PCD Framework — Home

People-Centred Design → in TB, Airborne Infectious Diseases & Lung Health

A group of women sitting together outdoors during a community health discussion

What is The
PCD Framework?

A practical framework for TB and global health teams to integrate People-Centered Design into projects.

What is PCD?

People-Centered Design (PCD), often used interchangeably with Human-Centered Design (HCD), is an iterative, problem-solving approach that places the needs, behaviors, and experiences of those most affected at the heart of how interventions are designed. In health programming, this means collaborating directly with communities and the people who deliver or receive care to create accessible, culturally appropriate, and sustainable interventions — whether services, products, policies, or digital tools.

Why it matters for health programs

  1. 01

    Reaches more people. Deliberate outreach to groups and communities that health systems often fail to reach prevents solutions that work for some but leave others behind.

  2. 02

    Builds ownership. Involving implementers and communities throughout creates lasting buy-in and sustainable engagement.

  3. 03

    Addresses the right problem. User research and co-design with affected communities ensures solutions target real obstacles, not assumed ones.

  4. 04

    De-risks solution development. Early prototyping and testing surfaces failure points before significant resources are committed.

Three ways to integrate PCD into your work

PCD can be applied at different depths depending on your context, mandate, and available resources. The three approaches are not mutually exclusive — a project may use all three at different moments. These approaches work for both product innovation and service delivery innovation.

Note: This framework builds on the Re-imagining TB Care and Design for Health design dosages model.

End-to-End Process

Explore PCD Checklist

PCD as leading approach for your full project

Use PCD to guide every stage — from foundational setup through research, co-design, prototyping, and into implementation and scale. The E2E checklist helps teams plan, run, and measure a rigorous PCD process, and helps funders assess completeness in reports.

Choose this when you're building a new health solution from the ground up, or when you have the time and budget to make PCD the backbone of the whole project. The E2E Checklist helps you plan, track, and report on your work from start to finish, and shows funders that the process was done thoroughly.

Typical project duration: 12–15 months

Integrate PCD Ingredients

Rather than running PCD end-to-end, PCD Ingredients fold specific PCD practices — PCD Leadership Group formation, design research, co-design, solution testing, feedback loops — into a project or framework you already have.

Choose PCD Ingredients when your project structure is already in place, but you want to strengthen, e.g., participation, governance, evidence quality, or introduce design thinking at specific points in it. Go through the list of PCD Ingredients and select those that match your project phase and goal — they de-risk development and broaden participation without requiring a full PCD process.

Typical project duration: 1–3 months

Integrate PCD Sparks

Use a single, focused PCD activity to reframe a problem, shift assumptions, build buy-in, or unlock new thinking at a specific moment in your project. Go through the list of Sparks and find the activity that fits your intended outcome — Sparks unlock momentum without requiring a full PCD process.

Typical project duration: 1–4 weeks

Four phases — with key ingredients & sparks

Each phase has essential practices (ingredients) that de-risk development, and catalytic moments (sparks) that unlock new thinking. Highlighted items represent the highest-impact PCD activities.

Phase A

Foundational Setup

Ensure participation and representative decision making.

Ensures the right people, not just those with the loudest voices, hold power from day one. Grounds the project in lived reality before any decisions are locked. Prevents the most common design failure: starting with a fixed solution and retrofitting participation.

Phase B

Challenges & Opportunities

Understand lived realities, key challenges and opportunities for innovation.

Replaces assumptions with real evidence from the people most affected — including those hardest to reach. Ensures the problem being solved is the right one before resources are committed to design. Creates a shared evidence base that affected people, the PCD Leadership Group and implementers trust.

Phase C

Design, Prototype, Test

Convert opportunities into interventions and solutions that matter to people.

Prevents expensive failure at scale by testing with real users before committing to a solution. Ensures what gets built is desirable, contextually fit, and feasible — not just technically correct. Keeps people with lived experience as co-designers, not just validators.

Phase D

Implement, Adopt, Scale

Adjust to needs and scale solution.

Ensures the solution keeps working for real people after handover — not just at launch. Builds community ownership so improvements happen without external dependency. Turns project experience into shared knowledge that strengthens the whole program.

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Phase A

Foundational Setup

PCD Leadership Group

A representative PCD Leadership Group is established at the start of the project and involved in every major decision. It includes people with lived experience, frontline implementers, hard-to-reach groups, and system owners, making it one of the most important investments in a successful PCD process.

Who uses this framework

The PCD Framework serves different roles at different points in a project. Each stakeholder group draws on the same underlying PCD Checklist, PCD Ingredients, and PCD Sparks — just at different depths and moments in the project.

