• How can we structure conversations to engender growth from every perspective?
• What are effective ways to engage with the global community and learn from others’ experiences?
• How can we foster collaboration and avoid reinventing the wheel in our initiatives?
• How do you navigate the power dynamics of social impact changemaking?
• What are better ways you can set your organization up to affect social change at a global scale?
In this episode, we talk to Robert Fabricant about making an impact at a local and global level through service design. Robert is Co-Founder and Partner of Dalberg Design, where he brings human-centered design and innovation services to clients looking for new, creative approaches to making breakthroughs in social impact and international development. We talk to him about how his years of experience in human-centered design has shaped his perspective on how we think about relationships when designing services for communities around the world, and how inclusion in service design means not only bringing communities aboard to participate in creating solutions, but also deeply examining how you can create space and opportunity for people and entire organizations to navigate existing power structures better.
PI: What has worked well when you want to set the stage for good conversations internally in your team, but also when you set conversations with your clients or those that you’re designing solutions for?
RF: First and foremost, we have become increasingly comfortable openly acknowledging and discussing the power dynamics, whether imagined or existent, right at the outset of our conversations. This practice has been a notable and valuable aspect of our professional development over the past eight years as a team. In previous experiences, such as working in design studios, these dynamics were often addressed sporadically rather than through a structured process. However, we have now incorporated this approach into our interactions.
One noteworthy benefit of this practice is that during our feedback sessions twice a year, we prioritize discussing each cohort within our small team of 30 people, with each cohort typically consisting of five or six designers, including senior designers. This approach allows me to understand how each team member is progressing comprehensively. As a result, I enter internal discussions with the awareness that I must consider the perspective and needs of each individual, tailoring my responses to empower them and contribute to their personal growth. I have learned that subtle guidance and nudges can often be more effective than imposing strong personal opinions, a tendency I am aware of and actively working on, as Fanny can attest.
In addition to our internal practices, when working with clients, our team has found it beneficial to ask open-ended questions that create space for these crucial conversations. While our team members can facilitate these discussions, they may not always feel comfortable initiating them, so we aim to foster an environment where such conversations naturally emerge.
RF: I find it frustrating to contemplate the vision and institutionalization of service design. It often seems to revolve around the notion that by carefully scripting touchpoints, especially the self-guided ones, and providing the right information at precisely the right moment, individuals will feel adequately supported throughout a process. However, I believe this is somewhat illusory. The crux lies in human dynamics, trust-building, and how people engage with one another rather than orchestrating intermittent touchpoints.
I’m also disillusioned by the idea of constructing systems expected to capture and pass along such information seamlessly. It’s frustrating to witness blueprints and designers attempting to distill relationships’ intricate, evolving nature into a rigid, repeatable recipe that anyone can execute at any time. It feels like an unattainable aspiration to tidy up the world.
Designers often strive to clean up the world excessively, but the world’s inherent messiness is what makes it fascinating. If it were entirely tidy, we’d need engineers and social scientists. This is where I find myself repeatedly grappling because I want my team to recognize the profound potential for design rather than viewing it as an ambiguous web of relationships. However, when I present a journey map or service blueprint, expecting it to bring about significant change, it often falls short, leaving me perplexed about what went wrong.
PI: So, you’re leading into the next question that I wanted to ask you is, you know, you, you’ve mentored and you mentor and coach so many people along your career. What is one piece of advice, that you just gave us some, but give us some more advice that you think has impacted some of the people you’ve mentored?
RF: You all are really delving into some profound questions here, which makes me reminisce about the wisdom that comes with age. When it comes to design, it often hinges on the approach, with some designers striving to rein in that control and perfection, finding the right moment to let go of that sense of meticulousness. It’s crucial to appreciate that a significant portion of what we do remains emergent and messy, and embracing that rather than trying to rigidly define everything is essential. This theme frequently arises in my line of work, as very few projects ever truly reach completion.
One of the significant challenges we face, and Fanny, you can certainly attest to this, is that many of our partners and clients don’t prioritize quality as much as we’d like them to. They often don’t want to invest the time and effort required to refine a design to the point where it functions and shines brilliantly. This can be frustrating and even lead to a desire for more control. However, timing is crucial in these situations. I find myself wondering how to approach this issue without disempowering others.
How can we create a space with a concrete foundation for collaboration, serving as an anchor to help people envision different possibilities and mindsets without becoming overly prescriptive about factors that are unrealistic or need to evolve with changing conditions and people’s lives? This is a significant concern.
