Evaluation of open-ended, clustering, and discrete choice methods for user requirements development in a low-income country context

High quality user requirements are positively correlated with successful design outcomes, but engaging stakeholders within low-income contexts can present financial and time-related challenges to product developers from non-local industrial and academic institutions with limited knowledge of the context. Existing literature provides guidance for engaging stakeholders during the early stages of product design in high-income country contexts, but few studies have examined the effectiveness of these methods in low-income country contexts. This study evaluated three user requirements elicitation and prioritization methods including open-ended, clustering, and discrete choice. Ghanaian healthcare delivery stakeholders with varying types of expertise, years of experience, and from various types of healthcare facilities were recruited to allow for diversity of responses. Participants included physicians (n = 10), nurses/midwives (n = 16), biomedical technicians (n = 14), and public health officers (n = 7). A hypothetical mechanical device for managing and treating postpartum hemorrhage was chosen to characterize each method's ability to elicit and prioritize user requirements. The open-ended method captured general requirements of a design concept, yet resulted in predominantly generic requirements. The results from the open-ended method were used to inform the clustering and discrete choice methods. The clustering and discrete choice methods were useful for inferring in-depth user requirements and eliciting stakeholder priorities. The clustering method revealed that usability and affordability were high-priority requirements among all four stakeholder groups. An individual difference scaling analysis was performed using the clustering method outcomes, which indirectly identified ease-of-use, availability, and effectiveness as the priority user requirements categories. Stakeholders ranked ease-of-use as the highest-priority user requirement, followed by performance, cost, and place-of-origin requirements, using the discrete choice method. Given the significance of the ease-of-use requirement, an analytical framework based on sub-requirements was developed for quantifying stakeholder needs. Lastly, the relative merits of the three elicitation approaches and their implications for use with different stakeholder groups were examined.