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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
Summary
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.
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.
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