Guiding principles

The principles below serve as reminders when investigating and responding to challenges that involve people.

Photograph of a woman and a man Village Health Workers in Zvipiriri Zimbabwe during a card sorts activity part of an interview. The woman is looking at the camera proudly and holding the Joy card in her hand. Then man is looking closely at the other cards.
Editorial illustration of a mother holding her child and a health worker besides her with a medical chart in her hands.

The following six principles are grounded in what we know to be true about human behaviour and can improve the effectiveness of our efforts.

They are intended as reminders when investigating
and responding to demand-related challenges.

Small is big: We tend to overlook the small stuff, like the inconvenient barriers of dealing with health programmes. Because people don’t always make reasoned calculations weighing costs and benefits, the small stuff can dominate decision-making.
Knowing is not Enough: Knowing about technology, how treatments work or having an accurate understanding of a health benefit does not necessarily correlate to high levels of participation. When we accept that it is possible to alter behaviour without ever changing what is in someone’s mind, we open ourselves to more innovative solutions.
Attention is Elsewhere: Most people, most of the time, are not thinking about the best health practices. And when they are, it’s not always (or often) given a very deep reflection. If we remind ourselves that most people spend little time thinking about vaccination, we will ask less of users and make our programmes simpler, and easier to use.
Context Comes First: One of the more common terms in public health is ‘behaviour change.’ A singular focus on behaviour change can be misleading. Changing the context in which people behave often has more powerful implications for ‘behaviour change’ than directly asking that people change their behaviour.
Truths are Buried: What people believe, say and do can be three different things. How we explain our own behaviour is not always accurate. This makes it critical to disentangle what people self-report about their behaviours from what is actually happening.
Intentions are not Actions: Intentions can be poor predictors of corresponding actions. Instead, we should focus on what it takes to get caregivers and health-care workers to act. Behaviour depends as much (if not more) on removing the barriers to taking action as it does on forming intentions.

Next step: Explore the HCD Process

Discover the five questions that guide the HCD process and how they lead to inclusive, equitable solutions.