Designing for Cervical Cancer Screening in Rural Nicaragua: A Case Study in the Informal Emergence of Complex Human-Centered Service Design

Global health access and delivery in low-and middle-income countries constitutes a complex challenge for service design. While previous studies have examined how human-centered design (HCD) methods can make an impact on global health challenges, how HCD is leveraged in the design and implementation of health services in global contexts remains poorly understood. In this work, we introduce a case study of an organization called Mujeres Moviles, which provides cervical cancer education, screening, and treatment in rural Nicaragua, and-grounded in more than 100 hours of field research-we trace the organization's journey from its founding to the scale-up of its pilot program. We critically evaluate how Mujeres Moviles' activities align with conventional HCD models, revealing a striking consistency with HCD models, despite the organization receiving no formal training or guidance in service design or HCD approaches. These findings have important implications for service design practitioners working on global health challenges and for service design theorists seeking to support designers working in complex problem spaces.