by Yuting Lien, Summer Consultant
In the South African province of KwaZulu-Natal (KZN), the HIV infection rate is among the highest in the world. Local clinics offer free information, testing and other services, but many people refuse to visit them.
In Zambia, Community Health Workers (CHWs) serve a crucial role in Last Mile Delivery of healthcare services. Yet most CHWs do not understand the efficacy of their services, or even the true demand.
And in Kenya, young girls living in poverty have the potential to help develop their communities – but they struggle to connect with each other.
Why?
Robert Fabricant, VP of Creative at frog design, argues that the reason could be the “engagement gap” – a mismatch between a problem and its existing solutions. At the second New York-based D. Talks held last month, Mr. Fabricant spoke about how user-centered design – a process that highlights the needs, wants and limitations of end users – could help fill this gap. Frog has used this design process to foster mobile solutions in healthcare and poverty alleviation.
Consider the HIV epidemic in KZN. In a population of 10 million, of which an estimated 4 million people are infected with HIV, only 500,000 have been tested and know their status – a mere 5%. And of the estimated HIV-positive population, only 5% are currently in treatment, with a 40% default rate over two years.
The frog team set out to better understand their target audience – largely low-income, young South Africans – and develop a solution that would maximize engagement. Awareness was the first step, and in a country where 80-90% of the population has access to a cell phone, mobile technology was an ideal delivery channel. Partnering with local NGOs and mobile companies, including iTeach, Praekelt, MTN and PopTech, the frog team developed a campaign that delivered HIV awareness information via “Please call me,” a type of text messaging commonly used in low-income communities. The messages contained direct links to HIV/AIDS counseling services, tripling the number of daily calls to the National AIDS Helpline.
But awareness was just the beginning. The low level of HIV testing, despite the availability of free clinics, was a critical concern. In particular, young men were absent from the system. By engaging directly with this group, the frog team learned the reason behind this was that young people were ashamed of being seen at the free clinics, and, instead, wanted to test in private.
In response to this finding, frog collaborated with on-the-ground partners and piloted an innovative HIV self-testing kit. To reduce stigma and maintain cultural relevancy, the team recruited local celebrity endorsers, and made sure that the packaging included a compelling call-to-action that directs users to a mobile hotline. To facilitate scalability, the kit uses off-the-shelf diagnostics and modular packaging that can be made out of low-cost, locally-available materials. The initial response from focus groups has been overwhelmingly positive.
Across Africa, frog has used similar participatory processes in the realm of healthcare and poverty alleviation. In Zambia, frog collaborated with UNICEF to help Community Health Workers collect and use data to better serve their patients. Frog also conducted workshops with young girls in Kenya to understand how they liked to communicate, and designed mobile applications to help them collaborate and share ideas across physical distances.
By directly engaging populations to develop user-centered designs, frog has helped drive solutions toward problems that affect much of the developing world. 
Mr. Fabricant presented at D. Talks, a forum that brings together the development community in each city where Dalberg is located. D. Talks aims to drive dialogue and critical thinking on global development issues and provide networking opportunities within the community. Angela Rastegar and Dan Zook are based in Dalberg’s New York office and serve as the New York D. Talks coordinators. For information on upcoming D. Talks events, please visit dalberg.eventbrite.com.
