 In this episode, you're going to learn how to design services for contacts and cultures that are quite different from your current environment and then how to successfully scale these services. Here's the guest for this episode. Let the show begin. Hi, this is Priam. You're listening to The Service Design Show and this is episode 113. Hi, I'm Mark and welcome to The Service Design Show. This show is all about empowering you with the most effective skills and strategies so you can design services that win the hearts of people and business. The guest in this episode is an ethnographer who has done countless projects all across the world focused on helping to improve healthcare situations across the globe. Her name is Priam Shadda. If you've listened to the episode two weeks ago where we already explored what it takes to design successful services in low tech and low resource environments, you'll know that simplicity is key. In this episode, we're going to dig even deeper into that topic and we're going to focus on health and healthcare related challenges. You'll learn about why it's crucial to take stakeholders along and how to design in a context where you literally don't speak the language. Again, just like two weeks ago, it might sound quite distant from your current reality, but I really invite you to listen for the patterns and the bigger picture in Priam's story and think about how these examples translate to your own situation. If you're new to this channel, welcome and I'd love to have you to subscribe because we bring a new video that helps to level up your service design skills at least once a week. Don't forget to subscribe button and the bell icon to be notified when new episodes come out. So now it's time to jump into the conversation with Priam and the cheerful background noise that you'll hear is the livelihood of a day in India. Enjoy. Welcome to the show Priam. Hi Mark, thanks. Happy to have you here. We're going to continue on a theme from the last episode, but let's not spoil too much. For the people who don't know you, could you give like a brief introduction? Okay, sure. I'll try. Well, I'm Priam, I am Indian, but I live in Helsinki at the moment. Why Helsinki is a longer answer and maybe we can get into that a little bit later, but I am a trained ethnographer by sort of history and experience, but I currently work as design research lead with Scope Impact, which is a design company in the space of social impact. Okay. Yeah. And that's the topic we'll dive into in a bit. But before we do that, we're going to do the legendary 60 second rapid fire question round. Just answer as quickly as you can. Are you ready? I think so. Okay. Let's do it. Question number one is what's always in your fridge? Yogurt. Yogurt. Okay. Which book are you reading at the moment? Oh, I'm actually reading Jane Eyre. It's from 1857. It's like one of these classics that I had never read and I found it on my childhood bookshelf. So I'm doing it. Awesome. What superpower would you like to have? Oh, I think teleporting. That would be convenient in these days. What did you want to become when you were a kid? I think for the most part an architect. And a final question and in this case, I'm really interested in your answer. What is the first time you learned about service design? I think it was about a couple of years ago at my first, well, technically design sort of environment, job in a design environment. And I guess intuitively I knew of it, but it was I think the first time I saw it. I saw like an article written about it and I saw people speak about it and that sort of piqued my interest. Yeah, because you said you're an anthropologist or an ethnography background, right? And that's not something that's a very useful skill and background to have in a service design context, but it's not per se, not every ethnographic. I'm going to stumble upon that word a lot in this episode. It's not a common thing to get into service design. So yeah. Yeah, no, absolutely. It was sort of certainly not like obvious to most people at first. But I think with the more you talk about it, the more they see applications for it. I think service design uses a lot of principles for anthropology and ethnography. Absolutely. Yeah. Yeah. It's it's it's one of those things where I think where these two fields overlap is where really interesting things happen. So for the topic of our conversation today, like I already mentioned, we're going to continue and build upon the previous episode with Gonzalo and Firaq, where we started talking about designing sustainable solutions in low resource, low tech environments. And with you, I want to dive deeper into a specific topic around that. And that's health, right? Because that's a topic that's dear to your heart. Can you tell a little bit about that? Sure. I guess I did sort of allude to it a bit when I spoke about what I do currently, but I work in the space of health. And what we do at Scope is we try and emerge with creative solutions to really complex challenges in the space of global health and development. So just to name a few sort of health challenges that I've personally worked on are, let's say, and natal care in which also means like care for pregnant women. I've personally worked on adolescents, sexual health. And in general, I think my focus has been a lot on sexual and reproductive health and well-being. And I think it's just to sort of add to that. Currently, with the pandemic, we've had to pivot what the impact of that has been on just even sexual reproductive health in specific, but also health in general. You know, I think people's ideas are changing. So what is the question these days is quite obvious. But I would say what is at stake? Like, why is this a topic that's dear to your heart? And why are you so passionate about this? A few reasons. I mean, obviously, starting out, I think most people we're all driven by something that helps make an improvement in our lives or in the lives of