In my work, I make a conscious effort to discourage the use of overly technical design jargon. Interestingly, as Ravi and I transitioned from Frog and began working more broadly, we observed that the same specialized language was prevalent internally and externally in corporate design teams. While this may indicate progress, it’s also created a hyper-specialized technical field. It’s refreshing to operate in a space where this level of institutionalization hasn’t taken hold.
We often find that people respond positively to our work, which, despite their initial perceptions, is rooted in common sense. Somewhere along the way, organizations like the World Bank started relying heavily on spreadsheets when interacting with people would have been far more effective. Designers aren’t solely bearers of these skills, but we’re not social scientists. We’re here to bring a different perspective focusing on practical solutions rather than just publishing reports.
I do encounter some challenges within our team regarding emotional maturity and wisdom. Some of our designers are young and highly emotionally attuned, like the designer in Dakar, who excels at connecting with people on an emotional level. However, some designers require time to mature in this aspect. The question is, how do we convey this message and create a comfortable environment for growth? When we initiated this practice, there were numerous mid-career designers eager to embark on this type of work, approaching it from a different wealth of experience.
I think it’s a great question. We’ve gone from a firm that spoke a bit more output on outputs to one that focuses more on process and capacity building. So, people feel a little uncomfortable sometimes putting an idea solution out there sketching it out, or giving it shape and form and pointing to it.
Designers excel at initiating this process and are skilled at putting ideas into action. It’s not about personal ownership, and offering feedback is welcome as it contributes to progress and creative thinking. So, part of our goal when working together is to ignite this creative process.
We aim to demonstrate various straightforward, low-fidelity methods to help individuals enhance their existing approaches or explore new ideas. Our goal is to facilitate these discussions as a group rather than focusing solely on individual drawings or sketches. This process, along with the use of participatory tools, strengthens the skill sets of those already proficient in community activism, engagement, and building.
A significant part of our work involves layering these participatory tools and empowering individuals with the confidence to use them effectively. Our emphasis lies in ensuring that the community’s voice and the individuals themselves influence the language, content, and all aspects of the process, fostering a sense of ownership.
Another key aspect of our work is assisting communities in taking greater ownership of their data, findings, and insights. We provide them with tools and strategies to achieve this. These are some of the core components of our work. We are continuously exploring ways to stay engaged throughout the process and align it with our business objectives. In some cases, we collaborate with community-based partners to secure funding. However, it remains a challenging endeavor to garner support for sustained engagement at this level.
PI: So modeling and training, new ways of thinking and working, rather than actually just doing the work for them, is a way to make sure that there’s flexibility, long-term and sustainable impact.
RF:
In any healthy design process, when working with a community-based partner, it’s crucial to identify individuals with curiosity and creativity, often hidden or suppressed. My career began in criminal justice within an advocacy organization, which was quite intense and lacking in equity support at times. The goal is to discover such individuals and ignite their passion. Some of them eventually join our team or participate in fellowships to become more integrated into our work.
Occasionally, members of our team immerse themselves in other organizations for a period. We aim to cultivate this collaborative approach. Additionally, we have the advantage of working closely with colleagues engaged in policy and other large-scale initiatives. This allows us to apply our insights to influence government health policies, digital health policies, or the priorities of major funders like the Rockefeller Foundation. This access to influential conversations is a perk of being part of a long-standing firm specializing in this type of work.
Currently, we are collaborating with the Pima County Health Department, essentially the health department of Tucson. I’ve been involved with them for just under a year, and I hope this partnership will continue for a few more years. Tucson is unique in several ways, with its status as the largest county bordering Mexico and a significant tribal population. It also features pockets of progressive communities within the broader context of Arizona’s political diversity, including far-right elements. Our project is a fascinating blend of these factors.
Initially funded by the Office of Minority Health, our project primarily aimed to address equity in COVID outcomes, particularly vaccination. However, it also allows us to explore broader equity and literacy issues for the Latino population in Tucson. We’ve been working closely with the Health Department and a smaller provider serving this demographic. Importantly, they have engaged several community-based organizations from the outset, including the library system and literacy-focused entities in the county. This collaboration involves a diverse array of partners, each working on different timelines. Equity and literacy are complex challenges that take time to address.
