A Design Thinking Agenda for Public Health

Despite substantial investment in new policy programmes, pilot interventions, digital health tools, cross-sector partnerships, and transformation initiatives, innovation efforts in public health do not consistently consolidate into sustained system-level improvement. The principal cause of this issue is misalignment within the system: the policy direction, organizational incentives, service and operational design, and citizens’ experiences often appear to be driving in different directions, producing divergent behaviour. Research in health services has shown that many of the innovations developed to improve the delivery of healthcare do not become part of standard practice due to the requirement for organizations to be ready to adopt new technologies, the fit between the organization and the innovation, and the amount of work required to establish new behaviours over a period of time. These shortcomings are not primarily technical but come from the absence of a system-level design competence that connects policy intent, service delivery, and lived experience, which is an absence that we suggest Design Thinking (DT) can address.