Funding decisions & due diligence

Screen and compare project applications for PCD readiness and design quality — across research, co-design, prototyping, and implementation. Use the Funding Application Checklist either as criteria integrated into your existing review framework, or as a standalone checklist alongside it. The same checklist carries into delivery, so you can monitor whether PCD practices are being completed to a high standard throughout the project, not just at the proposal stage.

Project guidance & quality improvement

Use the framework as a live planning and quality tool throughout the project — not something you consult once at the start and then shelve. At each phase, work through the corresponding section of the End-to-End Process Checklist, or pick the PCD Ingredients or PCD Sparks relevant to that stage and fold them into the project you already have.

Program governance & learning

Create consistent PCD standards across countries and partners. Support coaching, capability-building, and comparability of approaches across a portfolio of projects. Use the PCD Checklist as a shared rubric to compare PCD quality across teams and track improvement over time — both internally, and externally.

Supporting implementing teams

Help implementing teams successfully run a PCD process. Use the PCD Framework to identify gaps, prioritize support, build capability, and track quality throughout the project.

Built through the Stop TB Partnership's Re-imagining TB Care Initiative

This framework emerged from the Re-imagining TB Care (RTC) initiative of the Stop TB Partnership — a program designed to support a creative, participatory, and systematic approach to identifying, prioritizing, and selecting TB service delivery and product innovations — reshaping when, where, and how TB services are accessed and delivered. Working with the NGOs Walimu and FIT, we co-developed the PCD Toolkit alongside TB program teams, communities, and civil society in Uganda and Viet Nam, testing what it takes to make People-Centered Design work inside real health systems. The resulting tools and resources are freely available on the RTC platform.

Learn more about the Re-imagining TB Care initiative

RTC Resources

01

RTC PCD Toolkit. A PCD process guide — kick off, understand people's needs, identify and select innovations — with downloadable templates for each phase.

Open RTC PCD Toolkit

02

InnoScan. A structured innovation scan to identify and prioritize solutions from a long list of TB service delivery and product innovations.

TB Innovation Sandbox

03

Uganda & Viet Nam Case Studies. How the FIT team in Viet Nam engaged 80+ Stakeholders and how TB-affected communities in Uganda shaped service redesign.

Read case studies
A woman adjusting her glasses while wearing a protective mask, in conversation with another person

Acknowledgement

Co-Creators & Partners

The PCD framework was co-created with the RTC country teams in Uganda and Viet Nam, including implementing partners Walimu and FIT, national TB program teams, community representatives, civil society organizations, and frontline health workers who participated in design research, co-design sessions, and validation workshops. The framework also builds on the intellectual foundations of the Design for Health design dosages model and is inspired by the broader global health design community.

Feedback & Review

We are also grateful to colleagues at the Global Fund, UCSF, and TB REACH, who reviewed the framework and shared feedback that helped sharpen its content and usability.

Stop TB Partnership, hosted by UNOPS RTC MARK

Donors & Funding Partners

The Re-imagining TB Care initiative — from which this framework emerged — was made possible through the support of our donors, KOICA (Korea International Cooperation Agency) and the US CDC (Centers for Disease Control and Prevention). Their commitment to innovation and people-centered approaches in global health has been instrumental in developing and testing

KOICA KOREA CDC

Explore PCD
Sparks & INgredients

A team gathered around a table reviewing sticky notes and design materials during a workshop session

What are pcd ingredients?

What are pcd Sparks?

Rather than running PCD end-to-end, PCD Ingredients fold specific PCD practices — PCD Leadership Group formation, design research, co-design, solution testing, feedback loops — into a project or framework you already have. Choose PCD Ingredients when your project structure is already in place, but you want to strengthen, e.g., participation, governance, evidence quality, or introduce design thinking at specific points in it. Go through the list of PCD Ingredients and select those that match your project phase and goal — they de-risk development and broaden participation without requiring a full PCD process.

Use a single, focused PCD activity to reframe a problem, shift assumptions, build buy-in, or unlock new thinking at a specific moment in your project. Go through the list of Sparks and find the activity that fits your intended outcome — Sparks unlock momentum without requiring a full PCD process.

Find the right PCD elements for your goal. Applicable to both product innovation (diagnostics, digital tools, devices) and service delivery innovation (care pathways, community programs, implementation models) in TB, airborne infectious diseases, and lung health. Note: The ingredients and sparks shown here are not a comprehensive list — they represent recommended elements that add the highest PCD value or impact.

phase A –
Foundational Setup

PCD Leadership Group

A representative PCD Leadership Group is established at the start of the project and involved in every major decision. It includes people with lived experience, frontline implementers, hard-to-reach groups, and system owners, making it one of the most important investments in a successful PCD process.