We’ve approached this as a puzzle, collaborating and adapting the program as we progress. Our efforts have involved research, participatory design, and the development of concepts to strengthen connections, trust, and equity. We’ve also engaged in co-creation and prototyping. Currently, we’re at the stage where additional partners have joined us to run a pilot program, particularly focusing on evaluation.
It’s fascinating to observe how experts and providers are beginning to incorporate ideas about equity and inclusion into their approach, shaping how they engage with the community. We’re fortunate to have a Mexican-American designer leading our efforts, providing a valuable perspective.
PI: And what would you say is a really unexpected reaction that you’ve gotten in this process of trying to connect with the community, you know, trying to get a better understanding of kind of the background and the context that you really still think about to this day.
RF: You know, one of the things I often contemplate is the complexity of the healthcare system. I’ve had the opportunity to work briefly in Mexico within their healthcare system, and Danny, who leads this project, has Mexican-American roots and spent some of her formative years in Mexico City. This experience has highlighted a few intriguing aspects.
Firstly, the significance of personal connections in the Mexican healthcare system stands out. It’s remarkable how accessible doctors are through platforms like WhatsApp, making it easy for patients to reach out. In contrast, here in the United States, the time with healthcare providers is often limited, and the advice given can feel culturally distant from the lives of immigrants, even in a place like Tucson. There are numerous challenges associated with this disparity. What’s striking is that healthcare professionals in the United States are becoming increasingly aware of these challenges and are actively seeking ways to better understand and connect with patients on a cultural level.
Stepping back from this particular project, which focuses on COVID-related work and global health, it’s an interesting moment in healthcare. Many experts are becoming less confident in their assumptions about what makes healthcare systems work. The expected responses to various solutions and data have not played out as anticipated. This uncertainty creates an opportunity for designers like us because it challenges the established presumptions.
In my interactions with individuals from health departments and clinical settings, I’ve noticed a greater openness to acknowledging the difficulties in effectively communicating and guiding patients on their health journeys. It’s been fascinating to witness these reactions. Moreover, the competence of individual healthcare providers in communication varies significantly. It’s surprising how different their approaches can be when you visit different clinics, even within the same area. Each provider has a unique style, and their perception of patient engagement differs widely.
In essence, it’s an intriguing challenge to navigate these differences and find ways to improve healthcare communication and delivery.
PI: Having that cultural or contextual understanding from the provider side is crucial to these health outcomes, especially for health interventions and all these different communities. And I think the most exciting thing is then how do you, how do you scale that understanding and those solutions when it comes to when those variables and factors are at play?
RF:
It’s quite easy, but I believe it presents a challenge for us as designers. We become deeply engrossed in the subtleties of context, searching for systems and approaches that can extend beyond a single healthcare system to the entire county. This aspect is particularly fascinating when working within the community.
The primary challenge we face is that certain events tend to occur solely within the clinic, often occurring too late in the process. This results in a significant gap. The Health Department has had some success with large-scale campaigns and provider training, but there’s a substantial space in between to explore. Within the communities and cultures we engage with, we’re striving to understand whether organizations or individuals, some of whom have religious affiliations, are influencing people’s behaviors or engaging in these conversations earlier.
We’ve been concentrating on a program called a “promotora,” which involves community volunteers providing guidance on navigating the healthcare system. We’re working on expanding this program and integrating it more closely with clinics to facilitate smoother transitions. There are other models similar to this, including efforts to expand the community health worker model, which offer scalability and broader coverage, and these are under consideration.
However, it’s essential to have the time to iterate these models through multiple cycles, rather than simply handing over a blueprint. Fortunately, we’re in a position where this is possible. The primary drawback is that some aspects of our work require evaluation, but only certain elements lend themselves to a rigorous evaluation process at this stage.
The challenge lies in finding a balance where there are numerous benefits and avenues for scalability, alongside a need for specific proof points to secure funding for scaling initiatives. Much of what we’ve learned about people’s lives and trust is intricate and fluid, making it tricky to impose an evaluation process on these aspects.
In summary, our current situation involves partnering with behavioral insights evaluation experts and community partners with extensive reach within the community. It’s a continual effort to align these two elements.