others. And in this case, I think I found a sweet spot where it teaches me a lot. And I see that in small ways, we're at least trying to make things a little bit different or improve things even by little in the areas around us. The other thing, obviously, is that, you know, with the pandemic and I hate to bring the pandemic into this conversation, but we do. We can't ignore it. I think more and more are starting to think a lot more about global health and health systems and what does it mean for one country to have well functioning health systems and what does it mean for another to not? And how do we address that? How do we solve for it? And those are the kinds of things we've thought a lot about in the last three years. And I mean, of course, the company has existed even before I worked here. And, you know, there are lots of people in the world who think about this more and more. And I do think design has a really strong role to play in that. What's interesting about these topics is we'll be talking about some examples that might feel quite distant to, let's say, let's generalize to say, the Western world. But I think the things you learned through working, maybe quite remote areas, a lot of the basic principles and strategies that are behind those solutions could also be very well translated into the Western health care system. So let's dive into that. I'm really interested in, can you give an example of a project that you worked on and what were some of the challenges that you encountered? What were some of the things that you found to be surprisingly effective? Sure. I mean, there are many, but maybe I'll go with a single thread here in terms of this project that's pretty close to my heart that we worked on in rural Tanzania. It's a part of a larger project which was actually cutting across several countries. But in the case of Tanzania, we were interested in finding creative solutions that improve the sexual health and well-being of adolescent girls in specific. And how that started out was that, you know, that's a pretty broad topic because you can improve the quality of life or, you know, care and well-being of adolescents in a million with different ways. So right from the beginning, we had to work really hard to even frame the problem really specifically that what is it that we're trying to improve here? Yeah, so I'm curious, like if we go back one step, where did this question come from? From us, because I think our donor was kind enough to sort of give us a really sort of large and a great brief as that, which allowed for a lot of room for creative interpretation and allowed for a lot of creative sort of processual sort of thinking and room to play with. So we started to think that, hey, as sort of the interdisciplinary team that we are, everyone's sort of shared agenda was to really think that we can't solve for everything. So let's find the one thing that we are sort of heading towards to solve. Bearing in mind the entire time that no problem is often just one, you know, it's connected to many sort of different pieces and it's result of many complex sort of interrelated things, but still, you know, just sort of funneling down to that one thing that we'd like to solve for is, you know, as we all do in part as part of the design process. And in this case, we did that by like reviewing a lot of existing material on teenage and adolescent girls in rural Tanzania and speaking with a lot of local experts and partnering really closely with local partner organizations and the government in really trying to understand, OK, what is it that's currently happening and what is it that needs, you know, some sort of an intervention or which what is the indicator that needs to move a little more than it currently is. And yeah, the question I have here is, and maybe that's applicable to all the examples you're going to give, but you're an organization based in Helsinki and then you're going to work on a project in Tanzania. What's the dynamic there? I can, how do people respond? How do you get buy-in from the local community? Yeah, that's a really tough one, and which is where the owners of building that and maintaining that comes on us, because I think at least in my previous sort of experience working with the creative teams, you know, this is something that like the partner managers do, or, you know, where they build partnerships or, you know, at a client lead level, someone else does. But in our case, we had to really make local partners feel like we were in it and we had brought ourselves up to speed on the complexities that are at play. We were culturally sensitive. We were culturally aware, we were socially sound. What does that mean? So how do you do that? Yeah, so that was always a bit tricky. At times it meant reading up a lot on what that specific behavior means to the local context. So for example, if I'm thinking about again, adolescent girls and let's say, you know, the high incidence of teenage pregnancy, we would try and dive into it from a very sort of local literature point of view and see what does that tell us about it. But it also means really finding the right partners that also educate you as you go along and keeping your assumptions to a very, very, very minimum, where we assume nothing, our tools assume nothing, our hypotheses assume nothing. And then we take that to local experts and local partners and expect the same sort of objectivity from them. So I think to maintain that and to sort of keep that as a design principle almost in the way we work with local organizations and local communities has been really important to our work because I think the ethical boundaries can blur pretty quickly. And quite often you have to remind yourself of like, who are we and why are we here and how much do we know, right? So that has always been a bit challenging, I'll be honest. But personally, this is also where I think I mentioned this in our previous conversation that this is where we're not the only designers