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Through a Human Lens: Health of Informal Workers

Above Children

For years, consumer product and marketing firms have utilized user-centered product development approaches to attune their offerings to customers’ needs and wants. Increasingly these human-centered design (HCD) techniques are being applied in the social sector to create more impactful interventions that meet target beneficiaries where they are. In several areas of work, The Rockefeller Foundation has integrated HCD approaches in our strategy development work to integrate a “user perspective” on social and environmental problems.

We wanted to understand not only the constraints people face in making choices about health and wellness, but also how the assets of this population could be used to design more effective interventions.

Most recently, the Foundation partnered with to better understand how the urban working poor in the developing world view their health. We wanted to understand not only the constraints people face in making choices about health and wellness, but also how the assets of this population could be used to design more effective interventions. The team spent several weeks last summer visiting cities across Southeast Asia and sub-Saharan Africa, including Bangkok, Manila, Durban, and Nairobi, and met with individuals in their homes, workplaces, and community spaces, such as markets and places of worship.

Below we highlight some key findings from’s work. Using a common tool of HCD, we also pose several “how might we” questions to stimulate thinking on how these learnings could be practically applied.

Key Takeaways


1. Bring services to where people are.

The urban working poor are an incredibly diverse group of individuals, who often live in disparate communities and are involved in a range of work types. However, certain locations, such as a vendor’s stand in a central city market or a gaming center, often bring together people from different parts of a city or community and can be helpful channel to reach a large number of urban working poor throughout the day. From a design perspective, this insight highlights opportunities to leverage existing connection points in a community and trusted individuals to deliver care in new ways.

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2. Leverage the influence and proactivity of “optimizers.”’s work also highlighted different mindsets and behaviors among the urban working poor, which when tapped can empower an entire ecosystem. One behavior segment identified was “optimizers” – or individuals who demonstrate successful behaviors relating to work, health, and finances regardless of their age, gender, or location. Optimizers are often early adopters, characterized by their proactivity and willingness to try new things. In their own lives, they often tell powerful stories of having changed their circumstances for the better. For example, MaDlamini runs a successful traditional herb market at Warwick Junction in Durban. Although MaDlamini is a firm believer in traditional healing, she will often take people to the hospital if she recognizes they have a disease, such as HIV/AIDs, that she is unable to treat. MaDlamini’s leadership position in the community coupled with her willingness to support different approaches to addressing health issues are emblematic of the optimizer mindset.

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3. Design with financial resilience in mind.

An inability to pay for health care and the opportunity costs of accessing care, such as travel costs or time lost at work, are significant barriers to accessing health services for many urban working poor individuals. Providing these individuals with the financial knowledge and tools to prepare for health issues can greatly increase an individual and their family’s resilience when faced with a health catastrophe. In Kenya, chamas (i.e., lending groups) were seen as an effective tool to encourage individuals to purchase insurance for themselves or family members. For example, a mango seller in Nairobi, Grace, belongs to a chama that requires its members to purchase health insurance. After testing out the health insurance card, Grace then bought one for her brother.

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Human-centered design can be a powerful tool for development practitioners, enabling us to better customize interventions to the unique needs of target beneficiaries and the specific contexts in which they live. In this case, the insights surfaced through project will help inform further design and research as the Foundation explores interventions to meet the health needs of these individuals.

More information on’s findings and the full report can be found at A Human Lens on the Lives of Informal Workers.

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