well, the idea is they are to be used on a level that is build of 16x16 tiles but the characters themselves are 16x24 so they kinda spill out to the top tile.
this works well both from 3/4 tilted view (like nuclear throne, crypt of necrodancer, enter the gungeon and similar) or entirely side view (most platformers, Mario could be 2 tiles big after eating the shroom!)
Don’t know your use-case but hopefully it helps :)