in the project. This is what I keep saying. Quite often the girls that we're designing for, we're designing with them and the people that the community members that we meet, they're designing for themselves and we're just facilitating the process. So again, to recognize that, yes, you need to know a lot of the cultural nuances and sensitivities, but you don't need to be a master because there are already people who live it and are masters at it. You just need to know when it's your turn to sort of step in and move it along the process, I mean. Yeah. And if I look at the design challenges that I worked upon, you know, that's a completely different context, but the principles are the same. You're facilitating the process, you're helping the true experts, the local experts to define the challenges, come up with the solutions. So what were some of the things in this project that really stood out for you in terms of things that didn't work, things that did work? Right. So once we did sort of narrow in on wanting to address, you know, the incidence of teenage pregnancies, we also realized that the narratives that we were hearing about adolescent girls were pretty unidimensional, you know, most people in our sort of preliminary fieldwork were telling us so adolescent girls are rude, they are badly behaved, they have no focus, they have no goals for their future, but we wanted to challenge that and unpack that a little because surely there's more to it. So to overcome that like sort of one narrative that we were hearing, we designed tools to facilitate a broader conversation. So and bearing in mind again, that discussing a lot of the things around teenage pregnancies or sexual sort of behavior, or just like, you know, sort of actitudinal things are difficult, they're sensitive topics and they're difficult to discuss. We needed to keep that in mind when designing these tools. So one tool that we designed, for example, was just, I mean, you can take a, you know, persona building sort of as an exercise, right? But we layered that with local objects and artifacts. And then we layered that with local images of sort of things that encompass a girl's life, including influencers, including sort of objects again. And then we wanted them to pin it onto dresses that, well, that girls wear. So it became sort of like a creative building exercise interspersed with a lot of conversation around that choice of those objects and what that means to the girls life, who this girl is, why is she wearing that? What is she using? So it just led to a sort of a more free conversation around who these girls are and why they fill their lives with the people and the objects and the experiences that they do. And because of that, we managed to get a lot of insight into many sort of the different different different kinds of adolescent girls that exist in those communities, which they do as everywhere else, to be honest. But also that when designing for adolescent girls, that's the reality, you know, that's what we're working with and not just one of them or one kind of them. Yeah. And this sounds really like creating the tools to facilitate the process and also going beyond just verbal ways of researching, verbal ways of creating and using tangible things. You can point that and you can have a conversation around, right? That makes it, yeah, much more tangible. How did the people on this project respond to this approach where they used to a more design approach or was this the first time they get in touch with it? What were some of the responses you got? Well, internally, we piloted it a lot based on the people that had traveled to the contexts that we were working with. But we also then leaned on our local partners to really sort of comment on on the sort of the course of the discussion on whether or not these were feasible to carry out. But then again, I want to remind or sort of bring back into the conversation maybe what I said earlier about how it's also the course that the conversation takes. It's also what people share back with us that ends up shaping it. You know, it's as much their design process as it is ours. So what ended up happening was that it wasn't anticipated, but older women responded to these dresses a lot better than younger girls did. Because I think it gave them a chance to really creatively express what they weren't able to express as young girls and creatively express their observations of the girls from around them in a way that didn't make them feel the need to be the judgmental aunties that they were sometimes being or be the doting mothers that they were sometimes being or being the role model grandmas that they were being, you know, it just allowed them to be women to the girls around them. And I think that to me was really powerful. If you look back on this project, what's the thing that you're most proud of? A few things. I think first like how our tools were really able to get us to engage the right way with our sort of community members and our participants and always putting us at unequal footing where of course I'd go in with a discussion guide in hand, but the discussions is very much co-shaped as I said. The second thing is also like one of our other tools that we use for research was again to discuss some even tougher topics to discuss like events that happen in girls' lives that tend to derail them. And these events can be pretty sensitive. You know, they can be the loss of a parent, they can be loss of an income, they can be getting sexually assaulted, they can, you know, a wide range of, you know, sort of life stuff and other stuff. But where we were able to take learning from both of these is that we were able to represent that in the solutions we created. And interestingly enough, the solutions were designed keeping the needs of the girls in mind, but they were actually designed for the local government to use and to roll out as part of like their complex sort of system of governmental sort of players and