Pcd launch event

A structured kickoff brings the PCD Leadership Group together to build a shared understanding of the challenge, align on the project's direction, and create ownership before research begins.

phase B –
challenges & opportunities

design research

Qualitative research, such as interviews, observations, and focus groups, is carried out with people affected by the challenge. This helps the team understand people's needs, experiences, and everyday realities, including those of hard-to-reach groups who are often missed by traditional research.

Validation & prioritization workshop

A synthesis session where the PCD Leadership Group reviews the research findings, challenges the original assumptions, and agrees on the most important opportunity areas before ideation begins.

phase C –
design, prototype & test

co-design solutions

Solutions are developed with the PCD Leadership Group and intended users, not for them. Teams generate a wide range of ideas, or explore existing solutions through an innovation scan, before agreeing on the strongest options using clear criteria.

test solutions with users

Solutions are tested with the people who will use and deliver them in realistic conditions, across at least two rounds. Findings are documented, improvements are made, and decisions are recorded so the solution evolves based on evidence.

innovation scan

A structured review of existing solutions, approaches from other settings, and emerging innovations. It helps teams understand what has already been tried, what has worked, and where opportunities remain before creating something new.

prototyping workshop

A co-design workshop where the PCD Leadership Group explores a wide range of ideas, develops the most promising concepts, and creates concept notes to take forward.

phase D –
implement, adopt, scale

continuous feedback after implementation

Feedback channels and regular review processes stay in place after launch so users can continue to shape the solution. This helps keep it relevant, effective, and responsive as needs change.

About thePCD Framework

Two community health workers wearing masks in conversation at a clinic table

Context & rationale

People-Centered Design (PCD) is an iterative, problem-solving approach that places the needs, behaviors, and experiences of those most affected at the heart of how interventions are designed. It is not a new concept — its principles of participation, self-determination, and community leadership have long been affirmed in global commitments. The challenge today is no longer whether to commit to it, but how to translate that commitment into practice as innovation scales rapidly across TB and lung health programming.

About

This framework does not introduce the concept of people-centeredness. It operationalizes these existing commitments — translating them into practical, measurable steps that implementing teams and funders can apply across the project lifecycle.

What the PCD Framework Adds

  • A phase-by-phase design process — governance, research, co-design, prototyping, scale — that operationalizes the principles above.
  • Structured participation requirements at each phase, with named decision points where affected communities hold influence.
  • A checklist and assessment layer funders and teams can use to evidence the how, with whom, and at which decisions — not just the intent.
  • Applies across services, products, policies, and digital or AI-enabled tools — with particular attention to digital innovation, where speed of rollout most often outpaces participation.

What the PCD Framework Does

  • Translates existing global commitments into actionable, measurable process steps for program design and implementation.
  • Provides a shared language and standard that funders and implementing teams can apply consistently across portfolios.
  • Supports due diligence in funding decisions — helping reviewers assess whether PCD is genuinely embedded or merely stated.
  • Strengthens accountability to communities with lived experience, frontline workers, and underserved populations throughout design and scale.

What the PCD Framework Does Not Do

  • It does not replace the WHO End TB Strategy, the Global Plan, CRG approaches, or any other established framework. It extends them.
  • It does not introduce new normative commitments or redefine what people-centered care means — these are well established.
  • It is not a compliance checklist imposed from the outside — it is a quality and learning tool for teams that want to do PCD well.
  • It does not cover clinical care standards, drug development pathways, or diagnostic accuracy — it is specific to program and solution design.
  • It is not intended to be a standalone methodology — it is designed to integrate with existing application and program frameworks.

This framework is explicitly positioned as an operational extension of — not a departure from — the global commitments listed below. Each shapes what good people-centered design looks like in TB and lung health programming.

Note: This is not a complete list. It offers an overview of some of the important global frameworks and commitments that shape what people-centered design looks like in TB and lung health programming.

Existing frameworks

WHO End TB Strategy

The World Health Organization's global strategy for ending TB, built on three pillars covering care, bold policies, and research. It establishes people-centered care, community engagement, and human rights as core commitments of the TB response — the principles PCD puts into practice.

Global Plan to End TB

Stop TB Partnership's plan setting out the investments and actions needed to reach global TB targets. It names community leadership and rights-based approaches as central pillars, reflecting PCD's core conviction that affected communities should shape the response.

