We Are All Caregivers: How Noora Health Supports a User Group in Patient Care

Family caregivers are essential for patient recovery journeys - especially in low- and middle-income health systems. But: they are mostly overlooked as a critical actor. Noora Health, a nonprofit born from a Stanford d.school project, focused on the specific challenges and needs of this user group. Noora’s team used human-centered design to develop the Care Companion Program - reimagining how health systems can better support and partner with patients’ families.

Applying Design Thinking: From d.school Project to Care Companion Program

Noora Health’s journey starts in 2012, when Shahed Alam, Katy Ashe, Jessie Liu, and Edith Elliott participated in the Stanford University d.school course “Design for Extreme Affordability”. “The four of us were semi-randomly brought together as self-selecting graduate students who took an intense, idealistic class”, Jesse Liu says. “Each of us came in with a growth mindset, but (the course) served as an incubator that was a positive feedback spiral to think in terms of radical possibilities. Our early experimental days helped us challenge the expectation that ideas are required to be realistic. The (course) community normalized failure as necessary. It set a high bar for the amount of perseverance a team should reasonably have to implement and iterate on an idea.”

Noora Health’s founding team met at Stanford University’s d.school.

Observation & Empathy
The team’s challenge focused on the healthcare journey of patients in India. In many public hospitals across the country, healthcare workers are stretched thin. Patients often remain in hospital for critical interventions, but once they go home, families are left to manage complicated aftercare — medication, wound care, warning signs, nutrition — often with little guidance. The design researchers immersed themselves in hospital wards, noticing how family members hovered over patients, waiting, listening, but were rarely coached for caregiving. Through shadowing, interviews, and deep empathy work, they surfaced the hopes, fears, and constraints of caregivers — from low health literacy to cultural taboos, from lack of confidence to systemic fragmentation. Today, Noora Health describes this as a power imbalance: “Those who care most for patients — their loved ones — are left out of patient healing. Families and their patients often leave healthcare facilities anxious, confused, and ill-equipped to care for their loved ones, leading to preventable complications and, in some cases, death.”

Defining & Framing the Problem
The team collected the problems and challenges that family members faced in their role as lay caregivers. Even though the family members were struggling in their role, they were also deeply motivated, compassionate, and present as well. The designers saw an opportunity: what if we could empower family caregivers with the right knowledge, training, and emotional support — turning them into a scalable resource for improving patient aftercare? Rather than designing for patients alone, Noora reframed the problem: How might we enable family caregivers to become confident, skilled, trusted collaborators in a patient’s care journey? They chose to center their innovation on the caregiver as the “user,” not just the patient.

Ideation & Co-creation

Rather than prescribing top-down training, Noora engaged multiple stakeholders — healthcare workers, nurses, patients, and family members — to co-create educational materials. These became the basis of Noora’s Care Companion Program (CCP).

Digital tools support both healthcare staff and families outside of health facilities.

Prototyping & Testing
The Noora team prototypes both physical and digital tools like mock-ups of flipcharts, posters, or communication artifacts for maternal and newborn care in Nepal. Then they test them in situ: nurses and families review, validate, and provide feedback.

Implementation & Scaling
Noora embeds material into hospital workflows: they train healthcare workers to deliver CCP sessions, and they build trust with local health systems so that CCP becomes part of routine care. They also support caregivers post-discharge through a remote engagement platform, delivering timely reminders, educational nudges, or check-ins via messenger services when they return home.

An overview of training material.

The Care Companion Program (CCP)

The CCP is an adaptable, context-specific, and human-centered suite of educational tools and training for patients and caregivers. By partnering with healthcare systems, the program ensures that patients and their families receive continuous support and education from the time they first visit a healthcare facility until they return home, improving health outcomes in the long run. „As part of the CCP, healthcare staff in public hospitals and clinics are trained to transfer health skills to family caregivers and patients. Then, our digital tools support both healthcare staff and families outside of health facilities“, Noora Health writes.

A visualization of Noora Health’s creation process.

Embedding Design in the Organization’s DNA

Noora Health developed from a university project into a global nonprofit with hired employees. Jessie Liu describes Noora Health as a starfish organization, in reference to the organizational form described by Brafman & Beckstrom (2006): a decentralized network based on shared ideology – and the perseverance to keep existing and growing anew, even if “a leg is cut off”, e.g. employees leave and are replaced by new hires. “A good team can mean a lot of things”, Jessie Liu writes: “Compatible personalities, shared values, aligned motivations, or humor. Practically, that meant that we all enjoyed having annual retreats in treehouses where we made art to describe our best future selves, and resorted to playing ‘what is your nightmare’ to genuinely air our fears that tail-spun into hilarity. At the core, we knew that we could share our best selves, our worst selves, but always our true selves with each other.

Noora Health doesn’t treat design as a one-off method; design is institutionalized as a way of working. On their blog, Noora Health declares that human-centered design anchors everything they do. Several practices illustrate how deeply design thinking is woven into their culture:

Empathy-driven decisions: Important design choices (like how to communicate nutrition advice to new mothers) are made not from the boardroom, but from the voices of caregivers, nurses, and patients. Noora acknowledges that assumptions about behavior, gender, rituals, and caste only surface when listening deeply.
Rapid prototyping & testing: Even after co-creation, the team continues to test “almost final” artifacts in real-world context before full implementation.

Healthcare staff in public hospitals and clinics are trained to transfer health skills to family caregivers and patients.
Healthcare staff in public hospitals and clinics are trained to transfer health skills to family caregivers and patients
Healthcare staff in public hospitals and clinics are trained to transfer health skills to family caregivers and patients
Healthcare staff in public hospitals and clinics are trained to transfer health skills to family caregivers and patients

Healthcare deals directly with human lives, emotions, fears, and needs. So, at first glance, it may seem like it should be people-centered by default. However, the systems, structures, and decisions that shape healthcare delivery often feel, or can be, far removed from the lived realities of those they intend to serve.

Impact: Outcomes Fueled by Design Thinking

Noora Health’s design-driven model has produced measurable results:

They have trained more than 30 millions of caregivers (according to a WHO partnership announcement).
In cardiac care, their Care Companion Program reportedly reduced post-surgical complications by 71 %.
In neonatal care, they achieved an 18% reduction in newborn mortality in facilities where CCP was deployed.
Noora Health’s programs have spread across several countries (India, Bangladesh, Indonesia, Nepal) and care areas (maternal/newborn, cardiac, chronic diseases, oncology, tuberculosis, COVID-19).

Beyond numbers, Noora’s design practice strengthens caregivers on an emotional level. Caregivers who feel seen and supported can better advocate for themselves, and adhere to care plans better.

A 2024 New York Times article on Noora’s collaboration with a hospital in India.

Outlook: Scaling – Globally and Systemically

On its tenth anniversary in 2024, the nonprofit has ambitious goals: reaching tens of millions more caregivers, deepening partnerships with governments, and embedding caregiver training into mainstream health systems. „By 2027, we’ve set our sights on reaching 70 million caregivers across India, Bangladesh, Indonesia, and Nepal“, the team says. “It’s not just about scaling our work, but scaling what works best for caregivers.” And: „Evidence fuels everything we do. As we look to the future, we’re doubling down to make our approach even more data-driven and rigorous.“