Core Nigeria’s Design Clinic brought together 22 Niger and Lagos state public health professionals as well as programmatic staff from Clinton Health Access Initiative (CHAI) Nigeria to learn about human-centered design (HCD) and practice applying the HCD process to improve primary healthcare services, especially in light of challenges introduced by COVID-19.

Participants delved deeper into the Discover phase through four facilitated online Design Clinic workshops, tailored HCD tools and materials, as well as through remote mentoring and coaching sessions.

The Discover Phase.

The Discover Stage is about learning directly from the people for whom you are designing, immersing yourself in their lives and context to better understand their experiences and needs. The Discover stage usually involves critically evaluating the problem and the populations for whom you are trying to develop solutions. Understanding the needs of the people you aim to serve is critical to the rest of the HCD process.

Learning Goals.

Introduction to HCD

Participants learn about the stages of the HCD process, the characteristics of the approach, how HCD differs from other health and development approaches, and the benefits that HCD can provide when designing programmes.


Participants learn how to select a Design Challenge and frame their team’s Problem Statement. They are introduced to design research and apply these methods to better understand the people and relationships connected to their Design Challenge.

HCD Principles.

The following competencies or mindsets have been identified as key to successfully applying the HCD process. Participants will be assessed on these mindsets as the Design Clinic progresses:

  • Empathy
  • Creativity
  • Open-mindedness
  • Collaboration
  • Iteration

“Personally for me, I think one of the things the design clinic has done, is just making you see the whole public health experience in a whole different light. We have several facets to public health challenges and sometimes you want to do everything at once. It is important to be able to prioritise. Even though you have several challenges, you have to look at what you can prioritise at that point in time for you to be able to get the desired outcome.”

-Design Clinic Participant

“It (the HCD approach) encourages the two State governments to start having conversations, and not to operate in a silo, discussing problems irrespective of their units.”

-Design Clinic Participant

Discover Phase Summary.

Participants engaged in the following activities over the course of four months via the Zoom platform and utilising the digital whiteboarding tool Miro, taking an active learning-by-doing approach:

  • Overview of the HCD process
  • Selecting Design Challenges
    • Niger team focusing on delivery of material, newborn, and child health services during COVID-19.
    • Lagos team focusing on deadlines in routine immunisation rates due to COVID-19.
  • Learning how to frame an effective Problem Statement and crafting one for each state team.
  • Diving deeper into the whys and hows of design research, understanding methodologies and generative tools with real-life examples as well as co-creating appropriate versions of the tools to be used in the field.
  • Planning design research in Lagos and Niger states, further defining research focus and participant sample, as well as developing questions and design research activities.
  • Conducting design research activities in both states and documenting field findings.

Design Research.

The Lagos State team’s design research activities were delayed by two weeks due to the evolving protests in Nigeria. The team was eventually able to visit Eti-Osa and Alimosho primary healthcare centres to conduct interviews and utilise the card sorting tool. The team also used the People, Objects, Environments, Messages and Services (POEMS) tool, which helps guide structured observation of complex environments and processes.

The Niger State team conducted design research utilising interviews and focus groups supplemented by card sorting tools in Kontagora and Suleja primary healthcare centres.

Key Takeaways / Lessons Learned.

  • Competing priorities for participants has meant that they do not always have the time or bandwidth to fully engage in workshops or mentoring sessions.
  • In response to the above realisation, halfway through the Discover phase Scope and CHAI pivoted to provide more targeted mentoring sessions, more HCD framing and knowledge building, and more examples and activities to demonstrate core competencies.
  • Project work takes more time than expected in this new context, not just due to remote and technical issues, but also due to competing priorities to CHAI and government participants, made more challenging by the current context.
  • Miro and Zoom have been effective in teams working across time zones, geographies, and different levels of comfort with technology however, it took time early in the process to help participants navigate to new technologies.
  • Problem Framing and narrowing focus is a difficult process, requiring time and thought, especially when cutting across hierarchies.

”It actually helped to conceptualize a different perspective of the current situation in both states. We have a different situation in Lagos than we have in Niger. But the fact that we have all come together to sort of like brainstorm, helped us to understand the kind of challenges we are facing” 

-Design Clinic Participant