Declaration of Rights of People Affected by TB

A community-led declaration, developed by TBpeople with Stop TB Partnership support, affirming the rights and dignity of people affected by TB. It grounds the TB response in lived experience and self-determination — the same starting point PCD takes when designing with, not for, communities.

Community, Rights and Gender (CRG) Approaches

Stop TB Partnerhip's CRG establishes community, rights, and gender as a cross-cutting priority across TB programming. It centers the perspectives of affected and marginalized groups, which PCD operationalizes through participatory design.

Words Matter Guidance

Stop TB Partnership guidance on how language shapes perception and reduces stigma in TB. It reflects a people-centered value at the heart of PCD: that how people are described affects their dignity, participation, and care.

TBpeople and Community-Led Networks

TBpeople — the global network of people affected by TB, with national chapters across several countries — and other community-led networks embody the meaningful community leadership that PCD depends on, ensuring affected people lead rather than inform.

WHO Guidance on Digital Health & AI

WHO guidance on introducing digital tools and artificial intelligence responsibly in health systems. It calls for co-design, safeguards, and accountability — the people-centered conditions PCD applies when innovation enters programming.

UN Human Rights & Participation Frameworks

International human-rights instruments establishing the right to participate in decisions affecting one's own health and life. They make participation a right rather than a courtesy — the legal and ethical foundation PCD is built on.

Declarations on Primary Health Care

Alma-Ata & Astana's foundational declarations (1978 and 2018) that established people-centered primary care as a global health principle. They set the original commitment to organizing health around people's needs — the idea PCD carries into how interventions are designed.

Acknowledge-ment

Co-Creators & Partners

The PCD framework was co-created with the RTC country teams in Uganda and Viet Nam, including implementing partners Walimu and FIT, national TB program teams, community representatives, civil society organizations, and frontline health workers who participated in design research, co-design sessions, and validation workshops. The framework also builds on the intellectual foundations of the Design for Health design dosages model and is inspired by the broader global health design community.

Feedback & Review

We are also grateful to colleagues at the Global Fund, UCSF, and TB REACH, who reviewed the framework and shared feedback that helped sharpen its content and usability.

Stop TB Partnership, hosted by UNOPS RTC MARK

Donors & Funding Partners

The Re-imagining TB Care initiative — from which this framework emerged — was made possible through the support of our donors, KOICA (Korea International Cooperation Agency) and the US CDC (Centers for Disease Control and Prevention). Their commitment to innovation and people-centered approaches in global health has been instrumental in developing and testing.

KOICA KOREA CDC

PCD Checklist

What is the PCD Checklist

Process checklist

Funding checklist

Rather than a single claim that a project "was people-centred," the PCD Checklist breaks the process down into concrete, checkable criteria across all four phases of PCD — foundational setup, research, co-design and testing, and implementation and scale — so completeness can be verified, not assumed. It comes in two modes: Running a PCD Process, for teams working through the full process end to end, and Funding Application Review, for funders and review panels assessing PCD readiness before a grant is awarded.

Choose the PCD Process mode when you want to plan, track, and report on your own PCD process — work through it phase by phase, checking off each item as you complete it and expanding it for the evidence and resources behind it.

Choose the Funding Application mode when you're screening or comparing applications or reviewing project reports for PCD rigor — go through the 8 criteria most relevant to assessing readiness before award, using each item's expected evidence as a structured quality lens rather than a pass/fail test.

Acknowledge-ment

Co-Creators & Partners

The PCD framework was co-created with the RTC country teams in Uganda and Viet Nam, including implementing partners Walimu and FIT, national TB program teams, community representatives, civil society organizations, and frontline health workers who participated in design research, co-design sessions, and validation workshops. The framework also builds on the intellectual foundations of the Design for Health design dosages model and is inspired by the broader global health design community.

Feedback & Review

We are also grateful to colleagues at the Global Fund, UCSF, and TB REACH, who reviewed the framework and shared feedback that helped sharpen its content and usability.

Stop TB Partnership, hosted by UNOPS RTC MARK

Donors & Funding Partners

The Re-imagining TB Care initiative — from which this framework emerged — was made possible through the support of our donors, KOICA (Korea International Cooperation Agency) and the US CDC (Centers for Disease Control and Prevention). Their commitment to innovation and people-centered approaches in global health has been instrumental in developing and testing.

KOICA KOREA CDC

How to use thePCD framework

A community gathering with local officials and health workers reviewing project materials at an outdoor TB program event

the right tool for the right moment

quality assurance not compliance

The PCD Framework is designed to be used differently depending on who you are and where you sit in the program lifecycle. This page explains how each audience can apply it — and what it should and should not be asked to do.

