised
to how it’s delivered. For a service to have the desired impact, it’s essential to gain a deep
understanding of the people you will be serving—not only what they need and desire, but what
limitations they face, what motivates them, and what’s important to them.

• How might we design a water delivery service providing clean drinking water along with
health and nutrition products?
 • How might we design new services engaging low-income parents in after-school
education for their children?

• How might we design a sustainable business model for a pit latrine emptying service?

Spaces
Physical environments give people signals about how to behave and influence how they feel. By
rethinking the design of hospitals, classrooms, public transportation, banks, libraries, and more,
we can create new experiences and interactions in these spaces. Human-centered design can help
make the emotional parts of a space as important as the functional.

• How might we design hospital waiting rooms to mitigate the transmission of airborne
diseases?

• How might we redesign the common areas of a community housing structure to

encourage connecting and cooperation among neighbors?

• How might we make the space inside a bank less intimidating for first-time savers
signing up for a new account?

Systems
Designing systems is about balancing the complexity of many different stakeholder needs with
the needs of the social enterprise. For example, if you were designing a new type of school, there
are the needs of the students, parents, staff and faculty, community, and perhaps investors.
Systems design often involves setting high-level strategy such as stating visions, priorities,
policies, and key communications around these ideas.

• How might we redesign the school lunch program for an entire city while providing for
differences in individual schools?

• How might we design a system linking social entrepreneurs from around the world?

• How might we redesign a banking system for low-income citizens who have limited
knowledge of banks?

The Design Process

The human-centered design process has three phases—the Inspiration phase, the Ideation phase,
and the Implementation phase. In the end, you’ll know that your solution will be a success
because you’ve kept the people you’re looking to serve at the heart of the process.

In the Inspiration phase you’ll learn directly from the people you’re designing for as you
immerse yourself in their lives and come to deeply understand their needs. In the Ideation
phase you’ll make sense of what you learned, identify opportunities for design, and prototype
possible solutions. And in the Implementation phase you’ll bring your solution to life, and
eventually, to market.

Expect to find yourself shifting gears through the process, moving from concrete observations
to highly abstract thinking, and then right back again into the nuts and bolts of your prototype.
We call it diverging and converging. You’ll diverge and converge a few times, and with each
new cycle you’ll come closer and closer to the solution that is best suited for the people you’re
designing for.

INSPIRATION

I have a design challenge.

How do I get started?
How do I conduct an interview?
How do I stay human-centered?

IDEATION

I have an opportunity for design.

How do I interpret what I’ve learned?
How do I turn my insights into
tangible ideas?
How do I make a prototype?

IMPLEMENTATION

I have an innovative solution.

How do I make my concept real?
How do I assess if it’s working?
How do I plan for sustainability?

Mindsets of a Human-Centered Designer

Human-centered design is as much about your head as your hands. These Mindsets
uncover the philosophy behind our approach to creative problem solving, and show that how you
think about design directly affects whether you’ll arrive at innovative, impactful solutions. Spend
some time watching these seven Mindsets videos on the class platform.

Learn From Failure

“Don’t think of it as failure, think of it as designing experiments through which you’re going to
learn.”

Failure is an incredibly powerful tool for learning. Designing experiments, prototypes, and
interactions and testing them is at the heart of human-centered design. So is an understanding
that not all of them are going to work. As we seek to solve big problems, we’re bound to fail. But
if we adopt the right mindset, we’ll inevitably learn something from that failure.

Make it

“You’re taking risk out of the process by making something simple first. And you always learn
lessons from it.”

As human-centered designers, we make because we believe in the power of tangibility and we

know that making an idea real is a fantastic way to think it through. When the goal is to get
impactful solutions out into the world you can’t stay in the realm of theory. You have to make
your ideas real.

Creative Confidence

“Creative confidence is the notion that you have big ideas, and that you have the ability to act
on them.”

