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IMPACT: A Structured Human-Centered Design Process for Integrating Community Health Worker Insights Into Program

Svea Closser1, Marium Sultan2, Erin Finley3

  • 1Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. sclosser@jhu.edu.

Global Health, Science and Practice
|June 22, 2026
PubMed
Summary
This summary is machine-generated.

Community health workers (CHWs) in Pakistan used a human-centered design process to propose policy improvements for polio vaccination. Their input led to meaningful changes, boosting motivation and confidence among these essential female health workers.

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Area of Science:

  • Global Health
  • Public Health Interventions
  • Human-Centered Design

Background:

  • Community health workers (CHWs) are vital for primary healthcare globally, yet often lack influence in program design.
  • Existing health hierarchies marginalize CHWs, limiting the incorporation of their frontline insights.
  • Considering CHWs' needs and ideas can enhance the effectiveness of health programs.

Purpose of the Study:

  • To implement and evaluate a human-centered design process (IMPACT) engaging CHWs in policy improvement for polio vaccination in Pakistan.
  • To assess the impact of CHW participation on program design and worker motivation.
  • To explore facilitators and barriers to incorporating frontline worker innovations in public health.

Main Methods:

  • A human-centered design process, IMPACT, was used with female CHWs involved in polio vaccination (2020-2022).
  • Facilitated idea competitions and workshops engaged over 400 CHWs, with policy suggestions refined with local policymakers.
  • CHWs presented shortlisted ideas to policymakers for selection and implementation; qualitative interviews assessed experiences.

Main Results:

  • 181 policy improvement ideas were submitted, with 9 selected for implementation.
  • CHWs reported high value in the process, noting it was their first opportunity for input and expressing a desire for more.
  • The process boosted CHW motivation and confidence, with implemented changes perceived as helpful, despite being adjustments rather than major overhauls.

Conclusions:

  • The IMPACT process successfully facilitated engagement and collaboration between female CHWs and policymakers in a gender-stratified environment.
  • Structured participatory approaches can empower marginalized frontline health workers to contribute valuable policy innovations.
  • This study highlights the potential of human-centered design to improve global health interventions by valuing the expertise of those at the grassroots level.