The framework is not designed to become an additional compliance requirement or reporting burden. It is a quality assurance and accountability tool — one that helps distinguish between projects that name PCD in their proposals and those that genuinely apply it across the design process: from problem framing and research, through co-design and prototyping, to implementation, adaptation, and scale.

Used well, it surfaces what was actually done — how, with whom, at which decisions, and with what evidence — so that both funders and implementing teams can act on the difference between stated intent and demonstrated practice.

PCD is broader than consultation or community engagement alone. It is an iterative design process that integrates the lived experience of affected communities, the operational realities of frontline workers, and the constraints of the health system — translating all three into solutions that work in context.

The checklist makes that process visible: a project can show which design practices it applied, where in the lifecycle, and with what rigour — rather than relying on a single claim that "we involved the community."

two pathways to put the pcd framework into practice

Early feedback from funders and implementing partners points to two complementary opportunities for how the PCD Framework can enter the funding and implementation cycle. Both draw on the same underlying criteria — what differs is where the framework lives, and how much of the process it guides.

opportunity 1: pcd as standalone process

The PCD framework is used as a self-contained guide for the complete PCD process: the Funding Application Checklist shapes and assesses the proposal, and the end-to-end Process Checklist then guides and measures the work through implementation, adaptation, and scale.

  • Where it lives: alongside the project, as a quality and completeness check from proposal through to scale.
  • What it asks of teams: plan, track, and evidence each phase A→D.
  • Strength: full process integrity — commitments made at application are carried through, and verifiable, during implementation.
  • Built from: the Funding Application Checklist at application, and the Process Checklist during the project.

opportunity 2: pcd as integrated process

The PCD framework is integrated into an existing project, process, or operational framework through its Ingredients and Sparks: the most relevant Ingredients and Sparks are selected to fit the project and add the most value, then run with the support of the guidance — so PCD strengthens work already in motion rather than sitting alongside it as a separate process.

  • Where it lives: inside the existing project, process, or operational framework — its templates, workflows, and review or reporting cycles.
  • What it asks of teams: run the selected Ingredients and Sparks within the existing workflow — no additional tool, no separate process.
  • Strength: lowest adoption effort — it meets reviewers and applicants where they already work.
  • Built from: criteria drawn from the Ingredients and Sparks, adapted to each framework's structure and language.

how to use the pcd framework

funders & donors

Bilateral and multilateral donors, grant-makers, program officers, and technical review panels who assess and approve TB and lung health program applications.

Use the Funding Application Checklist to screen, compare, and assess project applications for PCD readiness and design quality — across problem framing, research, co-design, prototyping, and implementation. It can be applied in either of two ways:

  • With selected criteria integrated into your existing application framework
  • As a standalone checklist alongside your review process, without creating a separate assessment layer

Funders and donors are uniquely positioned to signal what quality people-centered design looks like across the projects they fund — and to support implementing teams in delivering on it. The PCD Framework can support this across the grant cycle:

  • Assess the quality of PCD practice in funding requests — including how, for example, affected communities and users have shaped the problem framing, the proposed solution, and the implementation approach.
  • Monitor PCD implementation quality and rigour over time — using the process checklist to assess whether PCD practices are being completed to a high standard.
  1. 01 Open the Funding Application Checklist: Switch to "Funding Application Review" mode in the PCD Checklist. This version is structured around the 8 criteria most relevant to assessing an application before a grant is awarded.
  2. 02 Screen each criterion against the application: Each checklist item includes the evidence or documentation you should expect to see. Use these as the basis for your assessment — not as pass/fail, but as a structured quality lens.
  3. 03 Identify gaps and flag conditions: Where criteria are absent or weak, this can inform grant conditions, capacity-building requirements, or technical assistance referrals — rather than automatic rejection. Please note that, depending on your project context and the framework in place, not all criteria must or can be met.
  4. 04 Use the process checklist for mid-term and final reviews: The full end-to-end checklist can be used during implementation reviews to assess whether PCD commitments made at application have been carried through in practice.
Open the funding application checklist

Implementing teams

Country teams, NGOs, and consortium partners who design and deliver TB and lung health programs at the country level.

Use the framework either as an end-to-end Process Checklist or as an integrated approach — picking the PCD practices that strengthen the project you already have. The right choice depends on your project's stage, scope, and existing process.