interventions. And really sort of we, for the second half of the project, basically we work closely with local government members to really work, see how what it is that would aid them in addressing these needs that we were able to find in the first part of the project. Yeah, right. Because that's eventually how we started this conversation. It's a maybe a low tech, low research environment, sensitive topics, and then how do you design solutions in a way that actually get embraced by the people who you're designing for. And what you're saying here is working with the people in government, for instance, who need to provide the environment, who need to create the context and environment that enables these solutions. How was that? How was it? Because working with the local communities and let's say the end users and the context of the end user, that's one thing. But having a stakeholder like a government entity, getting them to understand this way of working and the solution that you're putting forward is a completely different thing, right? How did that work? Absolutely. I couldn't agree more. What I would say is that they actually enjoyed it. I think it's very rare that they come into contact with real sort of like findings which are not in the form of, you know, sort of let's say quantitative data or in the form of reports. So what they were getting from us were narratives. What they were getting from us were, you know, sort of like softer needs. But then again, what we prepped also in order to get their attention was we mapped what it is that they're currently doing and how could the things that we're finding fit into that. So it needed a bit of sort of like laying it out for them. And I will say there was a lot of relationship building that went into it. There were times when at the end of a long field trip to Tanzania, we would go to meet members of the government to give them an update, you know, as tiring because they were often in a different part of the country because I think when you're working with extremely busy sort of establishments like the government and extremely complex and bureaucratic ones, you have to pay respect to that sort of need of communication and sort of expressing your involvement a certain way. And we worked hard at that. And is that maybe a key part of the design process that a lot of people overlook? Like the relationship building maybe doesn't feel like part of the design process. But if your goal is to create impact, it's actually is. It absolutely I couldn't agree with you more. I'm laughing because we had so many discussions amongst like the designers on this project, including me, where we said, but why do I need to go to meet this head of government? You know, surely someone else can do that. I'd much rather continue to be on field, co-designing, testing. But you know, when we heard it directly from the horse's mouth, so to speak, it changed things for us. When we understood the bureaucratic sort of expectations or resource limitations, we think we absorb that information differently because we were working closest with the designs. Yeah. Yeah. And that's the that's a theme that has been coming up on the show quite often where having empathy for in this case, it's not per se the client, but let's say if the government is the one who is going to implement this, they could be declined. Having empathy for them as well, seeing them as people and with their needs, with their pain points, with their things that keep them awake really enables us to that. That's the thing we often overlook when we design solutions. We are so focused on the end user, while the people who need to enable these solutions, they also need to fit into this context. Yeah. And that's what I hear you saying at least. Absolutely. And I would just sort of rephrase that to say that for us, the government folks ended up becoming users as well, because the solutions that we ended up designing were actually like a three part sort of modular toolkit for for local government officials, where the girls were not actually the focus of it. The focus was very much around what it is that they need to run all five of those solutions, which sort of part of the constellation of their world it sits within. And what do they need to keep it sustainable? Because the needs from a girl's point of view, no one argued with that because I think these are long standing challenges, but we realized pretty quickly that the convincing was actually needed or rather the designing was also needed to make it happen. Do you have a different example where maybe where things were even more challenging? Maybe I don't know if challenging is the right word, but I did work on a project where we basically designed like a group pregnancy counseling experience. It's called group antenatal care sessions for three different cultures and countries actually. I wasn't a part of the first one. The first one was in Uganda even before I joined this company, but when I joined our client in which case our donor was interested in taking it to Kenya and then eventually we took it to Guatemala. Now the challenge slash most interesting piece of that work for me was the fact that these cultures are extremely different. When you say something like this, like taking it to Kenya, taking it to Guatemala, I'm like, how? That feels like completely different worlds, right? Yeah, and they are, they absolutely are. But here's when you know, here's when the processor that spoke of earlier, you know, bringing yourself up to speed to a certain extent matter. But then again, I think we adopted a more agile approach in this project where we went in with what we had created in the other countries, even just to sort of prototype and co-design further with people there directly pretty early on, like we spent some time doing design research and understanding some basic sort of differences and made those quick adjustments to our service journey. We made those adjustments to our tools. Like for