The Design of Public Decision Making

In some sense our public environment is a by-product of the interactions and frictions between the different public decisions and the way in which these decisions have been made over time. The subject of my design analysis work, more often than not, is public health services and the study of several phenomena that arise in the public systems, shaping their personality. We are continuously, also tasked with identifying levers and linchpins that need to be cranked or changed to improve public health service systems. In all this complexity, decision making comes across the one thing that continuously and dynamically shapes systems and therefore designates itself as an area that we must understand and rethink.


Here are some free-associated thoughts and questions on the design of decision making:

How does one define what kind of a public decision making environment / system will lead to desirable impact?

Evidence based, multi-perspectival, inclusive, accountable, with enough flexibility to iterate and improve, and most importantly balanced may be some adjectives that one would like to use to describe an ideal decision making environment. Can we create this environment such that inspires bolder and experimental decision making?

What are the myriad elements of this decision making environment? What is the right data set, collective expertise and frame of mind that needs to come together?


Evidence is a bittersweet area: governments use ‘where is the evidence?’ almost as a shield to avoid bold and experimental decision making? Is it possible that even our relationship with evidence is skewed; do we see in evidence only what we want to see or are comfortable seeing? Can we get to know how decisioning happens now and what evidence is curated?

Are we too engrossed in symptomatic data, even though it is unsuitable to make decisions on how to improve things? Does the system have a good understanding of its own nadis, gunas and doshas and if not how does it get this self-awareness to make better decisions? What is the right data stimulus and permutations of data modelling that should be the base plate for decision making? Can we create an environment that grows into becoming self diagnosing and self correcting?


Why is the decisioning process not open to the people who are the receivers of the decision and its impact? Whose job is it to create a dynamic decision making environment and who is responsible for demanding this environment?

Finally and more specifically for better health outcomes, what kind of a decision making environment is required to further health innovation and mainstream the use of high impact health innovation and medical technologies in public health services delivery. This is a topic we address in a power packed panel themed: Deploying Health Innovation in Real-time Service Delivery at Scale at the Health Public Conclave on 22nd August at New Delhi.


Concept Note:

My team and I at the Bihar Innovation Lab will be framing these and other systemic questions as we deep dive into public service design and delivery in India. While this line of thought will be continued with follow-on reflections on the relationship between data and creative decisioning, do tell us about what you think of the challenge? How would you like to design decision making? What do you know that we don’t? Draw us into your perspective…

This entry was posted in Health Public. Bookmark the permalink.

Leave a Reply

Your email address will not be published. Required fields are marked *