PI: Ensure that it functions properly. Address that specific query, as well as the others we had lined up. When you zoom out and contemplate various models, I wanted to share something. I’m involved with a group here in Montclair called the “Navegadores.” It’s a network of individuals fluent in Spanish and English who volunteer to assist immigrant families in settling here and navigating the education system, which can be pretty challenging for non-English speakers. The core concept is this: you have organizers, and then there are numerous volunteers, each responsible for one, two, or even three families, depending on their availability. Essentially, we help them navigate the healthcare system, guide them through the intricacies of the school system, and assist when they encounter housing-related issues. This involves connecting them with the appropriate resources, translating, or offering guidance. It’s proven remarkably effective, functioning like a supportive network with many branches reaching out to help.
Now, considering the importance of the issue you’re discussing and zooming out a bit, what aspects do you believe deserve more attention, discussion, or action in the realms of health, immigration, diverse cultures, and the various approaches to addressing these issues?
RF: I believe our primary focus in the work we’re engaged in is to assist individuals in navigating their challenges and gaining a clearer understanding of what truly matters to them. This entails improving their ability to express their needs effectively. A common issue we’ve observed is that many people feel they lack expertise in this area, leading to a sense of falling short. This feeling is often exacerbated by unclear or uncertain immigration statuses, which can be a significant hindrance.
We have found that clinicians need to enhance their questioning skills. We are striving to shift from a predominantly problem-solving approach, especially concerning topics like COVID-19, recognizing that people may be reluctant to discuss it. This aspect ties back to your previous question and wasn’t surprising to us, though it might have been for our county department colleagues. COVID-19 currently holds a very low priority in people’s lives, particularly in low-income communities. It’s almost negligible in terms of influencing their health-related decisions.
Interestingly, despite this, it remains a prominent concern within the healthcare system, with clinicians attempting to address it, especially with pregnant women. It presents a real challenge, and I believe it necessitates establishing trust first before engaging in such conversations. Building trust may require multiple visits and more than just a quick 20-minute conversation. This is a common issue in the field of healthcare.
PI: It sounds like it all comes back to core values and building trust in the communities and for clinicians. Then what would you say is a question you wish was asked more often?
RF: I believe the key missing element in this scenario is a genuine understanding of the significant commitment required for a person to visit a clinic – the time, effort, and financial investment involved. If I had the power to change things, I would begin by acknowledging this aspect. It’s crucial to recognize the considerable time, effort, and money invested.
For individuals with children, a job, distant residences, a lack of transportation, or no access to a phone, these obstacles pose a substantial challenge. Each person’s time is incredibly valuable. This is where I believe there’s room for improvement. It’s intriguing that this process becomes formalized, with specific questions to be answered at various points in time.
These questions often fall under a category referred to as “social determinants of health.” While they serve to build a profile in the system and may have benefits in determining the support someone might qualify for, they don’t truly delve into understanding the person’s unique circumstances when they are sitting in your office. What did it take for them to get there? What do they mean to their family?
It’s essential to consider how best to assist this individual, as their presence likely signifies a significant investment of time and knowledge within their family. They might serve as a caregiver, and there’s a lot more to their story. This issue isn’t exclusive to Tucson or our clinic; it’s a recurring theme in all the community-based health work I engage in. In fact, it constitutes a significant portion of my personal portfolio. While our firm is involved in various activities, this aspect, I believe, embodies a fundamental principle of respect.
PI: Brilliant — and when you were taking a step back to think about the company’s values and how that will take you forward, what advice would you give now after having gone through that process?
RF: Great question. We recently welcomed a partner into our team, and I’d like to share their perspective. According to their advice, to better address equity in our external work, we need to reevaluate our internal operations and power dynamics. I wholeheartedly agree with this viewpoint.
As for my recent activities, I manage a diverse global design team with a scrappy approach, spread across various locations, including Dakar, Nairobi, Mumbai, London, and New York. We’re also in the process of establishing a team in Mexico City this year. While we are part of a larger firm with an impressive footprint, we’ve been on an intriguing journey.
One major focus has been internal restructuring. Last year, we dedicated significant time to aligning our values on equity with a new governance and leadership model. We collaborated closely with my partner, Ravi, to draft governing statutes and subsequently elected leaders for our design teams in Africa and Mumbai, who now partner with Ravi and me. This has initiated a shift in leadership dynamics as we evolve into a slightly larger decision-making group. We are currently a team of about 30 individuals, representing diverse cultural backgrounds, and we’re exploring how this affects our operations.
Moreover, across our portfolio, we’re actively seeking opportunities to enhance and deepen community-based partnerships, which are central to our work. While some projects naturally lend themselves to this approach, others may not. Last year, some team members outlined a vision for our equity and community-centered design approach. We are now identifying projects where we can integrate these principles and develop partnerships that allow for meaningful engagement. This year, we aim to assess whether this approach provides a more fulfilling experience for our designers and aligns with their ambitions.