instance, in Kenya, we used a calendar with, you know, how pregnancy apps use fruits to tell a woman or like the parents about like how the baby is growing. We used sort of metaphors like that to refer to how the fetus is growing in Kenya. But in Guatemala, even while doing our desk research, we realized that that's probably not going to work. We should probably just stick with more realistic sort of illustrations of how a fetus grows. And that worked out perfectly well. But to me, as like a third person who belongs to neither of those cultures, I was just like, how do we make that decision? But again, we don't. The people in those communities do. Yeah, yeah. And the key is to involve them from early on. Maybe that's, I'm curious, sometimes the challenge in the design process is when you're too similar to the end user, you eventually end up imposing your own ideas about what the needs, desires are. Like I think that's one of the challenges we're making personas or user profiles. If I do that in the Netherlands, I already have so many assumptions and biases when the end user is so different from yourself than like the humbleness comes maybe more naturally. And that's a question. Yes, I work a lot in India as well. And I always have. So, but maybe I'll answer that a little differently using actually two things that anthropology taught me. One is you know, sort of this idea of leaning on a balance between an emic and an etic perspective. So one is like the emic is when it comes from within the culture that you're designing for or well in anthropology or other social sciences you're studying. And etic is when you look at it from the outside in. And I think that it's really important in the work we do whether it's in your own culture or community or your country or in the work that I currently do to have a balance between the both because even if you're incapable of doing the emic part of it, get someone else to sort of bring you up to speed. But I think for a cross cultural or comparative point of view, looking at it from the outside is extremely important too. And there are ways to sort of like build that that sort of that objectivity that is the other thing that the social sciences teach you a lot about which is about how are you like objective to the thing that you're studying without letting your subjectivity affect how you're viewing it. Maybe a little bit more background into social science would be a good thing for a lot of service designers including myself. Getting back to Guatemala what happened there? Right. So as I said, like you know some people would view that as a challenge for me that was the most interesting part of the project where we saw a few things that worked out really well in Kenya. For example, we observed in the early sort of simulations of these group sessions that we did that it was really natural for the nurses and the mothers to hold hands and start to pray before they started the session. So we were working with indigenous Mayan communities in Guatemala and Highlands and we weren't entirely sure if praying together or singing together is even a part of their culture but we tried to ask a few people about it but pretty much on like less than half into the first day of field work everyone was just like you want us to sing and we were like we don't want you to do anything so you know we can skip that completely and more than anything for me personally speaking the language was a huge barrier because I don't speak any Spanish and I certainly don't speak the two sort of local languages that were being sort of spoken there which Keeche and Ma I think and our local partners that's when they sort of stepped in and this is when you know I think you were asking me earlier on what uptake of HCD or like you know sort of ease with the processes and why that matters and how people responded I think one thing we want to make sure right from the get go is that our local partners are on board with the things we are suggesting yeah yeah and that's so key because we are not the experts in in usually in the matter that we're talking about in this case you had done the project in two different areas so that you might become a subject expert at some point but usually we're stepping in into an area where we are known we're known with the design process and then we have to sort of extract the knowledge from the local communities and these local partners whether they are an NGO in Guatemala or maybe the finance or HR department in your organization working closely with those people making them not only as a research subject but a true partner I guess that's the key to success maybe what have you found is the thing that helps to make these other organizations feel like a partner in the project yeah I was just thinking that as you were speaking I think what's really helped is to have them be a part of the transformation process so for example if you know someone from the local partner organizations that's something particularly interesting one way of doing it is that sort of like holding on to it going back to our drawing boards and creating something with that but what we have tried to do more and more of is to think of the solution in that moment with them and I think for them to see the transformation of that information into an idea seed and then into a concept if at all and then like being combined with something bigger greater better it's been really really enriching both for us and I think for some of our partners as well and then of course I think like sometimes we've been challenged you know by our partners because they don't see the value of going to field with half concepts for example because let's be sort of let's remember in this moment that the world of global health and international development has a lot of programs running you know they have a lot of interventions running in field these interventions and programs are highly tested they are highly like you know well piloted and then for our sort of