Anyone can approach the world like a designer. Often all it takes to unlock that potential as a
dynamic problem solver is creative confidence. Creative confidence is the belief that everyone is
creative, and that creativity isn’t the capacity to draw or compose or sculpt, but a way of
approaching the world.

Empathy

“I can’t come up with any new ideas if all I do is exist in my own life.”

Empathy is the capacity to step into other people’s shoes, to understand their lives, and start to
solve problems from their perspectives. Human-centered design is premised on empathy, on the
idea that the people you’re designing for are your roadmap to innovative solutions. All you have
to do is empathize, understand them, and bring them along with you in the design process.

Embrace Ambiguity

“We may not know what that answer is, but we know that we have to give ourselves
permission to explore.”

Human-centered designers always start from the place of not knowing the answer to the problem
they’re looking to solve. And though that’s not particularly comfortable, it allows us to open up
creatively, to pursue lots of different ideas, and to arrive at unexpected solutions. Embracing
ambiguity allows us to give ourselves permission to be fantastically creative.

Be Optimistic

“Optimism is the thing that drives you forward.”

We believe that design is inherently optimistic. To take on a big challenge, especially one as
large and intractable as poverty, we have to believe that progress is even an option. If we didn’t,
we wouldn’t even try. Optimism is the embrace of possibility, the idea that even if we don’t
know the answer, that it’s out there and that we can find it.

Iterate, Iterate, Iterate

“What an iterative approach affords us is that we gain validation along the way...because we’re
hearing from the people we’re actually designing for.”

Human-centered design is an inherently iterative approach to solving problems because it makes

feedback from the people we’re designing for a critical part of how a solution evolves. By
continually iterating, refining, and improving our work we put ourselves in a place where we’ll
have more ideas, try a variety of approaches, unlock our creativity, and arrive more quickly at
successful solutions.
Design Thinking for Social Innovation

By Tim Brown & Jocelyn Wyatt

Designers have traditionally focused on enhancing the look and functionality of products.
Recently, they have begun using design techniques to tackle more complex problems, such as
finding ways to provide low-cost healthcare throughout the world. Businesses were the first to
embrace this new approach—called design thinking—and nonprofits are beginning to adopt it
too.

In an area outside Hyderabad, India, between the suburbs and the countryside, a young woman—
we’ll call her Shanti—fetches water daily from the always-open local borehole that is about 300
feet from her home. She uses a 3-gallon plastic container that she can easily carry on her head.
Shanti and her husband rely on the free water for their drinking and washing, and though they’ve
heard that it’s not as safe as water from the Naandi Foundation-run community treatment plant,
they still use it. Shanti’s family has been drinking the local water for generations, and although it
periodically makes her and her family sick, she has no plans to stop using it.

Shanti has many reasons not to use the water from the Naandi treatment center, but they’re not
the reasons one might think. The center is within easy walking distance of her home—roughly a
third of a mile. It is also well known and affordable (roughly 10 rupees, or 20 cents, for 5
gallons). Being able to pay the small fee has even become a status symbol for some villagers.
Habit isn’t a factor, either. Shanti is forgoing the safer water because of a series of flaws in
the overall design of the system.

Although Shanti can walk to the facility, she can’t carry the 5-gallon jerrican that the facility
requires her to use. When filled with water, the plastic rectangular container is simply too heavy.
The container isn’t designed to be held on the hip or the head, where she likes to carry heavy
objects. Shanti’s husband can’t help carry it, either. He works in the city and doesn’t return home
until after the water treatment center is closed. The treatment center also requires them to buy a
monthly punch card for 5 gallons a day, far more than they need. “Why would I buy more than I
need and waste money?” asks Shanti, adding she’d be more likely to purchase the Naandi water
if the center allowed her to buy less.

The community treatment center was designed to produce clean and potable water, and it
succeeded very well at doing just that. In fact, it works well for many people living in the
community, particularly families with husbands or older sons who own bikes and can visit the
treatment plant during working hours. The designers of the center, however, missed the
opportunity to design an even better system because they failed to consider the culture and needs
of all of the people living in the community.

