Macro: Change at the societal level


When designing at the macro or societal level, you will be considering how interventions should lead into new policies, regulatory frameworks or market dynamics. It is at this level that it becomes critical to think through what legal, economic, governance and other structures will be necessary to support your intervention in a sustainable way. As you move into this macro level, more strategic design and system innovation expertise can help you to think about how your intervention will operate across different scales to implement systemic change. Here you can also utilise design expertise to help convene and align diverse groups together, gain deeper understanding of market intelligence, and shape strategies for scaling and sustaining your intervention.

Common outputs or deliverables

Tips and tricks

  • Consider whether your team has a solid understanding of current regulatory policies, socio-political dynamics, and economic/market trends in relation to the intervention you are seeking to design.
  • Health systems operate differently in different contexts. Consider whether you have someone on your team who has deep expertise in health systems policy and financing, as what will need to happen at the systems level to ensure sustainability through political buy-in or broader marketing and distribution of your intervention.
  • You can benefit from partnering with one or multiple key stakeholder organizations when an investment is operating at this level. You will want strong systems design expertise, but it is also critical to include a partner who has extensive experience in the settings in which your intervention will launch to ensure the design will be ‘effective’ or likely to succeed in being adopted or implemented or both.


  • Consider full range of activities like design, production, marketing and distribution that a business goes through to bring a collection into the market. Introduction can be difficult and necessitates considering the full range of activities like design, production, marketing and distribution that a business goes through to bring a “solution” into the market.
  • Designing at the macro level necessitates a certain type of strategic design expertise, and usually requires design teams with experience facilitating complex multi-stakeholder collaborations and navigating competing interests.

Questions for potential partners

  • Can you tell me about an experience where you or one of your partners has worked on an intervention that was successfully adopted/implemented?
  • Not every intervention is successful. What have you learned about sustainability of designed solutions from projects where you did not succeed in ensuring adoption/implementation?
  • Change at a macro level takes quite a bit of buy-in from key stakeholders. Who do you see as the most critical stakeholders in this work and how will you engage them?
  • Can you share with me a bit about how you incorporate regulatory, policy or market intelligence in to your process? For example, how do you engage with and thoroughly understand local markets and actors, such as Ministries of Health, medical associations, key opinion leaders, and other local stakeholders over time?

Resources and links