design oriented processes appear a bit less robust in comparison but I think to really sort of again this is where partnership building comes in where you want to just get them to take the first few steps with you see the process move forward you know point out the small sort of slivers of ideas or that sort of silver linings that are sitting within like the conversations and then working it out together so I think taking them together is effortful but it's extremely important yeah it's effortful but it is the process like that's that's the work and so just like with what you said relationship building with the people who need to enable the solutions that is the work like we should embrace it and rather than feel that that it's a burden and I think it's been stated quite often but the design process is a is often very experiential process you have to be in it to feel the value as as abstract and as vague and as soft as that might sound but it doesn't help when you sort of take the results close the curtain and come back with an idea like it like you said that the transformation has to happen by going through the process so okay let's let's get back to Guatemala one more time where what I'm hearing you basically describe is how to scale solutions and that's of course a thing that we've been hearing a lot in service design like we have a solution a service that works here but how do we scale it onto more users more areas and we're talking about getting stuff from Kenya to Guatemala it's it's maybe more contrast but the principles are probably the same so again let's get back to Guatemala we're worried right so I think just in terms of if I were to compare both the service journeys you know we had to design for completely different sort of resource constraints we have to design for completely different social dynamics let's just say because the experience of a pregnant woman going for ant natal her ant natal care visit in Kenya is quite different from a local woman in the Guatemalan highlands going for hers just off the top of my head women in Kenya tend to or in the part of Kenya that people working in tend to come on their own but in the Guatemalan highlands they often came with not only their own kids if they have other children already but also with like you know sort of a plus one so it could be their partner it could be their sister-in-law it could be someone so just purely in terms of space making and place making it has serious implications you know so as like you know designers on field we were taking quick notes and we were reorganizing the space okay instead of seven people we have 13 or we have instead of 13 we have 30 so stuff like that would happen and then one of the other things that I found particularly sort of interesting was how you know if a society or a culture have certain sort of conflicts at the heart of it which in this case was that the healthcare workers the nurses were not viewed very well by the women that were coming to the facilities because they've all either had personal bad experiences in the past or they've heard of other women as having had really sort of disrespectful experiences with healthcare workers and that's a sort of a perception that the service journey had to deal with up front and center and I think anyone listening to this would agree that to design for to solve or to correct held perceptions is is an almost like impossible thing but what you can do is acknowledge it which is what we tried to do through certain small measures like just off the top of my head what I can remember is the nurses would normally wear their nurse outfits but what we requested they do is there's a certain fabric that indigenous Mayan women wear as like skirts and it's like a woven like it's a specific weave from that part of the world so we try to infuse that in the outfits that or like the apron we gave them like a service sort of tool of an apron where they could stuff some of the materials into and we made that apron out of the local material just to it's it's a small gesture but just to build some acceptability and some relatability I think and that's what we heard also in the previous episode that the solutions we seek it's not about how complex or how fancy they are it's about how impactful they are and if wearing a different apron does the job then wearing a different apron does the job and I think it's it's good to remind ourselves that sometimes the the best solutions are the most simple solutions the challenge often we face is that we have to deal with an outside world that perceive these solutions as too simple or too easy or might say well I could have come up with that in an afternoon like that's the that's the that's the bias we're fighting against but yeah absolutely and you know and as again designers and creatives and other people that are part of our team at scope we felt that way constantly where we want to be cutting edge you know where you want to try and see how artificial intelligence or something that's great and exciting and can do great things for you know all the causes is available to us but it doesn't it's it's not needed and the problem at hand can be solved by something that the community has come back to us with which is a lot more intuitive yeah which is a lot more acceptable yeah so yeah yeah that's a general thing that we're not going to solve quite uh quickly but it's the value of simplicity that's not valued uh what's that and yeah sorry and just and that's not to say that like you know a lot of uh now certainly especially with 2020 and you know the sort of the leapfrogging that technology and uptake of that has seen in in sort of all regions of the world uh we might have a different sort of solution in canvas next year when if and when we decide to engage with communities again because if phones are more available if you know internet has picked up a lot more than it currently is then I might be speaking a different tune or you know so in all cases it's coming up