This missed opportunity, although an obvious omission in hindsight, is all too common. Time
and again, initiatives falter because they are not based on the client’s or customer’s needs and
have never been prototyped to solicit feedback. Even when people do go into the field, they may
enter with preconceived notions of what the needs and solutions are. This flawed approach
remains the norm in both the business and social sectors.

As Shanti’s situation shows, social challenges require systemic solutions that are grounded in the
client’s or customer’s needs. This is where many approaches founder, but it is where design
thinking—a new approach to creating solutions—excels.

Traditionally, designers focused their attention on improving the look and functionality of
products. Classic examples of this type of design work are Apple Computer’s iPod and Herman
Miller’s Aeron chair. In recent years designers have broadened their approach, creating entire
systems to deliver products and services.

Design thinking incorporates constituent or consumer insights in depth and rapid prototyping, all
aimed at getting beyond the assumptions that block effective solutions. Design thinking—
inherently optimistic, constructive, and experiential—addresses the needs of the people who will
consume a product or service and the infrastructure that enables it.

Businesses are embracing design thinking because it helps them be more innovative, better
differentiate their brands, and bring their products and services to market faster. Nonprofits are
beginning to use design thinking as well to develop better solutions to social problems. Design
thinking crosses the traditional boundaries between public, for-profit, and nonprofit sectors. By
working closely with the clients and consumers, design thinking allows high-impact solutions to
bubble up from below rather than being imposed from the top.

Design Thinking at Work

Jerry Sternin, founder of the Positive Deviance Initiative and an associate professor at Tufts
University until he died last year, was skilled at identifying what and critical of what he called
outsider solutions to local problems. Sternin’s preferred approach to social innovation is an
example of design thinking in action.1 In 1990, Sternin and his wife, Monique, were invited by
the government of Vietnam to develop a model to decrease in a sustainable manner high levels of
malnutrition among children in 10,000 villages. At the time, 65 percent of Vietnamese children
under age 5 suffered from malnutrition, and most solutions relied on government and UN
agencies donations of nutritional supplements. But the supplements—the outsider solution—
never delivered the hoped-for results.2 As an alternative, the Sternins used an approach called
positive deviance, which looks for existing solutions (hence sustainable) among individuals and
families in the community who are already doing well.3

The Sternins and colleagues from Save the Children surveyed four local Quong Xuong
communities in the province of Than Hoa and asked for examples of “very, very poor” families
whose children were healthy. They then observed the food preparation, cooking, and serving
behaviors of these six families, called “positive deviants,” and found a few consistent yet rare
behaviors. Parents of well-nourished children collected tiny shrimps, crabs, and snails from rice
paddies and added them to the food, along with the greens from sweet potatoes. Although these
foods were readily available, they were typically not eaten because they were considered unsafe
for children. The positive deviants also fed their children multiple smaller meals, which allowed
small stomachs to hold and digest more food each day.

The Sternins and the rest of their group worked with the positive deviants to offer cooking
classes to the families of children suffering from malnutrition. By the end of the program’s first
year, 80 percent of the 1,000 children enrolled in the program were adequately nourished. In
addition, the effort had been replicated within 14 villages across Vietnam.4

The Sternins’ work is a good example of how positive deviance and design thinking relies on
local expertise to uncover local solutions. Design thinkers look for work-arounds and improvise
solutions—like the shrimps, crabs, and snails—and they find ways to incorporate those into the
offerings they create. They consider what we call the edges, the places where “extreme” people
live differently, think differently, and consume differently. As Monique Sternin, now director of
the Positive Deviance Initiative, explains: “Both positive deviance and design thinking are
human-centered approaches. Their solutions are relevant to a unique cultural context and will not
necessarily work outside that specific situation.”

