Designing With, Not For: Human-Centered Design as Relational Practice

There is a renewed focus on equity and reciprocity as war, egoism, and other divisive forces have made health and impact-work more difficult. But many of these resources are normative in nature. They don't offer perspective on the self-doubt and despair inherent in the act of standing by others, in solidarity. It is essential to create resources on the complexity of rightdoing too, to offer comfort to change-seekers: they are not alone in how they feel. For this abstract we have drawn on our experience of producing a podcast on Ethics in Practice to suggest that this sense of connection can not only be nurtured by the end output but by our approach too. It can be embedded in our design choices right from the way we shape our ideas and interviews to the paperwork. The sum of these parts is greater than the whole. It moves the air. One of our guests wrote: "I am both honoured and encouraged by our conversation. [It] gave me hope and courage." This kind of impact on our spirit and our relationships should be documented even if it doesn't fit a ready matrix and for that, we need to flip our internal script: we need to believe that our gestures matter however small they may be. One person, one story, one dispersal, at a time.

This reflection shares learnings from a design-led collaboration to re-imagine communication and experience systems at Primary and Community Health Centres in Karnataka. Through a co-creation process with doctors, nurses, and patients, the project sought to make everyday healthcare communication more human, accessible, and meaningful.
The focus for the pilot was on improving existing spaces through signage, information racks, reception areas, and labour room infrastructure– using principles of inclusivity, simplicity, and user-centred design. Each intervention was tested with frontline workers and patients to ensure it addressed real needs with a very simple principle in mind- what is validated moves forward, what is invalidated is refined, tested and if still invalidated- let gone of without attachment. Our biggest takeaway- 'Keep it Simple, Stupid!' 
The collaboration revealed that small, context-specific decisions often have the most profound impact-such as a pharmacist requesting to include her child's photo in the immunisation poster, which transformed a visual aid into a source of pride and ownership. It also highlighted the need for flexibility, since large-scale implementation often involves last-minute changes and coordination across multiple stakeholders, who are always going above and beyond in the spirit of 'health for all'.

Ultimately, this experience reaffirms that co-creation is not just a design method but a mindset-one that bridges system priorities and human experience, ensuring that health communication is simple, sustainable, and truly used.

The HPV vaccine was introduced with a promise to reduce cervical cancer cases and the over 3000 deaths it leads to each year in Kenya. The introduction, however, was met with a lot of hesitancy, simply because the key voices of decision makers at community level, was not engaged from the onset. And not only, elders and parents, but also teenage girls themselves that was the target group, were uniformed and heavily believed in everything wrong about the vaccine's introduction. By applying Human Centered Design, PATH's Living Labs understood these gaps and the need for: simple and easy to understand information that dispelled myths and misconceptions, answered everyone's questions to clear doubts, so that all parties would accept the vaccine and endorse it in their circles. For teenage girls, we had to think creatively and find an engaging way of educating them, that would leave a lasting impression. Through co-creating and co-designing with teachers and health providers, the HATA (HPV vaccine Advocacy Through Art) intervention was born. HATA aimed at imparting knowledge to learners, both boys and girls between the ages of 10-14, and rolling out an art competition and presentation day that would allow them space to craft and share what they learnt with their fellow learners and parents through art. This approach appealed to learners, and motivated those due to get the vaccine, encouraging each other to brave the needle prick for a healthier future. 

What happens when you ask some of the most vulnerable adolescents in the world-Pashto girls in Taliban-controlled Afghanistan-to imagine their own futures? Against all odds, our research team engaged adolescent girls who are banned from school, restricted from public life, and officially invisible in the media, to help shape an animated television series designed for them. Through carefully crafted, participatory methods carried out in private homes and safe spaces, girls and boys aged 10–17 co-created characters, themes, and storylines for Between Skies, a forthcoming educational TV series by Impact(Ed) with MAGENTA as research partner. While the core aim of the series is to increase girls' self-confidence, build important life skills, and highlight the role of boys and men as allies, the process underscored the power of storytelling in the face of adversity.
What we found was that despite widespread anxiety, sadness, and bleak futures, girls overflowed with creativity and humor. They shared storylines that ranged from quietly resisting early marriage, to brothers unexpectedly becoming allies, to small everyday actions-teaching a sibling, helping a neighbor, joking at family gatherings-that restored a sense of control and dignity. Even in an environment that seems entirely hopeless, their narratives were infused with laughter, resilience, and hope.
This 10-minute story will share how we worked in one of the world's most restrictive environments to make the impossible possible: engaging Afghan girls to tell their own stories and inspire a series that can reach thousands through various channels, right into their homes.