Many of the perennial problems we have in Africa are rooted in human interactions and activities. Most of these human activities are so complex, unstructured and informal, and are shaped by unique cultural and traditional heritage, that many of the solutions that address similar problems in western society may fail at achieving similar results here.

This implies that we as Africans must come up with solutions that work for us in the long-term. And for us to achieve this, the design of such solutions must be centred around the lived experiences of fellow Africans who face these problems every day. From global health, through education and governance, effective solutions to many African problems in these sectors should involve the end-users (community members, traditional leaders, etc.) as important stakeholders whose inputs must be reflected throughout their design and development process. And this approach to problem-solving is what human-centred design is about. 

Before now, there haven’t been any continent-wide concerted efforts at channelling the human-centred design approach to problem-solving to the development of solutions to address problems in global health, education and governance in Africa. The Co-Creation Hub Design Lab was established to inspire a movement in this direction.

How might we get African governments, agencies, corporations, stakeholders and citizens to incorporate the human-centred design methodology into their operational processes that lead to the development of solutions to problems across the different sectors of the African economy?

Through a partnership with the Bill and Melinda Gates Foundation, the first edition of the Co-Creation Hub Design Traineeship has started this Africa-wide movement, and I’m proud to be part of the pioneer cohort of the movement. The last 6 months have been totally wonderful being one of the 15 design trainees of the Co-Creation Hub Design Lab selected from a pool of applicants from 5 African countries.

What started first as a one-month Bootcamp session at the Design Lab in Kigali Rwanda went on to transform me into a human-centred design consultant who was deployed to a health management consultancy organization in Abuja, Nigeria. I spent 5 months at the Solina Centre for International Development and Research (SCIDaR) where I applied the principles of human-centred design to co-create a solution that has the potential to significantly improve and sustain demand for routine immunization in rural communities in Kano State, Nigeria when implemented. 

You can click here to read about my one-month Bootcamp session experience at the Design Lab in Kigali Rwanda. 

Practicum Experience with the Solina Centre for International Development and Research

Following the Bootcamp session in Rwanda, those of us from Nigeria returned to our country and were deployed to different partner health organizations where we would apply the principles of human-centered design over a period of 5 months to help these organizations come up with solutions that can significantly improve routine immunization coverage in Nigeria. I was assigned to the Solina Centre for International Development and Research along with 2 other colleagues. 

The Solina Centre for International Development and Research is the nonprofit arm of the Solina Group Limited. It provides technical assistance to governments, private sector organizations and donors in the design and implementation of various global health programs across West Africa.

The three of us deployed here were posted to a unit which has been providing technical assistance, in collaboration with other global health organizations, in the implementation of various aspects of an almost 8-year program, the Northern Nigeria Routine Immunization Strengthening Program (NNRISP).

The program was developed to improve routine immunization coverage rate in 6 northern Nigerian states. The program is being funded by the Bill and Melinda Gates Foundation (BMGF) and the Aliko Dangote Foundation (ADF). I was attached to the team working in Kano state to provide technical assistance to the state’s ministry of health in strengthening the primary health care system of the state.

My work started with researching and analysing the landscape of routine immunization in Kano state to understand the key problems responsible for the poor coverage rate of this health service in the state. In addition to conducting extensive secondary research through a review of existing published literature and internal analysis documents from the organization and the state ministry of health, I designed and conducted interviews and focused group discussions with stakeholders at the state Emergency Routine Immunization Coordination Centre (SERICC), behavioural communications experts from UNICEF and the CHIGARI Foundation, health workers in primary health facilities in rural communities, traditional leaders and household members of rural communities.

I also shadowed a session on routine immunization in a primary health facility, carried out a rapid ethnography of a rural community and interviewed two engagement managers from the Solina Group to gather insights on how community members interact with primary health care interventions. 

A glimpse into different aspects of my work in Kano

My visits to primary health facilities and the rural communities opened my eyes to the critical challenges people in these areas face that directly and indirectly affect the way they interact with primary health services such as routine immunization. It also reinforced findings from secondary research and interviews conducted on how culture, religion, socioeconomic status, availability or lack of basic social amenities and education shape people’s perception of and attitude towards health interventions in their communities. 

Prototyping and testing sessions with stakeholders and community members

The above findings shaped the problem statements that informed the co-creation of ideas to improve and sustain demand for routine immunization especially in rural communities in Kano State. These ideas were bundled into 3 potential solutions. I prototyped one of the bundled ideas before the novel coronavirus pandemic. This solution (its prototype) was tested with the members and traditional leaders of a rural community.

It was a very interesting session as both the members (men and women) and the traditional leaders gave honest feedback on the solution; the prototype was also tested with the members of the Kano State Emergency Routine Immunization Coordination Centre (SERICC), and members of the Solina team in Kano for their feedback. All the feedback received informed the iteration of the solution. I developed an extensive report on the entire work and submitted it to both the Bill and Melinda Gates Foundation, the Solina Group and the Co-Creation Hub Design Lab. 

On the other hand, I participated in some of the Solina’s core activities. I attended Kano State’s end-of-the-year review of the primary health system strengthening program which held at the government house: this review had in attendance, either in person or virtually, the state governor, representatives from the Bill and Melinda Gates Foundation, Alhaji Aliko Dangote, the Minister of Health, the Executive Director of the National Primary Health Care Development Agency (NPHCDA), the Kano State Honourable Commissioner for Health and traditional leaders from some of the state’s Emirates.

One thing that stood out for me at this review was a remark from Alhaji Aliko Dangote, the Chair of the Aliko Dangote Foundation, one of the donors funding health programs in the state. He noted that there’s a need to develop a harmonized demand generation strategy that integrates all primary health care services into one as opposed to the current fragments of strategies for each health service in the state. 

At the Kano State Government House for End-of-Year Review of the Primary Health System Strengthening Program

My work in Solina saw me flying to Kano from Abuja and back almost every week for the 5 months period of the program. I wore the northern style outfit most of the time and coupled with my beard I blended in perfectly as a northerner; the only thing that surprised some people was finding out I don’t speak Hausa (I’m working on that slowly but gradually).

While in Kano, I explored some parts of the city at night. I visited a few night clubs and restaurants that served intercontinental dishes. I also became friends with a few health workers and experts in some of those primary health facilities in the rural communities I visited with some members of the state’s Emergency Routine Immunization Coordination Centre (SERICC).

The only thing I didn’t get to explore at my leisure in Kano was the food, but I ate different types of Suya and there was a type I tasted, though I don’t remember the name, that I can say is the best Suya I have eaten so far. 

Fun time with the Solina team in Abuja and Kano

The Kano state Solina team is the best. They made feel at home, provided me with all the needed support despite their busy schedules, engaged me in honest, critical conversations on current public health interventions being implemented in the state; we also had both formal and informal discussions on the strengths and weaknesses of the solutions I designed to further improve and sustain demand for routine immunization in the state.

The entire Solina team at the Abuja headquarters granted me immense support. I learned a lot from Solina on the complex nature of the implementation of health interventions in a low resource setting.

I’m grateful to the Co-Creation Hub Design Lab for making this program happen in the first place, the Bill and Melinda Gates Foundation for its funding support and the Solina Group Limited for providing an enabling environment and support for the fieldwork. I’m hopeful that one of the solutions I designed from my work in Solina will be taken further for piloting and implementation not just in Kano but across northern Nigeria and possibly the entire country to improve and sustain routine coverage. 

This piece was written by By Okechukwu Amako