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Meet the health workers who will co-create solutions for vaccine delivery

August 22, 2019 by Jacqueline Deelstra

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A nurse at a clinic in Nairobi, Kenya uses a wall chart to record their immunization statistics. Photo: PATH/Breese McIlvaine

Frontline immunization workers play a critical role in improving vaccine access and equity. A new initiative aims to leverage their firsthand experience to co-create innovative delivery solutions.

Frontline health workers have played a critical role in expanding immunization access and protecting children against vaccine-preventable diseases. Despite their incredible efforts, longstanding challenges like understaffed clinics and time-consuming paper registers still impede progress by demotivating health workers and taking time away from patients.

The new Living Labs initiative, a partnership between PATH, the Bill & Melinda Gates Foundation, and frontline immunization workers in sub-Saharan Africa, will create innovative solutions to these complex, longstanding challenges and accelerate global progress in immunization coverage and equity.

Using a human-centered design approach, PATH staff will deeply engage with health workers to understand the challenges they face, partner with them to brainstorm creative solutions, and then rapidly develop and test protypes of the most promising ideas.

The first Living Lab will be established in Nairobi, Kenya and will engage frontline immunization workers from all over Kenya.

Here are a few of the dedicated workers who will share their expertise.

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Martha, a maternal and child health nurse, prepares to administer immunizations at her clinic in rural Kenya. Photo: PATH

Martha, maternal and child health nurse

Martha works at a rural clinic in the western region of Kenya. She administers vaccines as part of maternal and child health services. Her clinic employs just two maternal and child health nurses to serve a population of about 5,000 people. She also conducts community outreach to educate households on immunization, family planning, and antenatal and postnatal care.

Martha loves her job and the impact she makes in the community. But she also feels discouraged when community members face long wait times to vaccinate their children or when she spends more time on paperwork than seeing patients. With seven years of experience as a nurse, Martha well understands the progress that has been made in delivery of vaccines in rural Kenya, as well as the challenges that remain unsolved. She believes that small changes in the work environment could lead to large increases in the motivation of nurses.

"A human being can perform the duties and responsibilities assigned, but a person will perform better who is motivated."
— Martha, maternal and child health nurse
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As the nurse-in-charge, Rehema manages a team of nurses that provides childhood vaccinations. Photo: PATH/Breese McIlvaine

Rehema, nurse-in-charge

Rehema is the nurse-in-charge at a busy public clinic in Nairobi, Kenya. She manages a team of nurses who provide childhood vaccinations. She has 20 years of experience as a nurse and has been the nurse in-charge for 10 years.

Her vaccination team sees about 150 patients each day at the clinic. In addition to giving vaccines, they weigh and measure all the babies and update the immunization ledgers to track statistics for the health center, and fill out vaccination booklets for each child to allow their parents to track their vaccinations.

The clinic is often overcrowded, so mothers and their children wait outside or on hallway floors until care can be provided. It is hard for the nurses to move around, and it creates a stressful environment with all the noise. Rehema said, “We don’t need big things…we just need encouragement and appreciation for the work we do.”

"I want that mother, that baby, to go home safe. That’s what motivates me. I want to serve people."
— Rehema, nurse-in-charge
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Salim, a community health promoter, counsels a mother on immunizations for her baby. Photo: PATH/Christopher Obong'o

Salim, community health promoter

Salim is a community health promoter in a refugee camp in Kenya. He has ten years of experience. At the clinic, he provides health talks to mothers as they wait for vaccinations for their children. In the community, he follows up with those who have gotten behind on their vaccination schedule to encourage them to visit the clinic. In the camp, he serves community members from a number of ethnic groups whose languages he does not speak, limiting the personal connection he can make with them.

Some refugees are steadfast in their cultural and religious beliefs against immunization. There are community members who refuse to bring their children to the clinic, preferring instead to use traditional medical practices. Despite the daily challenges and working long hours in the clinic and in the community, Salim loves his work and the changes he is able to effect through one-on-one health education.

"This work is my life. I feel motivated whenever I am passing knowledge to people. I feel like I am an important leader in my community, and delight in serving."
— Salim, community health promoter

Accelerating health innovation

By harnessing the knowledge and motivation of health care workers such as Martha, Rehema, and Salim, the Living Labs initiative will accelerate health innovation in the countries where PATH works. While the Living Labs will focus on rapidly ideating delivery solutions with frontline immunization workers in sub-Saharan Africa, PATH also expects to gain learnings from adjacent health challenges and adapt the model for other geographies.