The framework is most valuable for implementing teams when used as a live planning and quality tool — not consulted once at the start and then shelved. At each phase, you can either work through the corresponding section of the end-to-end Process Checklist, or pick the Ingredients & Sparks relevant to that phase and embed them in your existing project. Both routes use the same underlying content:

  • Funding applications: Use the Funding Application Checklist — or surface the relevant Ingredients & Sparks in your proposal narrative — to articulate and evidence each PCD step before submission to funders or review panels.
  • Before user research: Work through Phase A of the checklist — or pick the relevant Ingredients and Sparks — to confirm PCD governance is in place before research begins.
  • During research: Work through Phase B of the checklist — or pull in the relevant Ingredients and Sparks — to ensure the right stakeholder groups are included, participation is ensured, user research plans are documented, and synthesis insights inform decision-making.
  • Co-design & testing: Work through Phase C of the checklist — or apply selected Ingredients and Sparks — to ensure solutions are iterated with users, not just presented to them.
  • Implementation & scale: Work through Phase D of the checklist — or selected Ingredients and Sparks — to ensure people-centered design informs the adaptation and implementation of the solution as it moves to pilot and scale.
  • Capacity-building: Use the checklist criteria alongside the Ingredients & Sparks to build team understanding of what good looks like at each phase — useful for onboarding new team members and coaching partners.

External expertise is one of the most expensive line items in a PCD process — and teams often feel stuck once experts leave. Use expert support where it most affects method quality, and build your own capability everywhere else, so the skills stay with the team after the engagement ends. Every checklist item carries an Expert recommended or Team-led indicator to support this planning. As a rule of thumb:

  • Phase A: Expert: designing the kick-off and shared-direction format. Team: convening the PCD Leadership Group, stakeholder mapping, ethics and safeguarding submissions.
  • Phase B: Expert: research design, discussion guides, and synthesis methods — where teams most often get stuck. Team: recruitment, interviewing after training, documentation, validation workshops.
  • Phase C: Expert: co-design facilitation design, prototype strategy, and test protocols. Team: running sessions after coaching, building simple prototypes, collecting feedback, selection workshops.
  • Phase D: Expert: scale adaptation strategy. Team: pilots, implementation planning, feedback channels, governance cadence, continuous improvement.

Build a handover and coaching component into every expert engagement, so each "expert recommended" step also transfers capability to the team.

  1. 01 Decide your approach: end-to-end Process Checklist or integrated: Agree as a team which approach fits the project. If you are designing a new intervention with time and resources for a full PCD process, go with the end-to-end Process Checklist. If you are mid-project or working within a fixed program framework, use the Ingredients and Sparks library to pick the practices that strengthen the phases you already have.
  2. 02 Plan and track phase by phase: Before each phase, review the relevant criteria or selected ingredients to plan activities, evidence, and stakeholder involvement. Check off items as they are completed and expand each one for the specific evidence artifacts needed.
  3. 03 Use Ingredients & Sparks for the how: The checklist tells you what good looks like. The Ingredients & Sparks library explains how — with methods, standards, and examples for each element across all four phases.

health programs

National TB programs, consortium leads, and global health organizations that manage portfolios of projects.

Use the framework to create consistent PCD standards — enabling comparability, coaching, and systematic capability-building across a portfolio.

For program leads managing multiple country teams or grant cohorts, the framework provides a common standard that makes PCD quality comparable, and coachable:

  • Standard-setting: Embed PCD criteria in program guidance, call documents, and partner onboarding — creating a shared baseline expectation before projects begin.
  • Portfolio review & learning: Use the checklist as a standard rubric for comparing PCD quality across country teams and grant cohorts — and to track and communicate quality improvement over time, both internally and to funders.
  • Coaching: Use the Ingredients & Sparks to guide coaching conversations — helping teams understand not just what to do, but how to do it well and what evidence to generate.
  1. 01 Embed the framework in program and partner onboarding: Introduce the PCD Framework as a shared reference at the start of a program cycle or grant round — establishing a common language and standard that all country teams and partners understand from the outset.
  2. 02 Use the checklist to benchmark PCD quality across teams: Run a baseline assessment with each team at program start — mapping which checklist criteria are met, partially met, or absent. This creates a comparable picture across the portfolio and identifies where support is most needed.
  3. 03 Direct coaching to identified gaps: Use the Ingredients & Sparks library in coaching sessions — drawing on specific methods and examples to help teams strengthen the areas where they are weakest, rather than generic PCD training.
  4. 04 Revisit at mid-term and end-of-program reviews: Re-run the checklist assessment at key review points to track progress, surface new gaps that emerged during implementation, and document PCD quality improvement across the program cohort.

pcd experts

Design practitioners, PCD or human-centered design experts supporting implementing teams to run PCD processes in TB and global health contexts.

