This design report focuses on exploring the opportunities for technology-driven interventions to address health inequalities in children during their first 1000 days of life in Lamu, Kenya. Children’s health during the first 1000 days of life is crucial for their future development and overall health. Interventions that focus on improving health inequalities in the first 1000 days are cost-effective and help to reduce inequalities. In Lamu, Kenya, there is a young demographic and children’s health is worse than the national average, due to financial, geographical, and cultural constraints which make it difficult for communities to access quality healthcare. Technologies and innovation could help bridge the gap between communities and healthcare facilities to improve children’s health. The main research question that this report aims to answer is “How can we improve the healthy start to life in Lamu using available technologies within the local current context?”.
First, a focus for a health challenge for this project is found, which had to be a relevant burden in Lamu in the first 1000 days, be culturally relevant, and present opportunities for technology. After mapping and eliminating health risks and problems in the first 1000 days based on these criteria, two health challenges stood out as relevant and offering opportunities: stunted growth and pneumonia. Experts from the KRCS recommended reframing stunted growth and focusing on (un)healthy nutrition, as it had not been focused on much in the region, was culturally relevant, and had the potential to make a significant impact.
Next, fieldwork interviews, observations and generative sessions were used to understand the context of (un)healthy nutrition in Lamu, as well as the local opportunities for technologies. Lamu is a diverse region with strong informal networks and social cohesion, but food insecurity, lack of awareness on the importance of healthy diets, and healthcare accessibility concerns are challenges. Community Health Volunteers are central in a wider approach to improve community health. Opportunities for technological enablers were found in the widespread adoption of phones, as well as the potential for anthropometric measurement tools as they are available and affordable.
The opportunities that were found from the context research were used to ideate and describe six different intervention scenarios, in which Community Health Volunteers use anthropometric measurement tools to enable various basic nutrition-based health services for children in the first stages of life at the community level. The basics of these scenarios were evaluated and co-created with Community Health Volunteers during the fieldwork. The scenarios vary mainly on the purpose of doing the measurements, how the technological enablers are used, and the impact that is generated. Two scenarios, the community-based growth monitoring scenario and the remote follow-ups scenario, were selected as the most promising after evaluation with local experts from KRCS. Further evaluation on the desirability, feasibility, and viability of these two scenarios resulted in the community-based growth monitoring scenario being identified as the most promising. One of the main barriers to implementing these interventions is the compensation of CHVs, and ways to overcome this issue are suggested. Finally, recommendations are given for further design and implementation