Abstract:
Background: Non-communicable disease (NCD) care in Sub-Saharan Africa is challenging due to barriers including
poverty and insufficient health system resources. Local culture and context can impact the success of interventions
and should be integrated early in intervention design. Human-centered design (HCD) is a methodology that can be
used to engage stakeholders in intervention design and evaluation to tailor-make interventions to meet their
specific needs.
Methods: We created a Design Team of health professionals, patients, microfinance officers, community health
workers, and village leaders. Over 6 weeks, the Design Team utilized a four-step approach of synthesis, idea
generation, prototyping, and creation to develop an integrated microfinance-group medical visit model for NCD.
We tested the intervention with a 6-month pilot and conducted a feasibility evaluation using focus group
discussions with pilot participants and community members.
Results: Using human-centered design methodology, we designed a model for NCD delivery that consisted of
microfinance coupled with monthly group medical visits led by a community health educator and a rural clinician.
Benefits of the intervention included medication availability, financial resources, peer support, and reduced
caregiver burden. Critical concerns elicited through iterative feedback informed subsequent modifications that
resulted in an intervention model tailored to the local contextConclusions: Contextualized interventions are important in settings with multiple barriers to care. We demonstrate
the use of HCD to guide the development and evaluation of an innovative care delivery model for NCDs in rural
Kenya. HCD can be used as a framework to engage local stakeholders to optimize intervention design and
implementation. This approach can facilitate the development of contextually relevant interventions in other low-
resource settings