One program that might have benefited from design thinking is mosquito net distribution in
Africa. The nets are well designed and when used are effective at reducing the incidence of
malaria.5 The World Health Organization praised the nets, crediting them with significant drops
in malaria deaths in children under age 5: a 51 percent decline in Ethiopia, 34 percent decline in
Ghana, and 66 percent decline in Rwanda.6 The way that the mosquito nets have been
distributed, however, has had unintended consequences. In northern Ghana, for instance, nets are
provided free to pregnant women and mothers with children under age 5. These women can
readily pick up free nets from local public hospitals. For everyone else, however, the nets are
difficult to obtain. When we asked a well-educated Ghanaian named Albert, who had recently
contracted malaria, whether he slept under a mosquito net, he told us no—there was no place in
the city of Tamale to purchase one. Because so many people can obtain free nets, it is not
profitable for shop owners to sell them. But hospitals are not equipped to sell additional nets,
either.

As Albert’s experience shows, it’s critical that the people designing a program consider not only
form and function, but distribution channels as well. One could say that the free nets were never
intended for people like Albert—that he was simply out of the scope of the project. But that
would be missing a huge opportunity. Without considering the whole system, the nets cannot be
widely distributed, which makes the eradication of malaria impossible.
The Origin of Design Thinking

IDEO was formed in 1991 as a merger between David Kelley Design, which created Apple
Computer’s first mouse in 1982, and ID Two, which designed the first laptop computer, also in
1982. Initially, IDEO focused on traditional design work for business, designing products like
the Palm V personal digital assistant, Oral-B toothbrushes, and Steelcase chairs. These are the
types of objects that are displayed in lifestyle magazines or on pedestals in modern art museums.
By 2001, IDEO was increasingly being asked to tackle problems that seemed far afield from
traditional design. A healthcare foundation asked us to help restructure its organization, a
century-old manufacturing company wanted to better understand its clients, and a university
hoped to create alternative learning environments to traditional classrooms. This type of work
took IDEO from designing consumer products to designing consumer experiences.

To distinguish this new type of design work, we began referring to it as “design with a small d.”
But this phrase never seemed fully satisfactory. David Kelley, also the founder of Stanford
University’s Hasso Plattner Institute of Design (aka the “d.school”), remarked that every time
someone asked him about design, he found himself inserting the word “thinking” to explain what
it was that designers do. Eventually, the term design thinking stuck.7

As an approach, design thinking taps into capacities we all have but that are overlooked by more
conventional problem-solving practices. Not only does it focus on creating products and services
that are human centered, but the process itself is also deeply human. Design thinking relies on
our ability to be intuitive, to recognize patterns, to construct ideas that have emotional meaning
as well as being functional, and to express ourselves in media other than words or symbols.
Nobody wants to run an organization on feeling, intuition, and inspiration, but an over-reliance
on the rational and the analytical can be just as risky. Design thinking, the integrated approach at
the core of the design process, provides a third way.

The design thinking process is best thought of as a system of overlapping spaces rather than a
sequence of orderly steps. There are three spaces to keep in mind: inspiration,
ideation, and implementation. Think of inspiration as the problem or opportunity that motivates
the search for solutions; ideation as the process of generating, developing, and testing ideas;
and implementation as the path that leads from the project stage into people’s lives.
The reason to call these spaces, rather than steps, is that they are not always undertaken
sequentially. Projects may loop back through inspiration, ideation, and implementation more
than once as the team refines its ideas and explores new directions. Not surprisingly, design
thinking can feel chaotic to those doing it for the first time. But over the life of a project,
participants come to see that the process makes sense and achieves results, even though its form
differs from the linear, milestone-based processes that organizations typically undertake.

Inspiration

Although it is true that designers do not always proceed through each of the three spaces in linear
fashion, it is generally the case that the design process begins with the inspiration space—the
problem or opportunity that motivates people to search for solutions. And the classic starting
point for the inspiration phase is the brief. The brief is a set of mental constraints that gives the
project team a framework from which to begin, benchmarks by which they can measure
progress, and a set of objectives to be realized—such as price point, available technology, and
market segment.

