Pilas
Fighting Diabetes
in El Salvador
Health
Strategy
“No problem” was the problem
My Role
As part of the Ingenious Behavior team, an innovation lab within the Ingenious Agency, I got to participate in several aspects of this project:
User Research
Behavioral Design
Product Design
UX
Design System
UI
Prototype
On-site live testing sessions
The real problem
Even though the National NCD Survey results showed that 1 in 4 adults in El Salvador are prediabetic, paradoxically the real monster was that people didn’t see anything wrong with their behavior; everything seemed just fine.
Pretty quickly we realized we needed to wake people up, show how serious the situation was, and—most importantly—get them to engage with prevention. Not an easy task.
The MINSAL (Health Ministry of El Salvador), along with the IBD (International Development Bank), set out to face the challenge and hired Ingenious Behavior—where I collaborated as a Behavioral Designer—to lead those efforts.
Facing the monster
We were in charge of planning the strategy to address the situation and deliver a solid plan the organization could apply and scale.
A Behavioral Design Sprint was held, bringing together doctors, patients, specialists, and members of the MINSAL and the IBD to define, think, and create a solution.
The sprint was divided into two main phases. The first one, held remotely, focused on:
1 - Analyzing the context, users, and their environments.
2 - Defining specific value for each user and mapping the behaviors required to deliver it.
3 - Analyzing barriers that prevent those behaviors.
4 - Designing a public service mechanism—its brand, communication, and an app prototype—as part of that mechanism.
For the second module, we flew to El Salvador and met the rest of the team at the IBD offices.
There, we polished the strategy and finished the app prototype.
We gathered feedback from real users at three public medical institutions, testing the app and capturing their reactions, emotions, and thoughts.
My two cents
During the second phase, working on-site alongside renowned doctors, psychologists, and members of the MINSAL, one thing struck me: we were designing for a population with mid-to-low educational levels through the eyes of highly educated and experienced people.
It became clear that our top priority should be ensuring that whatever we presented would not make people feel bad about themselves (not educated or tech-savvy enough).
After expressing this concern to the team, I suggested we make the whole UX not only friendly, but obvious.
I wanted people to feel safe and reassured that they wouldn’t make a fool of themselves while engaging with a group of highly educated people taking notes and recording their reactions.
Output
Rather than a single experiment, "Pilas" is a system that incorporates several interventions together that can become the driving force behind all non-pharmacological prescriptions in El Salvador.
"Pilas" is a good example of how to use a behavioral design methodology to address a complex challenge. Using a multidisciplinary team, following simple exercises with a systemic approach, and focusing on providing value for all involved has allowed the development of a comprehensive and scalable prediabetes treatment service.
Key learnings
This experience taught us that complex health challenges require systemic solutions that address not only medical aspects but, more importantly, cultural factors. Only by addressing deep-rooted cultural habits can we then tackle practical medical needs.
In this context, we must make an extra effort to bridge the gap between expert knowledge and everyday experience, where success depends on making prevention feel accessible and empowering rather than overwhelming.
“Ingenious Behavior provided a clear structure and process to a complex public health challenge that one of our clients was facing.
The team seamlessly introduced an innovative process that guided a diverse group of public sector stakeholders to discover a new digital service to improve health in their country.
The team listened to the mission and vision of the client, in addition to the constraints in the context, and was able to produce MVPs and communication materials that effectively showcased their vision to decision-makers in record time and provide a clear roadmap to move from idea to MVP, to production.
I would work with Ingenious again."
Jennifer Nelson. IDB
