Insights from Embrace on Design for Social Impact

The following is reposted with permission from Embrace.  The original post appears here, originally published June 27, 2011.  

The Embrace Infant Warmer (profiled here on BoP Designer) is a low cost alternative to traditional incubators with many other benefits. In this insightful post, Embrace’s designers answer questions about design thinking and what it means to have been selected as a finalist for the INDEX 2011 design awards, asked by Embrace’s Business Development Manager, Ana Manzur-Allan:

Ana: Somebody said that to be an effective designer for social impact, we need to be humble listeners and fearless leaders, all at the same time, which is no easy feat. What are your thoughts on this?

Eu-wen: The person who said this was Emily Pilloton, founder of Project H Design and she is absolutely right. One of the key difficulties we face in our work is that the vision we have of the future, the vision that inspires and drives us in our work, is a fiction that many of our users and external stakeholders find difficult to be able to share with us. Our users grow up under severe resource constraints, and tightly circumscribed sociocultural norms. Opportunity to dream of something better is a luxury that we take for granted, but is often not even a rewarding exercise for people like our users because more often than not, that is exactly what it turns out to be for them – a dream.

Thus it is rare for us to be able to effectively co-create with our users, especially under the kind of pressing timelines that we put on ourselves (change should have happened yesterday, and I am impatient). The only viable strategy to create effective design for social impact, is then to carefully understand our users as best we can, in ways that they might not even be able to imagine themselves because we are imagining them interacting in a future with a new product that does not really exist yet. It then becomes our terrifying responsibility to take this understanding, and boldly make design decisions on behalf of our user. I guess I actually would tweak Pilloton’s statement to say “bold” rather than “fearless” because especially where Embrace is concerned, developing medical devices for social impact, failures in our design’s usability can lead to exposing infants to more harm than good, and so it is with no small amount of both boldness and trepidation that I craft my design.

The nutshell is this: Designers and engineers generally do not come from poor villages. They thus need the humility and tremendous empathy to understand their users who come from completely different backgrounds and often utilize very different mental models to understand and frame their world. Bold leadership is thus especially necessary when you consider how audacious and presumptuous one must be to create a design for people so unlike yourself.

Ana: How does design thinking co-exist with emerging innovation paradigms such as working directly with the end user? How important is it for humanitarian and/or social design?

Rajan: Working directly with the end user is important in all design but especially so for social design. It is obvious that good products are ones that have features, functionality, aesthetics, and usability that please the end user – it’s what influences them to adopt and use those products.

However, this is usually a bit easier for most designers because the designers are often end users themselves. For example, when designers and engineers make a new phone, they inherently understand what the users look for because they use their cell phones everyday and have vast experience and understanding on what the needs are and what would make a good design. I can only imagine if someone like my grandmother, who is not an avid user of a cell phone by any means, were to be in charge of designing a cell phone. For example, I have noticed the need to easily dial a phone number when someone texts it to me (rather than having to memorize it and then type it in to dial), but there is no way my grandmother would think of this need or feature herself (and even if I explained it to her, I’m not sure if she’d really understand it). She would likely end up designing a super simple phone with very little functionality and with large, tactile buttons that are easy for her to press. If I were forced to use this cell phone, which was designed by someone else and for someone else, I would be pretty unhappy because it does not meet my needs or desires. Unfortunately, that is what we often see in our work – medical devices designed for the needs and requirements in the western, developed world are being marketed and sold in the developing world. Embrace aims to fill this gap by making appropriately designed solutions for our end users by better understanding their environment, context, and needs.

When I think of the ludicrous idea of putting my grandmother in charge of designing a cell phone for me, I often feel like that is very analogous to what my job actually is. We are trying to understand our users and design a product for them even though we can hardly pretend to relate to their lives, struggles, or desires. It is a challenge but also a pleasure. As a designer at Embrace, you are forced to learn so much about people so different from you, which is an eye-opening and inspiring experience. It also challenges us in our work to make the right product so that our users are satisfied. In order to do this, we have to throw away our own assumptions of what might make a good design and instead be all ears and listen to the users and what they want. This itself can be challenging due to language barriers, cultural differences, and the users’ frequent hesitance to be open with us (due to shyness, intimidation, fear, and the taboos and stigmas that surround the issues we are addressing). However, our passion to understand and ultimately help improve the lives of our users is what fuels us to overcome these challenges, which can only be done through close interactions directly with them.