But just as a hypothesis is not the same as an algorithm, the brief is not a set of instructions or an
attempt to answer the question before it has been posed. Rather, a well-constructed brief allows
for serendipity, unpredictability, and the capricious whims of fate—the creative realm from
which breakthrough ideas emerge. Too abstract and the brief risks leaving the project team
wandering; too narrow a set of constraints almost guarantees that the outcome will be
incremental and, likely, mediocre.
Once the brief has been constructed, it is time for the design team to discover what people’s
needs are. Traditional ways of doing this, such as focus groups and surveys, rarely yield
important insights. In most cases, these techniques simply ask people what they want.
Conventional research can be useful in pointing toward incremental improvements, but those
don’t usually lead to the type of breakthroughs that leave us scratching our heads and wondering
why nobody ever thought of that before.

Henry Ford understood this when he said, “If I’d asked my customers what they wanted, they’d
have said ‘a faster horse.’” 8Although people often can’t tell us what their needs are, their actual
behaviors can provide us with invaluable clues about their range of unmet needs.
A better starting point is for designers to go out into the world and observe the actual experiences
of smallholder farmers, schoolchildren, and community health workers as they improvise their
way through their daily lives. Working with local partners who serve as interpreters and cultural
guides is also important, as well as having partners make introductions to communities, helping
build credibility quickly and ensuring understanding. Through “homestays” and shadowing
locals at their jobs and in their homes, design thinkers become embedded in the lives of the
people they are designing for.

Earlier this year, Kara Pecknold, a student at Emily Carr University of Art and Design in
Vancouver, British Columbia, took an internship with a women’s cooperative in Rwanda. Her
task was to develop a Web site to connect rural Rwandan weavers with the world. Pecknold soon
discovered that the weavers had little or no access to computers and the Internet. Rather than ask
them to maintain a Web site, she reframed the brief, broadening it to ask what services could be
provided to the community to help them improve their livelihoods. Pecknold used various design
thinking techniques, drawing partly from her training and partly from ideo’s Human Centered
Design toolkit, to understand the women’s aspirations.

Because Pecknold didn’t speak the women’s language, she asked them to document their lives
and aspirations with a camera and draw pictures that expressed what success looked like in their
community. Through these activities, the women were able to see for themselves what was
important and valuable, rather than having an outsider make those assumptions for them. During
the project, Pecknold also provided each participant with the equivalent of a day’s wages (500
francs, or roughly $1) to see what each person did with the money. Doing this gave her further
insight into the people’s lives and aspirations. Meanwhile, the women found that a mere 500
francs a day could be a significant, life-changing sum. This visualization process helped both
Pecknold and the women prioritize their planning for the community.9

Ideation

The second space of the design thinking process is ideation. After spending time in the field
observing and doing design research, a team goes through a process of synthesis in which they
distill what they saw and heard into insights that can lead to solutions or opportunities for
change. This approach helps multiply options to create choices and different insights about
human behavior. These might be alternative visions of new product offerings, or choices among
various ways of creating interactive experiences. By testing competing ideas against one another,
the likelihood that the outcome will be bolder and more compelling increases.

As Linus Pauling, scientist and two-time Nobel Prize winner, put it, “To have a good idea you
must first have lots of ideas.” 10 Truly innovative ideas challenge the status quo and stand out
from the crowd—they’re creatively disruptive. They provide a wholly new solution to a problem
many people didn’t know they had.

Of course, more choices mean more complexity, which can make life difficult, especially for
those whose job it is to control budgets and monitor timelines. The natural tendency of most
organizations is to restrict choices in favor of the obvious and the incremental. Although this
tendency may be more efficient in the short run, it tends to make an organization conservative
and inflexible in the long run. Divergent thinking is the route, not the obstacle, to innovation.
To achieve divergent thinking, it is important to have a diverse group of people involved in the
process. Multidisciplinary people—architects who have studied psychology, artists with MBAs,
or engineers with marketing experience—often demonstrate this quality. They’re people with the
capacity and the disposition for collaboration across disciplines.