with solutions that fit the environment and that's the key it's not about coming up with solutions that use a fanciest technology but really fit the environment are and have a realistic chance of being sustainable making an impact what would you say is the biggest lesson you took away from this project um my biggest lesson was to avoid any assumptions uh to to prototype and simulate experiences as early as you can in the process and expose the people that you're co-designing with to that experience quite early on in the process so I don't know if I mentioned this but we never did traditional design research for this project we only started with simulations of these group sessions where we actually trained nurses and while training the nurses the questions that came up that helped us make that training process better while running the uh sort of the antenatal care experiences we learned how to make that better we noticed the things that were awkward we noticed the things that happened on its own and those were like and of course we would supplement it with like more interviews etc but I think seeing people or sorry helping people see the experience early on helped us see how they relate with it and how it fits within their world and how it can be made better um and then thirdly my biggest takeaway was uh excellent local partnerships uh you know you need those I would have we would have never been able to do any of the stuff that we did in this project if it weren't for the ownership and the sort of the support that we got from our local partners what is the thing that you would say um is the is there a general key takeaway that people who are listening and watching to this episode and maybe are in a completely different context can take away from it so I I'm working at a telecom operator in I don't know Croatia and if we would have a conversation which what what lesson would you share with me what do you think I could take away from your experiences um I think the one thing and I I'm not very good at giving like career advice but what I would say it's changed for me personally is it's taught me to think about results in a very different way uh I think in my previous uh experiences I'm used to shorter projects I'm used to seeing the thing that I'm creating whether it's a report or whether it's a solution right at the end of it but uh you know the kinds of topics we work with are sort of long haul you know it takes a while for the for the you know it's for things to even change even a little and I think what that has taught me is the belief in simpler solutions as we discussed of incremental changes versus like big changes and I do think that has a lot of value no matter what sort of work you're doing because I think quite often a source of project frustrations can be not knowing how to do the big thing but uh we often lose sight of the small things that we can do to get to the big thing and that's something that I hold close when I work on the project that we work on and and if I can dig into that for uh one final minute how do you measure progress for yourself how do you know that you're actually creating an impact I well that is another actually topic on its own I know what I would say but what I will say is that uh on a personal level of course you you know create milestones uh as you would just to see a project moving forward if you're like leading a project or if you're in like sort of seeing how it comes together but even at like a higher level I think what at least our organization had tried has tried to do now is put an impact framework in place where we hold ourselves accountable for putting together a sort of it's called a theory of change in the global health and development world and we sort of adapted that to how we approach designing for solutions as well and I know it sounds uh a little too complex for now but as soon as sort of we were all introduced to it it's actually the most intuitive way to think about like how what are we getting towards like what is the big picture vision that we want to achieve which is a big change we want to see in the world let's say and what are the smaller ways to get there who's going to help us get there um and what are some of the assumptions that are at play here so just these are some of the things and I think what that does for us at a project level or you know task level is that everything becomes attached to a certain thing that helps us create that big change so it it makes you want to work on it harder and it makes you want to make sure it gets done so you can move on and and that's maybe a challenge in a lot of uh uh commercial and corporate context that you have no clue why you're actually doing it you're doing it because I don't know three months ago the CEO put it on the agenda but yeah any who uh yeah if people want to continue this conversation with you what's the best way to get in touch um I'm very LinkedIn friendly I am extremely reachable on email um and I can share that uh with you Mark and I mean you have my details yeah yeah the LinkedIn profile will be in the show notes of this episode yeah thank you for for sharing your uh experience your stories I'm always amazed in how much parallels there are in the design process across across the globe no matter which challenge we're trying to solve and I think it's really good to hear uh to hear so thank you again for sharing that I really hope you enjoyed this conversation with Priam and that you were able to translate some of her stories to your own context if you know somebody who needs to hear these stories as well grab the link and share this episode with them that way you'll help to grow the service design show family and that helps me to invite more guests like Priam here on this show for you if you want to continue learning about skills and strategies that help you to design services that win the hearts of people and business make sure to check out this video because we're going to continue over there