Academic Journal
IMPACT: A Structured Human-Centered Design Process for Integrating Community Health Worker Insights Into Program Policy in Pakistan.
| Τίτλος: | IMPACT: A Structured Human-Centered Design Process for Integrating Community Health Worker Insights Into Program Policy in Pakistan. |
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| Συγγραφείς: | Closser S; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. sclosser@jhu.edu., Sultan M; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA., Finley E; The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA., Gerber S; Independent Consultant, Truchas, NM, USA., Shafique M; Sohail Inc., Islamabad, Pakistan., Ahmed S; Sohail Inc., Peshawar, Pakistan., Shah IA; Khyber Pakhtunkhwa Emergency Operations Center, Peshawar, Pakistan., Khurshid N; World Health Organization, Peshawar, Pakistan., Naz F; Sohail Inc., Peshawar, Pakistan., Nayyab S; Sohail Inc., Peshawar, Pakistan., Fei C; Johns Hopkins University, Baltimore, MD, USA., Sohail A; Sohail Inc., Karachi, Pakistan. |
| Πηγή: | Global health, science and practice [Glob Health Sci Pract] 2026 Aug 10; Vol. 14 (1). Date of Electronic Publication: 2026 Aug 10 (Print Publication: 2026). |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: U.S. Agency for International Development and Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs Country of Publication: United States NLM ID: 101624414 Publication Model: Electronic-Print Cited Medium: Internet ISSN: 2169-575X (Electronic) Linking ISSN: 2169575X NLM ISO Abbreviation: Glob Health Sci Pract Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Baltimore, MD : U.S. Agency for International Development and Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs, 2013- |
| Ιατρικοί όροι (MeSH): | Community Health Workers*/organization & administration , Immunization Programs*/organization & administration , Health Policy* , Program Development*, Poliomyelitis/prevention & control ; Humans ; Pakistan ; Female ; Primary Health Care |
| Περίληψη: | Background: Community health workers (CHWs), most of whom are women, are the bedrock of primary health care provision in much of the world. CHWs are often employed at the bottom of health hierarchies where they have little voice; in state programs and vertical initiatives, accountability has generally flowed downwards. Yet many programs might function better if CHWs' needs and ideas were considered in program design. Methods: From 2020-2022, we implemented a human-centered design process called IMPACT with CHWs working on polio vaccination in one district of Pakistan. The name IMPACT draws from the steps in the process: Identify problems and brainstorm innovations; Make and refine ideas; Present and evaluate ideas; and ACT to disseminate and implement. We held a facilitated competition for teams of CHWs, all of whom were women, to propose policy improvements to polio vaccination. In total, 417 CHWs participated in the design process facilitated by our team, and more than 500 additional CHWs participated in sessions facilitated by local supervisors. We worked with local policymakers to short-list the best ideas. Teams of CHWs presented the short-listed ideas to a panel of provincial and national-level policymakers, who selected ideas for implementation. We conducted interviews with CHWs and policymakers throughout the process to understand their experiences (n=82). Results: We received 181 idea submissions over two rounds of the process; 9 ideas were chosen for implementation. CHWs valued the process enormously; most said it was the first time their insights had been considered, and they wanted more opportunities for such input. The second round of the process was more effective than the first, with workers generating more complex ideas and program staff running workshops themselves. We heard, across management levels, that the process had positively impacted CHW motivation and confidence. Overall, the innovations selected for implementation were in the form of adjustments rather than major programmatic changes. Yet CHWs reported that the changes made were helpful and that it was very meaningful to have contributed to program policy. Conclusion: IMPACT facilitated substantive engagement and collaboration from both male supervisors and frontline female workers in a highly gender-stratified setting. Structured processes can allow the least powerful actors in global health interventions to draw on their frontline experience to suggest policy innovations. (© Closser et al.) |
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| Grant Information: | INV-005843 United States Bill & Melinda Gates Foundation |
| Entry Date(s): | Date Created: 20260622 Date Completed: 20260810 Latest Revision: 20260826 |
| Update Code: | 20260826 |
| PubMed Central ID: | PMC13455854 |
| DOI: | 10.9745/GHSP-D-24-00050 |
| PMID: | 42331614 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 2169-575X |
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| DOI: | 10.9745/GHSP-D-24-00050 |