Using design thinking to engage the Nigerian public in health news

by Nuno Vargas
Oct 30, 2018 in Miscellaneous

The way we told stories in the past doesn’t always work today.

Traditionally, editors and reporters would think of stories they believed the audience needed, and then deliver those stories as best they could. But in our increasingly mobile and wired world, audiences change quickly. How can an editor be confident that a story that seems important to the audience really is?

The short answer: By getting to know the audience so deeply that their needs are revealed. If that sounds impossible, take heart. A new approach is proving to be an ideal way to make it possible.

The Design School at Stanford University developed design thinking, its groundbreaking approach to human-centered design, to allow those who develop products and services to better understand their users' needs. Journalists are applying design thinking to strengthen news reporting all around the world.

Strong journalism requires deep reporting. Human-centered design, with its focus on detecting the needs of end users, provides tools for doing just that kind of journalism. It satisfies the call for reporting that takes a deep dive into a subject.

Hala Nigeria, a project of the ICFJ Knight International Journalism Fellowships, has taken the principles of design thinking, and the tools that are based on them, to Nigeria, where citizens’ needs for solid health information are fundamental – and often a matter of life and death.

Getting started: the empathy phase

Empathy is the core element of design thinking, and it's a vital part of any successful engagement strategy for media products.

Hala Nigeria, which I assist, has a straightforward but profound goal: To "increase public engagement and amplify citizen voices in health news in Africa’s most populous country."

But driving engagement is anything but easy in today's world of information overload. To succeed, you must understand the needs of the people you are trying to reach, their thoughts, emotions and motivations. Only then will you be able to design a way to best approach them. 

Human-centered design thinking as pioneered at Stanford allows us to draw a blueprint for how to reach people in a way that compels them to engage. We draw this blueprint by first understanding the choices each person makes, and the reasons behind those choices, as well as by observing the person's behavior.

These observations will produce insights that will lead news organizations to design better ways to reach their audiences in ways that leave them ready and eager to act or engage.

Journalists are natural-born design thinkers

Journalists ask questions – and doing that is at the heart of human-centered design. We build empathy with our subjects by listening to their stories, talking to them, and working alongside them. By immersing ourselves in their lives, we learn the details, the not-so-obvious facts.

Typically, we listen and observe so that we can best understand the situation our sources find themselves in, allowing our stories to go deeper. 

So why can’t journalists use these same skills, these same powers of observation, to learn what our readers’ needs are when it comes to the news they get from us? We can, and increasingly we are. 

It’s not always easy, though. Every audience represents a different challenge. Boosting their engagement with news - even really important news, like the health-related work so badly needed in Nigeria - is a complicated matter.

This is particularly true in a place as diverse and spread out as Nigeria. Habits, traditions and local characteristics all play a role in making our potential audience engage with certain stories and ignore others. Every group behaves differently. These factors are only compounded when a user believes the news he or she encounters is related to something as important and urgent as giving birth or immunizing your child against polio.

Putting design thinking into action in Nigeria

So how did we put these insights to use in Nigeria, as part of the Hala Nigeria program? 
Teams conducted interviews and observed the behavior of potential news consumers. The teams, made up of finalists from the Hala Nigeria program, went into the areas where their stories were happening and interviewed the subjects of their story, who are also the “users” or consumers of the end product.

They gathered insights from what they heard, but also from what they saw. The recorded not only the answers, but their subjects' emotional reactions and body language. They usually interviewed each user more than once, typically while going through his or her normal daily routine.

Stepping back, looking for insights

After the interviews, we looked over the information that had been gathered in the empathy phase and scrubbed it for insights.

Insights work as nonverbal clues, the way people say things, their body language, their emotions while addressing an issue. We also looked for “need-finding factors,” or unmet needs. Need-finding comes from the objective realization that several needs are not being fulfilled, and that there is room for improvement.

One reporter interviewed a man about self-medication. Initially, the man said that he always takes his malaria tablets. Yet the reporter noted something inconsistent in his body language, and asked a few more questions. By the end of the interview, the man shared that he normally buys knock-off malaria pills because they are cheaper. These are a problem in Nigeria because they may be fake or expired, providing no protection against the disease and potentially causing more harm than good.

Developing solutions to meet real needs

The challenge is to use all these insights to first understand what the users’ real needs were, and then to apply our own expertise as journalists to develop media solutions that can meet those needs.

A team reporting on traditional birth attendants initially focused on the subject of modernizing health care conditions and the need to make more deliveries happen in hospitals. But after a series of interviews, the reporters detected that the story was really that hospital workers had not earned the trust of expectant mothers, who avoided the hospital as a result.

Over two days, we helped the teams clear up misconceptions, re-focus on their users, and relentlessly challenge a number of assumptions related to the stories they felt they should be telling. Against all this, we asked them over and over to re-examine their assumptions about the stories’ capacity to drive engagement.

In one case we realized that users who had been victims of medical malpractice weren't even aware of the real disease that they were being treated for, let alone if the treatment was adequate. In another case, the users were taking fake malaria pills because they had been advised by their pharmacist, who also turned out to be a fake, but whom they still trusted because “it was the only medical advice they had near."

By the end, all of the teams had a clear understanding of what the users' information needs were. They each had a clear set of engagement-driven features ready to be deployed in several different ways. A team of judges selected the most promising projects, and the media organizations working on those projects now have embedded technologists to help bring the audience-engagement strategies to fruition.

The beauty of the process – and its frustration, too – is that the iteration cycle can be repeated again and again until we’re as close to perfect as time allows.

The next iteration of the project will involve improving our solutions by crossing them with external big data sets from government and non-government sources and accessing what technological resources are the most effective to build our product.

This last element is vital in a country like Nigeria, where feature phones are the most-used mobile device, online connections can be temperamental and a big part of the population is not exposed to this kind of technology.

Photo Credit: Patrick Butler, ICFJ.