Equitable, Scalable Change By Design: André Nogueira, PhD

Dr. André Nogueira didn’t initially intend to get a PhD or enter academia. He preferred to do his work in Design in a hands-on method. “But here am right now. I was at Harvard, Brown, now Johns Hopkins,” he said. “I guess there was an impactful side of Academia that I needed to discover.”

Based in the Johns Hopkins School of Nursing, his work helps address complex challenges that affect both people and the environment by intersecting design with other fields to create change. His research looks at how design frameworks and methods can make life better for communities across various domains, from health, economic development, gender inclusion, to habitat restoration.

“Design as a field is almost context agnostic. It works on the process of promoting change across different levels, product, services, organizations, systems, ecosystems, with my work tending to sit more at the organization, systems, and ecosystems levels,” he explained. “I intersect design with other disciplines to catalyze broader systems change within the realm of impact of that discipline…. and shape new initiatives.”

Dr. Nogueira describes design as a more informal field compared to other hard sciences. He gives an example of the difficulty involved in getting non-designers to engage with a change program when the designers themselves are not in alignment about the way they work.

“If you ask about user experience to 10 people, then they’re going to give you 10 different answers,” he explained. “Our approach is much more structured and allows for both the field to grow, as well as other fields to understand and engage with parts of the design.”

“Equity needs to be a property of the process, rather than only a desirable outcome.”

Originally from Brazil, Dr. Nogueira previously worked across 17 different states, designing new urban systems in unoccupied rural areas or in existing urban areas to regenerate and redevelop the land. While designing better solutions for people living in these areas, he says he came to the realization that equity and sustainability were the most effective way to proceed.

“First, we needed to rethink our criteria in prioritizing certain voices when designing our systems. We know that current approaches have brought significant implications for those who did not have a voice in the process but nevertheless were affected by it. When equity is embedded in the approach of shaping alternative futures, chances that results will lead to more equitable outcomes are likely higher,” he said.

“The second realization was understanding that our development processes were completely blind to the ecological dynamics that would sustain life. We needed to stop approaching sustainability as a special project and figure out ways of developing more sustainable approaches to systems change” he continued. “I knew that I needed to dive deeper into a discipline that understands and focuses on processes rather than only the outcomes.”

Most of his projects build design capabilities in those involved in the change context. This is a significant departure from conventional use of design knowledge, where designers act as problem solvers. Instead, Dr. Nogueira brings a more structured use of design, enabling others to adopt and adapt the approaches he has developed to fit their own context. For example, Dr. Nogueira worked with his colleagues in the Transform Rural India (TRI) initiative to create a new care model called “Neighborhoods of Care.” This model provides a new care infrastructure that enables villagers to navigate and intentionally connect the fragmented landscape of healthcare services in rural India”.

“The model introduces a new capability to community-based health systems that TRI called change vectors. As trusted community members, change vectors assume the function of care navigator within their neighborhood, providing a continuum of care across health, social, and community systems,” he explained. “Change vectors serve as an interface between people in the village and the formal health system, which is often tiered and specialized. It has been piloted in a couple of areas and now it’s going to six other pilot areas.”

India’s Diversity can be a Blueprint for Sustainable Development Approaches

Enacting these takeaways from previous projects led Dr. Nogueira to doing more work in India, which he notes has similar challenges with Brazil, but different leadership realities. “The stark contrasts in living conditions of both countries can spark creativity and innovation for more sustainable and equitable solutions, but it can also pose significant barriers, especially when working at the systems level,” he said. “There’s a drive that I see in Indian leaders, filled with ambition to drive change and an audacity to ask new questions I am yet to see in organizational leaders in my own country.”

He explains that one reason India may be doing things differently relates to the resilience of its people, who have resisted Western views of what development should look like for centuries. “Not without losses, India’s cultural diversity has resisted many forms of oppression throughout colonization. Rather than approaching diversity as a force getting in the way of progress, it should be celebrated as an asset for any future development,” he said. “That is how interventions will be able to be sustained at scale in India. The conventional approach to standard replication doesn’t work. We need new approaches to sustainable development.”

To Act Differently, People Need to See It Differently

“Our ability to envision alternative futures is defined by our experiences. And our experiences are made up by the way we interact with the systems around us. Many people living in Rural India have little visibility into the systems conditioning everyday life, such as governance, finance, health, education, environmental conservation, among others.” he explained. “A lot of the work we do is to make information about these systems and design knowledge accessible to people in ways that expand their perceptions about both the problems and potential solutions. By enabling people to work differently with new information about their own context, we shift the conditions upon which future decisions about everyday life are made. And that is one way that design can help people see the world around them differently, so they can act differently.”

Looking to the future, Dr. Nogueira plans to continue his efforts to enact change by design in communities where systemic issues require alternative thought and action. By developing local capability and designing with, not for, communities, his approach is a roadmap toward more resilient, inclusive systems. As global problems become more complex, his efforts build toward a future when design is leading the way toward equitable and sustainable change by the people who need it most.

“We’re helping design new conditions for people to see and shape their own futures, not just designing programs” he said. “If we want scalable change that lasts, it must be done across multiple levels yet led by those embedded in the context of change. It is time we develop new approaches that recognize lived experiences as a fundamental source of knowledge and the agency that people over shaping their own realities.”