Applying Human-Centered Design in Formative Research: Developing a Cluster Randomized Controlled Trial for a Culturally Tailored Women's Empowerment Program to Boost Immunization Service Uptake (Preprint)

Abstract

BACKGROUND Human-centered design (HCD) is vital for crafting impactful solutions, especially in regions with lower Routine Immunization (RI) coverage, like Northern Nigeria. The Routine Immunization Buddy System (RIBS), a human-centered solution, targets economically disadvantaged caregivers in Northern Nigeria. OBJECTIVE Through a community-based participatory approach (CBPA), this study explores caregivers' lives, focusing on socio-economic and health-related factors affecting immunization uptake, aiming to propose interventions for enhancing RI uptake. METHODS Employing a three-step HCD process, including the Discovery, Ideation, and Formulation phases, the study conducted Focus Group Discussions (FGDs) and Key Informant Interviews (KIIs) for caregivers and stakeholders capable of influencing the woman decision within a health setting. Semi-structured interviews facilitated an in-depth exploration of participants' experiences. Data collection utilized audio/video recordings, detailed notes, and observation sessions. Data analysis encompassed transcription, descriptive, and thematic analysis to inform evidence-based interventions. RESULTS The study found significant socio-cultural variations shaping healthcare access and decision-making among caregivers in Kaduna State were unveiled. Economic constraints and logistical challenges hindered healthcare access, particularly in rural areas. Marital dynamics showcased varying levels of spousal support and women's autonomy in healthcare choices. Caregivers expressed strong aspirations for economic empowerment, underscoring a collective yearning for personal and community advancement. Community-led initiatives, like advocacy campaigns and peer support networks, emerged as promising strategies to mitigate healthcare disparities. CONCLUSIONS Tailored interventions, informed by study findings, hold promise in addressing health disparities among Kaduna State caregivers. By addressing economic empowerment, fostering community-led advocacy, and establishing peer support networks, caregivers can make informed health decisions, contributing to community development. The findings from this research is being given strong consideration in the design of our cRCT study that aim to empower women to make informed decision about taking up immunization services.