Problem

How might we decrease misinformation and increase vaccination rates among communities in the DRC?

Findings

Nurses themselves were subject to misinformation. Elected officials were spreading misinformation and modelling vaccine skepticism.

Method

We conducted an extensive stakeholder mapping to understand the national and local health system. We ran interviews and observational studies with nurses and community members.

Solution

The community was looking to officials to model vaccine safety. Instead of targeting the community directly, we needed to convince nurses to be vaccinated. The nurses will then be able to be models for vaccine safety to the community.

At a glance

COVID-19 Vaccine Training, Design Research

Democratic Republic of Congo

 

As part of the vaccine rollout in the Democratic Republic of Congo, our partner wanted to test our remote training product as a solution to train nurses on the vaccines that would soon become widely available in the country. While the training would predominantly focus on storage and administration, our partner and the Ministry of Health recognized vaccine misinformation was a major barrier to getting the population vaccinated. We conducted user research to understand that and other barriers, and to learn from nurses and community health workers what they believed the path to vaccination was.

From this study, we smashed assumptions and discovered an path to fighting misinformation and equipping health workers with what they needed to be successful.

All photos : Jeanne, UNICEF

 

Project components

 

Study Design, Researcher Training & Support

All the user research was done remotely since COVID-19 measures were still in place. As the design lead, my role was to train and support the researcher remotely. I created guides for our in-country team, including interview guides, and trained our team how to use them.


Remote Content Development Workshop Design

The Human Centered Design research was used to develop content for a remote training. The workshop for this content development, which was hosted with the Ministry of Health, was developed to be run by our country teams. The workshop design was also templated as an improvement to the content development process for remote training.


Reporting & Project Design

All the research findings were synthesized and turned into artifacts which were used in the content development workshop for the participants to build empathy with users. Findings from the report was used to design the project collaboration with our university partner.

 

An early stakeholder map evolved multiple times through the course of the project. Once we were able to speak to health workers we learned where the challenges and bottlenecks were.

For example, people would not self-report COVID cases, and so the system relied on the trust bonds between community health workers and community members to identify potential cases. This trust bond, however, was being eroded because of misinformation. Community members believed that they were being lied to by the government about COVID and if community health workers pushed back, they would be called government agents. In an effort not to disrupt their work on things like routine immunizations, infant nutrition, or malaria prevention, the community health workers were taking a step back from fighting misinformation.

We broke down all the research into Guiding Principles, Reasons, and Reactions, to understand the nature of how health workers have approached the absolutely catastrophic pandemic, lockdowns, job losses, deaths, and community breakdown of the past 2 years. They were resilient and optimistic, and eager for training and support.

 

The interview responses translated into learning objectives for the remote training, and a series of recommendations for how to deliver training in a way that supported health workers with the information they need as well as the strategies for how to combat misinformation without further eroding trust with the community.

 

We created a series of personas for use in content development. These were presented to the Ministry of Health who wrote a training curriculum based on the needs of the users.

Findings & Designs

 

The #1 reason people get vaccinated is if their nurse is vaccinated

The most revelatory finding from our research was that if a health worker was vaccinated, their patient was likely to be vaccinated as well. This altered our strategy altogether and we redesigned the training to focus on convincing health workers (who themselves were hesitant) to get vaccinated.


Behaviour Change communications

Based on our understanding of nurses as feeling duty bound, and understanding that they sacrificed a lot over the past couple of years, we changed our messaging to focus on leadership. We understood that nurses as well as patients are afraid, and acknowledged that this was not unusual. Leadership is not about being unafraid, but about facing fears. We walked nurses through the facts of the vaccine but ultimately convinced them they would need to take the leap. 

Underlying the decision not to be vaccinated is fear, despair, and isolation. As a community, we support those who suffer the most, and help them through their darkest times. Fear, despair, and isolation are at the root of susceptibility to misinformation. Further isolation will only make people dig in deeper. 


Test, test, test

We developed a series of tests to validate the designs of our remote training. We ran pilots with groups of nurses, assessed the results, and implemented based on our understanding of what was most successful.

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