To operate within an interdisciplinary environment, an individual needs to have strengths in two

dimensions—the “T-shaped” person. On the vertical axis, every member of the team needs to
possess a depth of skill that allows him or her to make tangible contributions to the outcome. The
top of the “T” is where the design thinker is made. It’s about empathy for people and for
disciplines beyond one’s own. It tends to be expressed as openness, curiosity, optimism, a
tendency toward learning through doing, and experimentation. (These are the same traits that we
seek in our new hires at IDEO.)

Interdisciplinary teams typically move into a structured brainstorming process. Taking one
provocative question at a time, the group may generate hundreds of ideas ranging from the
absurd to the obvious. Each idea can be written on a Post-it note and shared with the team.
Visual representations of concepts are encouraged, as this generally helps others understand
complex ideas.

One rule during the brainstorming process is to defer judgment. It is important to discourage
anyone taking on the often obstructive, non-generative role of devil’s advocate, as Tom Kelley
explains in his book The Ten Faces of Innovation.11 Instead, participants are encouraged to come
up with as many ideas as possible. This lets the group move into a process of grouping and
sorting ideas. Good ideas naturally rise to the top, whereas the bad ones drop off early on.
InnoCentive provides a good example of how design thinking can result in hundreds of ideas.
InnoCentive has created a Web site that allows people to post solutions to challenges that are
defined by InnoCentive members, a mix of nonprofits and companies. More than 175,000 people
—including scientists, engineers, and designers from around the world—have posted solutions.

The Rockefeller Foundation has supported 10 social innovation challenges through InnoCentive
and reports an 80 percent success rate in delivering effective solutions to the nonprofits posting
challenges. 12 The open innovation approach is effective in producing lots of new ideas. The
responsibility for filtering through the ideas, field-testing them, iterating, and taking them to
market ultimately falls to the implementer.

An InnoCentive partnership with the Global Alliance for TB Drug Development sought a
theoretical solution to simplify the current TB treatment regimen. “The process is a prime
example of design thinking contributing to social innovation,” explained Dwayne Spradlin,
InnoCentive’s CEO. “With the TB drug development, the winning solver was a scientist by
profession, but submitted to the challenge because his mother—the sole income provider for the
family—developed TB when he was 14. She had to stop working, and he took on the
responsibility of working and going to school to provide for the family.” Spradlin finds that
projects within the InnoCentive community often benefit from such deep and motivating
connections.13

Implementation

The third space of the design thinking process is implementation, when the best ideas generated
during ideation are turned into a concrete, fully conceived action plan. At the core of the
implementation process is prototyping, turning ideas into actual products and services that are
then tested, iterated, and refined.

Through prototyping, the design thinking process seeks to uncover unforeseen implementation
challenges and unintended consequences in order to have more reliable long-term success.
Prototyping is particularly important for products and services destined for the developing world,
where the lack of infrastructure, retail chains, communication networks, literacy, and other
essential pieces of the system often make it difficult to design new products and services.
Prototyping can validate a component of a device, the graphics on a screen, or a detail in the
interaction between a blood donor and a Red Cross volunteer. The prototypes at this point may
be expensive, complex, and even indistinguishable from the real thing. As the project nears
completion and heads toward real-world implementation, prototypes will likely become more
complete.

After the prototyping process is finished and the ultimate product or service has been created, the
design team helps create a communication strategy. Storytelling, particularly through
multimedia, helps communicate the solution to a diverse set of stakeholders inside and outside of
the organization, particularly across language and cultural barriers.

VisionSpring, a low-cost eye care provider in India, provides a good example of how prototyping
can be a critical step in implementation. VisionSpring, which had been selling reading glasses to
adults, wanted to begin providing comprehensive eye care to children. VisionSpring’s design
effort included everything other than the design of the glasses, from marketing “eye camps”
through self-help groups to training teachers about the importance of eye care and transporting
kids to the local eye care center.