Additionally, we’ve introduced an outside firm into the equation to guide our internal processes. This firm, which we continue to work closely with, brings an external perspective, which has been valuable. However, it’s worth noting that the answers mostly originated from our team. The challenge has been in translating these ideas across different cultural contexts. While the firm primarily dealt with equity issues in the US, our team members bring unique perspectives rooted in post-colonialism, caste systems, and other deep-seated inequities.
In summary, our team’s journey has revolved around internal transformation and the importance of grounding ourselves before extending our equity-focused approach to the community. Personally, I’m constantly questioning my understanding of power dynamics and how they manifest. I’ve learned that while we can’t eliminate power dynamics entirely, we can place equity at the core of our firm. This journey has led me to seek self-awareness and transparency regarding my own role in these dynamics.
For example, as we’ve promoted team members to partner level, I’ve observed how their backgrounds influence power dynamics within the team. I am the most senior member in the firm, which comes with its own dynamics, including being sought after for wisdom. In conclusion, it’s vital to establish equity internally before promoting it externally. This is the essence of our team’s story. Additionally, I aim to find new ways to discuss and address power dynamics, seeking advice from peers to better understand and manage them. These are the guiding principles on my mind.
PI: I find your approach truly fascinating, especially your ability to generate unique solutions tailored to specific problems and audiences. As you look ahead, what lies on the horizon for both you and Dalberg design? What kind of challenges are you eager to take on next? Are there particular issues you’re keen to address, and how do you envision starting this new chapter? I recall you mentioning internal restructuring; could you please elaborate on your future plans?
We’re embarking on a journey that builds upon some earlier discussions and delves deeper into certain topics I’ve already touched upon. Let’s begin with an illustrative example that you brought to mind. While this isn’t something we frequently engage in, we are currently investing our time in a local partnership here in New York with an organization dedicated to providing support and services to unaccompanied migrant children held in federal government facilities, awaiting decisions regarding their potential deportation. It’s important to note that these children do not have access to legal counsel as a fundamental right. Moreover, many of them are quite young, ranging from five to twelve to fifteen years old.
Our partnership entails supporting this organization as they enter these facilities to educate these children about their rights, conduct one-on-one consultations, and help position them optimally on their journey, whether that means returning to their home countries or being placed here in the United States.
We are collaborating closely with this organization to scrutinize the overall experience and to improve their ability to establish trust, communicate effectively, and provide better services. We are exploring various tools and approaches to achieve these goals. I highlight this as one example because it exemplifies our broader objective, which is to determine the extent of our impact if each of our studios, for instance, were to partner with a local community-based organization that we support continuously. We aim to explore the potential for mutual learning and to contribute to shaping the future of the programs and projects we wish to be involved in.
We consider it a two-way street, understanding that we can learn just as much from these community-based partners as they can learn from us. This is a significant area of focus for us. In one instance, in Colombia, we appear to be nearing a point where there is funding to sustain such a partnership, although we are actively seeking ways to engage before that challenge is entirely solved. Our belief is that if we are engaged in meaningful work together, learning from each other, and addressing important issues, we will find a way to ensure its sustainability.
For us, this represents an opportunity to shift the dynamics of power and redefine how we collaborate with our clients. We aim to take our team on a unique journey, one in which they feel a genuine sense of ownership and accountability towards these organizations, not because they are clients or paychecks, but because we share a common mission. This is a key focus for us in the short term, and it aligns with our ongoing internal efforts to promote equity, extending its reach externally as well.
Our goal is to uncover how these experiences in vastly different geographic locations, working with partners in diverse contexts, can continue to enrich our understanding and ultimately evolve our practice.
PI:
“What’s a good way to find out more about what you’re working on and to connect with you?
RF: We may not be as proactive as we should be in sharing our ongoing projects, but we do make efforts to regularly publish updates on Dalberg Design’s website and occasionally on Dalberg.com and LinkedIn. Please feel free to contact me personally or reach out to our operations team at [email protected]. You can also find me on Twitter and LinkedIn if you’d like to chat!
I have a keen interest in learning about initiatives worldwide and recognizing that we’re not reinventing the wheel here. So, I’d love to connect with anyone interested in learning more about our work.
