How Macquarie is using human-centred design to help eliminate scabies in Fiji

By Harry Kellick, Service Designer

12 December 2023

— 6 minute read

Human-centred design (HCD) is a problem-solving approach used to uncover the needs of people and to design solutions for them. It values empathy, clarity, creativity, and co-creation.

At Macquarie we recognise the value human-centred design (HCD) brings in delivering outstanding products, services and experiences for our people, clients and communities. We use the Double Diamond model, a framework for innovation and a visual description of the design process, to ensure we fully understand the problem we are solving for and how we can best solve it. The two diamonds alternate between exploring an issue widely and deeply, known as divergent thinking; and then taking focused action, known as convergent thinking.  

Figure 1 - The Double Diamond (adapted from the UK Design Council).

A key example of where we have followed a HCD approach is through our partnership with the Murdoch Children’s Research Institute’s World Scabies Program (WSP). In 2019, the Program was one of the winners of Macquarie Group Foundation’s 50th Anniversary Award, which supports organisations addressing areas of social need through projects that provide lasting community benefit. 

Using an HCD approach, Macquarie collaborated with the World Scabies Program to establish a campaign to increase awareness and encourage treatment of the disease.

 

What is scabies?

Scabies is estimated to affect more than 400 million people cumulatively every year. A national survey conducted in Fiji of over 10,000 residents in 2015 reported an estimated national scabies prevalence of 18.5%. The infestation of tiny mites results in an itchy rash, can affect sleep, and is highly contagious. People suffering with scabies have visible legions which can result in stigma and social exclusion, increasing absenteeism at schools and in the workplace, leading to a loss of learning opportunities, and impacting families and communities more broadly. Scabies can also lead to bacterial infections of the skin which can cause severe disease.  

The World Scabies Program is working with governments and partners to eliminate scabies as a public health problem. This program aims to put scabies control on national and global agendas, implement community wide treatment strategies, and strengthen health systems to monitor and manage scabies.

 

The opportunity

At the time of our engagement, WSP was preparing for a mass drug administration (MDA) campaign across Fiji, where nurses offer medication to all members of the community to reduce instances of this widespread skin disease.

The campaign aimed to help 80 per cent of Fiji’s national population, or ~700,000 Fijians, over the course of three months. However, the Program faced challenges:

People aren't aware that:

Scabies is treatable

Medication is available

People are hesitant to:

Take western medicine

Figure 2 - Imagery used in Macquarie's HCD workshops

From this came a key question at the centre of our approach: How might we increase awareness of neglected tropic diseases such as scabies in Fiji? A diverse team from Macquarie partnered with the Program to develop, facilitate and participate in two workshops to explore how we could achieve this.

 

Workshop 1 – Exploring the problem

The first workshop focused on exploring how community members responded to existing campaign materials and how these learnings could inform both short-term and long-term opportunities to increase the success of upcoming campaigns.

Using a template asking ‘I Like, I Wish, and I Wonder’, we engaged in rapid brainstorming, sharing our favourite ideas back with the room after 30 minutes. Ideas raised included partnering with trusted community members and celebrities to become ambassadors for the World Scabies Program, and developing a promotional video for social media that showed the benefits of medication for anyone suffering with the skin disease.

After sharing initial brainstorming ideas with the Program, feedback highlighted the need to ensure the solution could:

  • reach remote communities
  • meet the limited budget available for media and video production
  • be workable for the small World Scabies Program team to deliver
  • ensure it was centred on a simple and concise message that would stick. 

 

Workshop 2 – Designing the solution

Taking this guidance on board, the second workshop focused on developing four deliverables: a tagline, radio advertisement, video advertisement and poster.  A timebox activity was used to ensure a maximum time allocation for each element, starting with the tagline. Three possible options for a tagline emerged:

  • FAST – Fiji Against Scabies Together 
  • Scratch out scabies for good 
  • #HappySkin – Happy skin is one tiny pill away 

Three smaller teams then rapidly prototyped either the radio, video, or poster deliverable within a 45-minute timebox. IDEO.org highlight that prototyping allows us to make ideas tangible, learn through creating and receive feedback quickly. Simple prototypes save time and help focus testing on the critical elements. 

 

Prototypes

The biggest challenge for the radio team was designing an advert for the short time slot available, with only 10 – 30 seconds to deliver a message that resonated.

The video team were encouraged to develop a storyboard and script, considering what types of imagery would be used: stills, videos or a combination of the two?

Figure 3 - Prototype output for the video ad

And the poster team needed to consider the different use cases, such as being posted on social media or being physically displayed outside medical centres and chemists.

Figure 4 - Prototype output for the poster

Refining the prototypes and distributing the final outputs across Fiji

Radio advert

Following the second workshop, the radio team reconvened to record their script as a final prototype. The World Scabies Program team tested the script locally and received useful feedback, allowing them to iterate. After final amendments, the radio advert was recorded and published. Since launching, the advert was played every day across five commercial stations in Fiji. It was also translated into different local languages.

Video advert

The WSP team pivoted the storyboard prototype to align with the radio script, and sourced volunteer actors for the final output. The video advert was aired on two major stations, Fiji Broadcast Company and Fiji TV, during prime time (7pm to 8pm) and was distributed across social media. 

Poster

Following the workshops, the poster team progressed their prototype into a hi-fi version. One major change was a focus on scabies on the feet, instead of other parts of the body, as this is where scabies typically occurs. Our poster is on display in approximately 2,500 different sites across urban areas in Fiji like Nadi and Suva.

Figure 5 – Final output for the poster displayed in Fiji

Key takeaways

The mission for the World Scabies Program is to eliminate scabies globally, starting with MDA rollouts across Fiji and Solomon Islands. It was exciting to share Macquarie’s understanding of HCD and use it to create real world impact. As someone who has joined Macquarie recently, it’s amazing to learn new skills at work and be given an opportunity to implement them in real-life contexts to see tangible social impact. Alongside the $A10 million WSP have received from Macquarie for their work in Fiji and the Solomons, these workshops enabled Macquarie staff to contribute in additional ways to its goal.