The Challenge
How might we understand and respond to the real needs of Kenyans amidst a global pandemic?
PART 2 COMING SOON!
The Context
In March 2021, months after the COVID-19 vaccine became available in the Global North, doses finally began flowing into the Global South. By June of 2022, Kenya had secured enough vaccines to reach their goal of vaccinating 18.5 million adults and 2.9 million teenagers by the end of the year. But there was a long way to go: Kenya had only managed to vaccinate 30% of the adult population and had only 6 months to triple their vaccination rate.
Though Kenya had some early success in getting people vaccinated, their already limited health system resources had been stretched beyond capacity. Challenges that impacted routine immunisation systems for years, such as a lack of trained human resources, misaligned timing of services, and poor access and infrastructure, also threatened COVID-19 vaccination efforts.
To ensure Kenya’s valuable doses did not go to waste, the Gates Foundation asked us to help them identify the most strategic investments to increase demand for COVID-19 vaccines in Kenya.
As of 13 June, 2022, only 31.3% of the adult population in Kenya, or 8.5 million adults, were fully vaccinated against a goal of 90% by December 2022.
By comparison, other Western countries such as the US, Canada, Germany and France had managed to fully vaccinate 70-80% of their adult population by mid-2022.
To meet their goal of vaccinating the remaining adult population by the end of 2022, Kenya would need to vaccinate at 2.5 times their current rate.
Image by freepik
So why was Kenya struggling to vaccinate their adult population?
What groups made up the 70% of under-vaccinated adults? How might we help them get vaccinated? And given the limited health resources, which of those groups should be prioritised?
What We Heard
The initial premise of this project assumed that with an adequate supply of doses, an investment in demand would unlock coverage. But was demand really the issue? Was supply really that equitable throughout Kenya? What about delivery and access?
To get answers to these questions, we dove into every bit of COVID-19 data in Kenya that we could get our hands on. Not only was the amount of available data vast, but it was rapidly changing, difficult to compare, and rarely made its way into the hands of local decision makers. Crowded and complex coordination contexts generally meant crowded and complex data environments, and vice versa.
Where would leaders battling a global pandemic find the time to sift through and understand all the data to make an informed investment decision?
Our Solution
We reached out to and connected with over 100 individual and collective stakeholders working on COVID-19 in Kenya to see if they could help clarify the data, connect it to real experiences on the ground, and help build a full picture of COVID-19 in Kenya.
In true detective fashion, we connected each piece of evidence with “red thread”, using questions and prompts to help guide stakeholders from one piece of evidence to the next. We then pieced together all the available data into an easy-to-follow narrative that guided overwhelmed and time-strapped decision makers through the available data in an engaging way. This “datascape” gave participants the complete story of COVID-19 in Kenya, the state of supply, delivery, and service design and how these things all connected to shape demand.
Introduction
Before entering the datascape, participants were presented with a clear and concise summary of the challenge facing decision-makers and the purpose of the datascape.
Datascape Overview
The data was organised by topic, visualised as “islands” with names that indicated what the data helped us understand. For example, “The Who Savannah” featured data around groups most affected by COVID-19, while “Vaccination-ville” featured current data on vaccination acceptance, access, and beliefs.
Where gaps emerged, we used risk, health and social behaviour models to create hypotheses about what might be happening across different geographies and population groups. We designed interactive moments within the datascape that allowed stakeholders to strengthen or revise the story with more nuanced or local information.
Island Close-ups
Each island contained cards with data, hunches and questions for our stakeholders to review and add more information.
After puzzling together all we could, we invited county-level stakeholders, representatives from the Ministry of Health (MOH) and health promotion officers from each of Kenya’s 47 counties and other partners from USAID, UNICEF, The University of Nairobi, CBCC, World Vision, and Final Mile to build upon the datascape, adding vital local context and data to bridge the gap between literature and reality.
Our workshop took over 80 national and county-level participants through the data. Images by CT team.
Though messy and laborious, this work was only the beginning. The datascapes and workshops shone a bright light on the fact that the best investment to stop the spread of COVID-19 was not to build demand for the COVID-19 vaccine, but in building up the health system as a whole. The insights that emerged from this first phase laid the first brick for the foundation of what would become a much larger project. Read more about how we’re helping to build the Kenyan Health System, brick by brick, here.
“People are only focusing on COVID-19 vaccination because that’s where the money is coming from. We need to use that money to focus on strengthening the overall health and immunisation system. The money that [donors are] giving the government for COVID-19 has a lot fewer restrictions, but the government needs to see it that way to fix the things that actually need to be fixed.”
Vaccine Programme Director for Kenya,
Implementing Partner
“COVID is not the only problem we are facing. There are other pressing health related problems, therefore, we should focus our efforts on Health Promotion which covers all health related issues instead of COVID.”
County Health Promotion Officer
