As digital technologies play a growing role in healthcare, human-centered design is gaining traction in global health. Amid concern that this trend offers little more than buzzwords, our paper clarifies how humancentered design matters for global health equity. First, we contextualize how the design discipline differs from conventional approaches to research and innovation in global health, by emphasizing craft skills and iterative methods that reframe the relationship between design and implementation. Second, while there is no definitive agreement about what the 'human' part means, it often implies stakeholder participation, augmenting human skills, and attention to human values. Finally, we consider the practical relevance of human-centered design by reflecting on our experiences accompanying health workers through over seventy digital health initiatives. In light of this material, we describe humancentered design as a flexible yet disciplined approach to innovation that prioritizes people's needs and concrete experiences in the design of complex systems.

Many current global health opportunities have less to do with new biomedical knowledge than with the coordination and delivery of care. While basic research remains vital, the growing cancer epidemic in countries of low and middle income warrants urgent action - focusing on both research and service delivery innovation. Mobile technology can reduce costs, improve access to health services, and strengthen health systems to meet the interrelated challenges of cancer and other noncommunicable diseases. Experience has shown that even very poor and remote communities that only have basic primary health care can benefit from mobile health (or 'mHealth') interventions. We argue that cancer researchers and practitioners have an opportunity to leverage mHealth technologies that have successfully targeted other health conditions, rather than reinventing these tools. We call for particular attention to human centred design approaches for adapting existing technologies to suit distinctive aspects of cancer care and to align delivery with local context - and we make a number of recommendations for integrating mHealth delivery research with the work of designers, engineers and implementers in large-scale delivery programmes.

Bone marrow of 61 HIV-1-infected patients and 23 control patients was examined to determine the incidence of B19 infection and its clinical impact in HIV-1-infected persons. Of the 61 HIV-infected patients studied, ages ranged from 22-47 years with a mean of 33.2 years. There was a man:woman ratio of 3.8:1. With regard to staging of HIV disease at the time of bone marrow sampling, 52 patients were CDC group 4, 5 patients were CDC group 3, and 4 patients were CDC group 2. Control patients, were not known to be HIV-1-infected, and had one of the following conditions: lymphoma, leukaemia, thrombocytopenia, thrombocytosis, anaemia, multiple myeloma, raised serum IgM. Thirteen of 61 HIV-infected patients and 0 of 23 control patients were positive for B19 DNA in bone marrow (two-tailed P value = 0.016). Within the HIV-infected group, the average haemoglobin among persons testing B19 DNA positive (n = 13) was 11.1 g/dl, compared with 11.5 g/dl among persons testing B19 DNA negative (n = 48). In conclusion, B19 persistence may be common and frequently subclinical in AIDS patients.

No abstract

No abstract