Use the framework to assess quality, identify gaps, and prioritize support — giving teams a structured view of where their PCD process is strong and where it needs investment. The expert-recommended / team-led indicators on each checklist item show where your involvement adds most value — and where to coach rather than deliver, so capability stays with the team.

PCD experts are often the bridge between the principle of people-centered design and its practical reality in resource-constrained health programs. The framework gives that bridge structure — making it possible to assess, explain, and improve PCD quality in a way that is legible to both design practitioners and program leads:

  • PCD assessment: Run the checklist with a team at engagement start to map what is in place, what is missing, and what the biggest risks are — grounding support in evidence rather than assumption.
  • Facilitation guide: Use the Ingredients & Sparks as a facilitation resource — explaining what good looks like at each phase to non-design audiences in accessible, concrete terms.
  • Quality tracking: Revisit the checklist at key milestones — after user research, co-design, and before pilot launch — to assess whether PCD quality has been maintained as the project evolves.
  1. 01 Run a baseline PCD assessment with the implementing team: Open the PCD Process Checklist and work through it collaboratively with the team — marking what is in place, what is partially addressed, and what is absent. This becomes the shared starting point for all subsequent support.
  2. 02 Prioritize where to focus support based on the PCD assessment: With the PCD assessment complete, identify the criteria with the greatest gap and highest risk — these are where expert support will have the most impact. Use this to scope the engagement clearly.
  3. 03 Use Ingredients & Sparks to guide and coach at each phase: As the project progresses, use the Ingredients & Sparks as a coaching reference — explaining what good looks like at each step, what evidence to generate, and how to involve the right people at the right moments.
  4. 04 Revisit the checklist at each major milestone to track progress: After user research, after co-design, and before pilot — re-run the relevant checklist sections with the team to assess progress, surface new gaps, and adjust the support plan. This creates a documented record of PCD quality improvement over time.

Acknowledge-ment

Co-Creators & Partners

The PCD framework was co-created with the RTC country teams in Uganda and Viet Nam, including implementing partners Walimu and FIT, national TB program teams, community representatives, civil society organizations, and frontline health workers who participated in design research, co-design sessions, and validation workshops. The framework also builds on the intellectual foundations of the Design for Health design dosages model and is inspired by the broader global health design community.

Feedback & Review

We are also grateful to colleagues at the Global Fund, UCSF, and TB REACH, who reviewed the framework and shared feedback that helped sharpen its content and usability.

Stop TB Partnership, hosted by UNOPS RTC MARK

Donors & Funding Partners

The Re-imagining TB Care initiative — from which this framework emerged — was made possible through the support of our donors, KOICA (Korea International Cooperation Agency) and the US CDC (Centers for Disease Control and Prevention). Their commitment to innovation and people-centered approaches in global health has been instrumental in developing and testing.

KOICA KOREA CDC

PCD glossary

A health worker at a desk reviewing monitoring screens and paperwork in a clinic office

Definitions of terms used throughout the PCD Framework — from core concepts to process tools and stakeholder categories.

C

Capability Building

Process & Tools

Training provided to team members — especially before user research — to ensure they can apply PCD methods appropriately.

Co-Design / Co-Creation

Core Concept

A participatory approach in which stakeholders actively contribute to generating and refining solutions, rather than being passive recipients.

D

Data Collection Methods

Process & Tools

Techniques used to gather evidence about people's needs and experiences — e.g., interviews, observations, and focus groups.

Decision Log

Process & Tools

A record of decisions, trade-offs, and the rationale behind them at key stages of the project — such as problem framing, ideation, prototyping, and solution selection.

E

Ecosystem Map

Process & Tools

A visual tool mapping all key stakeholders in a system and their relationships. Co-developed with the PCD Leadership Group to build shared understanding of the problem context.

End-to-End PCD Process

Core Concept

The complete PCD process, typically 12–15 months, running from initial setup through research, co-design, and into implementation and scale.

Ethics / IRB

Process & Tools

A formal review process evaluating the ethical acceptability of research involving human participants.

F

Frontline Workers

Stakeholders

Health workers or community personnel who directly deliver services to intended users. A core stakeholder group required throughout the PCD process.

G

Governance Cadence

Process & Tools

Regularly scheduled review and decision-making routines to ensure ongoing oversight of a solution after launch.

H

Hard-to-Reach Groups

Stakeholders

Populations that health systems disproportionately fail to reach, or that are typically left out of design processes — e.g., due to stigma, geography, or economic circumstances.

HCD (Human-Centered Design)

Core Concept

A design philosophy and process grounding problem-solving in the needs and contexts of the people being served. Used interchangeably with PCD in this framework.

