A day with co-creators exhibiting inclusive innovation in Kenya

Since 2019, the Living Labs team—PATH’s flagship initiative for human-centered design (HCD) expertise in global health— has engaged with diverse groups of thousands of users, including frontline health care workers, community members, patients, caregivers, opinion leaders, managers, and decision-makers at different levels of the health care system. We are continuously growing our user advisory group, which provides rich insights on the various health challenges we face. Our rapid process for co-creating solutions helps us quickly deploy answers by embracing a learn-by-doing approach.

In 2023, Living Labs supported the National Vaccines and Immunization Program (NVIP) in Kenya in applying HCD to explore why some children are not receiving vaccines and the determinants of low demand for immunization services; the team could then engage users in co-creating solutions to address identified barriers. In alignment with NVIP, PATH conducted the HCD activities in Turkana, Garissa, Kisumu, and Kakamega counties in Kenya. Despite significant efforts to increase access and promote uptake, additional efforts to help NVIP increase immunization performance were needed; the outputs were designed to accomplish this goal.

The inclusive innovation exhibition held earlier this year provided a unique opportunity to raise the voices of our users and their perspectives on proposed solutions that hold promise for addressing current health challenges if scaled. Participants at the event included representatives from the national-level NVIP and the Ministry of Health, county and subcounty health management teams, health care providers, and community members. The exhibition placed significant focus on the inclusion on the latter group by including community health promoters, opinion leaders, religious leaders, and caregivers.

During the exhibition, several solutions were presented by the user communities. A full suite of co-created concepts is available in our concept booklet. Several solutions are highlighted below.

Stakeholder Collaboration

Living Labs worked with users to ensure that chiefs and other influential voices in the community were equipped with knowledge about immunization. By providing the chief in Turkana with relevant information, we witnessed an increase in immunization awareness across his platform. As a result, the chief was able to bolster awareness among more than 30 community members, 30 community leaders, and 37 community health workers and public health officers in his region.

Mapping

Identifying and reaching children who are under-immunized can be a challenge. The mapping exercise tasked users with accurately capturing the correct number of children missing immunizations and the eligible group of children for each antigen in the catchment area. From there, they could identify which solution should be deployed based on need.

Through this exercise, the community health promoters in Garissa and Kisumu counties successfully identified and mapped 5,597 children to prioritize the outreach efforts.

The mapping exercise does not replace microplanning, which is a multifaceted process to make or update facility and/or district-level maps, identify priority communities, pinpoint barriers to service use, and develop practical work plans. Instead, it simplifies the process. When community health promoters conduct household mapping and annotate facility catchment area maps with performance indicators—for example, green pins or stickers for areas doing well, yellow pins/stickers for areas with moderate performance, and red pins/stickers for areas performing poorly—it becomes much easier to tailor interventions during microplanning to address the specific needs of each area.

HPV Vaccine Advocacy through Art

To increase self-knowledge among students and teachers of the human papillomavirus (HPV) vaccine, the HPV Vaccine Advocacy Through Art (HATA) concept was used to enhance curricula by means of an art competition in select schools. Students applied their knowledge of HPV and the vaccine through various art forms such as essays and poems.

At the schools where the HATA intervention was piloted, an increase in the number of girls vaccinated with one dose rose from 36 percent to 64 percent; increases from 40 percent to 60 percent were noted for girls becoming fully vaccinated with a second dose. Learn more about this solution in our recent article.

Nurturing Care for Early Childhood Development Standard Operation Procedure ( NCfECD SOP)

The PATH Early Childhood Development (ECD) team joined Living Labs to host a portion of the exhibition focusing on various solutions regarding nurturing care for ECD, co-created using HCD. Engagement with community health promoters and health care workers in Siaya County, demonstrated that while community health promoters possessed extensive knowledge of ECD—particularly after the ECD team had worked in the county for several years—they were unable to convey this information to caregivers in terms of appropriate dosages based on a child's age.

Collaboratively, the PATH teams developed a solution with the health care workers and community health promoters that standardized this nurturing care for ECD information so that it could be provided to caregivers during home and facility visits, tailored to the child's age. This standard operating procedure is also linked to the mother–child health booklet, making it easier for community health promoters and health care workers to direct caregivers to specific pages. This allows caregivers to independently review the booklet for age-appropriate ECD information.

To wrap up an inspiring day of solutions, we celebrated our users with certificates to commemorate their role in co-creating solutions and showcasing them at the exhibition. One very special certificate was awarded to Barbra Tioko Epat, a student at Kanamkemer primary school, who participated in the HATA competition. Barbra read her HPV awareness poem in Swahili, and the certificate was presented by the head of the NVIP Kenya, Dr. Rose Jalang’o.

As these solutions address immediate challenges, the counties continue to disseminate learnings at the local level. Turkana county hosted two radio shows during the 2024 immunization week sharing co-created solutions. Furthermore, county personnel continue to implement and refine solutions. Living Labs will check on progress and document lessons that emerge as solutions are scaled.

The Living Labs team was honored to host Dr. Jalang’o, the NVIP lead, and she was so impressed with Barbra’s poem that she suggested Barbra be part of the national HPV champions. NVIP also tasked counties to document the solutions they co-created to facilitate cross-learning across Kenya and support continuous improvements in the country’s immunization rates.

To learn more about our co-creation process, watch our recent webinar with HCD Exchange, Turning Insights into Powerful Solutions.