Working with VisionSpring, IDEO designers prototyped the eyescreening process with a group
of 15 children between the ages of 8 and 12. The designers first tried to screen a young girl’s
vision through traditional tests. Immediately, though, she burst into tears—the pressure of the
experience was too great and the risk of failure too high. In hopes of diffusing this stressful
situation, the designers asked the children’s teacher to screen the next student. Again, the child
started to cry. The designers then asked the girl to screen her teacher. She took the task very
seriously, while her classmates looked on enviously. Finally, the designers had the children
screen each other and talk about the process. They loved playing doctor and both respected and
complied with the process.

By prototyping and creating an implementation plan to pilot and scale the project, IDEO was
able to design a system for the eye screenings that worked for VisionSpring’s practitioners,
teachers, and children. As of September 2009, VisionSpring had conducted in India 10 eye
camps for children, screened 3,000 children, transported 202 children to the local eye hospital,
and provided glasses for the 69 children who needed them.

“Screening and providing glasses to kids presents many unique problems, so we turned to design
thinking to provide us with an appropriate structure to develop the most appropriate marketing
and distribution strategy,” explained Peter Eliassen, vice president of sales and operations at
VisionSpring. Eliassen added that prototyping let VisionSpring focus on the approaches that put
children at ease during the screening process. “Now that we have become a design thinking
organization, we continue to use prototypes to assess the feedback and viability of new market
approaches from our most important customers: our vision entrepreneurs [or salespeople] and
end consumers.” 14

Systemic Problems Need Systemic Solutions

Many social enterprises already intuitively use some aspects of design thinking, but most stop
short of embracing the approach as a way to move beyond today’s conventional problem solving.
Certainly, there are impediments to adopting design thinking in an organization. Perhaps the
approach isn’t embraced by the entire organization. Or maybe the organization resists taking a
human-centered approach and fails to balance the perspectives of users, technology, and
organizations.

One of the biggest impediments to adopting design thinking is simply fear of failure. The notion
that there is nothing wrong with experimentation or failure, as long as they happen early and act
as a source of learning, can be difficult to accept. But a vibrant design thinking culture will
encourage prototyping—quick, cheap, and dirty—as part of the creative process and not just as a
way of validating finished ideas.

As Yasmina Zaidman, director of knowledge and communications at Acumen Fund, put it, “The
businesses we invest in require constant creativity and problem solving, so design thinking is a
real success factor for serving the base of the economic pyramid.” Design thinking can lead to
hundreds of ideas and, ultimately, real-world solutions that create better outcomes for
organizations and the people they serve.

Footnotes
1
 "In Memoriam: Jerry Sternin," Positive Deviance Initiative.
2
 "Nutrition in Viet Nam," Positive Deviance Initiative.
3
 "What Is Positive Deviance?" Positive Deviance Initiative.
4
 "The Viet Nam Story: Narrated by Jerry Sternin," Positive Deviance Initiative.
5
 Kevin Starr,"Go Big or Go Home," Stanford Social Innovation Review, fall 2008.
6
 J.R. Minkel, "Net Benefits: Bed Netting, Drugs Stem Malaria Deaths: Proactive African Countries See Fewer
Children Felled by the Mosquito-Borne Disease,” Scientific American, February 4, 2008.
7
 Tim Brown, Change by Design: How Design Thinking Transforms Organizations and Inspires Innovation, New
York: HarperBusiness, 2009.
8
 Tim Brown, Change by Design.
9
 Jocelyn Wyatt, E-mail correspondence with Kara Pecknold, September 23, 2009.
10
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Biomolecular Sciences, London: World Scientific Publishing, 2001.
11
 Tom Kelley and Jonathan Littman, The Ten Faces of Innovation: IDEO's Strategies for Defeating the Devil's
Advocate and Driving Creativity Throughout Your Organization, New York: Random House, 2005.
12
 "Accelerating Innovation for Development: The Rockefeller Foundation and Inno-Centive Renew Partnership
Linking Nonprofit Organizations to World-Class Scientific Thinkers," Rockefeller Foundation, June 23, 2009.
13
 Jocelyn Wyatt, E-mail correspondence with Dwayne Spradlin, September 18, 2009.
14
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CASE STUDY: CLEAN TEAM
IN-HOME TOILETS FOR GHANA’S URBAN POOR