I

Ideation

Process & Tools

A structured creative process in which stakeholders generate potential solutions to a defined problem.

Implementation Plan

Process & Tools

A plan for delivering a solution in practice, covering roles, training, support, governance, and timeline.

Ingredient (Key Ingredient)

Core Concept

A specific PCD practice or method that can be embedded into an existing program or proposal without running a full PCD process. Ingredients de-risk delivery and broaden participation.

Innovation Scan

Process & Tools

A structured review of existing solutions, approaches from other settings, and emerging innovations, used to identify what has already been tried before creating something new.

Iteration / Iterative Design

Core Concept

The practice of repeatedly testing and improving a prototype based on evidence, with changes documented across multiple cycles.

L

Launch Event

Process & Tools

A structured kickoff that brings the PCD Leadership Group together to build a shared understanding of the challenge and align on the project's direction before research begins.

Lived Experience

Stakeholders

Direct, personal experience of the health condition or context being designed for. People with lived experience are a required stakeholder group throughout the PCD process.

M

M&E (Monitoring and Evaluation)

Process & Tools

Systematic processes for tracking whether a project is achieving its intended outcomes.

P

PCD (People-Centered Design)

Core Concept

An approach to designing health solutions grounded in lived experience, operational realities, and risk considerations such as stigma, privacy, and unequal access. Also see HCD.

PCD Leadership Group

Stakeholders

A structured group representing all key stakeholder categories that participates in key decisions throughout the project. Required to include people with lived experience, frontline workers, hard-to-reach groups, and system owners/decision-makers.

Pilot

Process & Tools

Testing a solution on a small scale in real-world conditions with intended users before wider rollout, to understand how it performs in practice.

Prototype

Process & Tools

A testable representation of a potential solution, built to explore and validate key uncertainties and risks.

R

Release Notes

Process & Tools

Documentation of changes made to a solution in each update cycle, used as evidence of active continuous improvement.

S

Scale & Adoption

Process & Tools

Expanding a validated solution beyond its initial sites while adapting it to new contexts and ensuring it is genuinely adopted and owned by local systems, not just replicated.

Scale Plan

Process & Tools

A plan for expanding a solution beyond its pilot context, including adaptations needed for different local settings.

Sampling Table

Process & Tools

A table setting out the target number of research participants by stakeholder group and region, along with eligibility, recruitment approach, and accessibility needs.

Service Blueprint

Process & Tools

A detailed operational diagram showing how a solution will be delivered — covering roles, workflow steps, handoffs, and support structures.

Spark (Key Spark)

Core Concept

A short, catalytic PCD activity — such as a launch event, an innovation scan, or an ideation workshop — used to unlock new thinking or shift assumptions at a critical moment, without running a full PCD process.

Synthesis

Process & Tools

The process of organizing, interpreting, and prioritizing research findings so that they directly inform design decisions, rather than only being reported.

System Owners

Stakeholders

Government officials, policymakers, and technical experts who hold authority over the systems in which a solution will operate.

T

Test Plan

Process & Tools

A plan for testing prototypes with intended users under realistic conditions, specifying participants, scenarios, and methods for capturing findings.

U

User Journey Map

Process & Tools

A visual tool tracing the experiences of key stakeholders across the touchpoints of a health service. Co-developed with the PCD Leadership Group.

User Research

Process & Tools

In-person or remote data collection activities (e.g., interviews, observations) conducted with participants in their real-world contexts.

V

Validation & Prioritization Workshop

Process & Tools

A half day to full day workshop where the PCD Leadership Group reviews research findings, challenges assumptions, and agrees on the most important opportunity areas before ideation begins.

Acknowledge-ment

Co-Creators & Partners

The PCD framework was co-created with the RTC country teams in Uganda and Viet Nam, including implementing partners Walimu and FIT, national TB program teams, community representatives, civil society organizations, and frontline health workers who participated in design research, co-design sessions, and validation workshops. The framework also builds on the intellectual foundations of the Design for Health design dosages model and is inspired by the broader global health design community.

Feedback & Review

We are also grateful to colleagues at the Global Fund, UCSF, and TB REACH, who reviewed the framework and shared feedback that helped sharpen its content and usability.

Stop TB Partnership, hosted by UNOPS RTC MARK

Donors & Funding Partners

The Re-imagining TB Care initiative — from which this framework emerged — was made possible through the support of our donors, KOICA (Korea International Cooperation Agency) and the US CDC (Centers for Disease Control and Prevention). Their commitment to innovation and people-centered approaches in global health has been instrumental in developing and testing.

KOICA KOREA CDC