Actor mapping: A Human-Centered Design approach to understanding the Kenyan immunization system

This is a third story in a blog series sharing insights from a Human-Centered Design research study of the immunization program in Kenya in early 2020. Please read the first story for more context on the work and our approach and the second story for insights around decision-making. A full report of the initial findings is also available for download.

Our team recently conducted interviews with healthcare workers and managers in Kenya to understand challenges around collecting and using data for decision-making in delivering immunization services. One of our core aims was to understand the moments of exchange between actors at different levels of the immunization system.

Human-Centered Design research frequently engages participants in visualization activities to understand complex systems and ideas. To help us unpack how actors interact with each other, what information is exchanged between them, as well as the circumstances for these interactions, the team used an actor mapping activity, outlined below.

During the activity design, simplicity of the process and materials was prioritized. The goal was to make the activity as participant-driven as possible, while still leveraging the information the team already knew.

Based on secondary research and expert interviews, the team identified key immunization system actors at the various levels. Actor cards were printed on color sheets to help differentiate between the various levels (National- pink, County-blue, Sub County-green, Facility-yellow).

Participants were asked to map out who they interact with as part of their immunization work, what information is exchanged (orange text), and what challenges they face (marked above as red dots and text). Finally, we asked them to identify decision-makers within their network (marked as green dots).

Each actor map was different, reflecting the various roles as well as the unique participant perspectives. Rather than focusing on capturing a comprehensive map, this method puts emphasis on accurately reflecting the participants’ mental models.

The information from all the participants was aggregated into a single system map indicating the flow and type of information used.

You can view more information on the Kenya system map and the actor profiles by downloading our initial Kenya findings report. From more insights from this study, stay tuned for additional stories in this blog series.

The Vaccine Data Discovery Research study is a joint research effort between Sonder Collective and John Snow Inc. (JSI) to apply the Human-Centered Design approach in order to uncover and prioritize data specific pain points and challenges that healthcare workers and managers at all levels within a country encounter in delivering immunization services in Kenya, the Democratic Republic of the Congo, and Mozambique.

Sonder Collective specializes in the application of Human-Centered Design to social and health challenges, particularly in low resource settings. The Sonder team has intensive experience conducting design research in maternal and newborn child health, sexual and reproductive health and rights, community health, health supply chains and HIV in Sub-Saharan Africa. John Snow Inc. (JSI) is a public health management consulting and research organization that works to improve health outcomes through strengthening health systems in partnership with country Governments. JSI works across immunization, maternal newborn and child health, nutrition, supply chain system design, paper based and digital information systems globally. JSI has led on immunization on USAID flagship projects like the Maternal and Child Survival Program, TSHIP and has been a key partner on MEASURE Evaluation for the past 20 years.