For the millions of Ghanaians without in-home toilets, there are few good options when it comes
to our bodies’ most basic functions. Working with Unilever and Water and Sanitation for the
Urban Poor (WSUP), IDEO and IDEO.org developed Clean Team, a comprehensive sanitation
system that delivers and maintains toilets in the homes of subscribers. Clean Team now serves
3,500 people in Kumasi, Ghana, making lives cleaner, healthier, and more dignified.

The Outcome

IDEO and IDEO.org teams designed a comprehensive sanitation system to serve the needs of
low-income Ghanaians. The Clean Team service is a custom-designed stand-alone rental toilet as
well as a waste-removal system, but the design work extended to the entire service ecosystem
including branding, uniforms, a payment model, a business plan, and key messaging. Unilever
and WSUP piloted the project with about 100 families in the city of Kumasi, Ghana, before
launching in 2012.

The Inspiration phase of the project was intense, with scores of interviews needed to understand
all facets of the design challenge. “Because sanitation is a systems-level challenge we knew that
we couldn’t just design Clean Team’s toilet,” says team member and designer Danny Alexander.
After six weeks of talking with sanitation experts, shadowing a toilet operator, digging into the
history of sanitation in Ghana, and talking to scads of Ghanaians, key insights about what the
toilet should look like and how waste should be collected emerged.
An important historical note came out too: For years Ghana had night soil collectors, people who
cleaned out bucket latrines each night. But because many night soil collectors dumped human
waste in the streets, night soil collection was banned in the 1990s as a threat to public health.
This meant the team could leverage an existing behavior around in-home waste removal, but
they would have to avoid any association with illegal dumping.

This was a lightning-fast phase in the project, one that leapt from learnings to prototypes in
seven weeks. After brainstorming with its clients and everyday Ghanaians, the team determined
which direction to take and began testing its ideas. What aesthetics did people like? Would a
urine-diverting toilet work? Were people comfortable with servicemen coming into their homes?
Where in the home would the toilet go? Can you design a toilet that can only be emptied at a
waste management facility?

By building a handful of prototypes and modifying existing portable toilets, the team got tangible
elements of the service into the hands of Ghanaians. They learned how the service should be
positioned, early ideas around marketing and promotion, as well as certain technical limitations,
namely that though flush functions appeared popular early in the goings, water scarcity was a
major factor to contend with.

One of the best parts of prototyping is that it gives you real-life feedback to one of your ideas.
The design team suspected that having someone come into subscribers’ homes to collect and
dispose of waste would be an element of Clean Team’s offer. The specter of night soil collectors
and a history of illegal dumping made it critical from a systems level, but would users accept it?
When the team discussed the idea with people, they heard that consumers would be happier
disposing of their own waste if it could save them money. Potential subscribers were also
reluctant to allow service people into their homes.

Though the team had a hunch about how the service would have to work, they put the idea to test
by running a prototype. By enacting even just a portion of the eventual Clean Team service, the
designers could learn how people would react not just to toilets in their homes, but also to others
emptying them.

Though the toilets themselves were popular, people quickly came to realize the value of someone
else taking care of waste disposal. Once potential subscribers experienced what it meant to have
a full toilet, and how involved proper waste disposal would be, their desires changed.

Once the service offerings, and look and feel of the toilet were more or less fleshed out, WSUP
ran a live prototype of the Clean Team service. Because tooling for toilet manufacture is so
expensive, WSUP used off-the-shelf cabin toilets, which approximated about 80% of the toilets
that IDEO.org would design to test the service. They got great results, went ahead with
manufacturing, and as of 2012, the toilets are in production, sport IDEO.org’s branding, and
have found their way into the lives of 3,500 people.

Learn more at
www.cleanteamtoilets.com.