Ana: When you’re designing for health and survival, the stakes are higher, and the design has to be that much more effective.  What’s your take on this?

Rajan: As I’ve mentioned above, we have some large challenges that can only be overcome through close interaction with the end users. And as with all products, this involves constant user feedback and iteration. Herein lies another challenge – when working on a medical product, you cannot simply make rough prototypes, have users test them, and gain what would be valuable feedback. We have an ethical obligation to ensure that any prototype or product that we put out for testing and feedback has been developed and tested to ensure safety and minimize risk. While it may tempting and beneficial to gather this feedback (especially since we are operating in a market without regulatory and legal constraints that allow us to do this, which many other companies take advantage of), we believe that it is not only our moral obligation to be patient, but that this approach will also lead to a more successful product in the long term.

This also pushes us as designers to think of creative ways to gather this valuable feedback without introducing any medical risk. We make “looks like” and “feels like” prototypes to get feedback on aesthetics and usability from our users without having to test the products on actual patients. We’ve taken our fair share of baby dolls to villages to have mothers, nurses, and doctors get as close to using the product as they can without introducing any risk.

Before making any claims on the efficacy of our product and before releasing it to the market, we thoroughly test our product through bench tests and formal, controlled clinical studies. We understand that to achieve our mission, it is more important to be completely honest than to push our product and ensure it is widely adopted. Through these studies, we learn of the true efficacy of our product, how well it performs, and in which scenarios. Our mission is to help our users and ensure their health, so if we were to not do these studies and instead push our product to be widely adopted, we might be preventing our users from using other products or practices that may be more beneficial to them, thereby going against our mission. These studies also offer us objective feedback on the performance of our products, so we can make informed decisions to design more effective solutions for our users. So although it does take a lot of time, money, and patience, the approach we take to ensure performance and quality is essential for us to achieve our end goal.

Ana: What does the process of design thinking look like?  How would you guide someone through the process?

Nag: Design is not art, but is inherently purposeful and practical – Beauty is not in the eye of the beholder, but in the hands of the user.

I do not believe designers create a product like artists create art. I rather see designers akin to one of the several agents who nudge and coax variations on a core idea along its evolutionary pathway to perfect adaptation.

I fundamentally subscribe to the idea of design happening in an analogous way as biological evolution. Order emerges out of chaos through a process of evolution by natural selection (performed by all the key stakeholders that contact the product as it evolves – the designer being just one of the stakeholders).

The key to good design would therefore not lie in any design philosophy or design methodology, but in a sincere commitment on the designers’ part to adapt their designs as quickly and efficiently as possible to the needs of their key stakeholders.

In this sense, the good design process is about building non-distorting, objective and fast feedback loops that are very sensitive to the needs of all key stakeholders in the space of delivering a new product – the user, the prescriber, the distributor, the funder etc.

The designer’s role in this process is –

    • To recognize the ecosystem in which the product is to be evolved
    • To recognize the stakeholders who will act as agents of selection
    • To co-create and continually refine these feedback loops with stakeholders
    • To listen to and empathize with the feedback generated in these feedback loops
    • To facilitate the production of non-random, deliberate mutations that can be fed back into the evolution loop

Ana: What does it mean to be selected as a finalist for the world’s most coveted design prize, INDEX: 2011? 

Honey: It is a true honor and extremely humbling! INDEX:2011 demonstrates how design has the power to be part of the solution of major global challenges, for Embrace, this translates to reducing neonatal mortality and morbidity in our world. We cannot wait to hear whether we have been selected, making it this far, for me personally is so rewarding. I am so proud of our team and of our organization.


Embrace was one of five finalists for the INDEX 2011 Award in the “Body” category.  It did not win first prize, but earned the People’s Choice Award, determined by a public online vote. It continues to grow on its own and with support from a partnership with GE.  Learn more about Embrace in this profile on BoP Designer or on their website.

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