Project Foundation and Boundaries

Your Why
You have seen firsthand, through your work as a public health professional, how preventable diseases continue to affect children because of missed immunizations, delayed follow-up, and gaps in health information. During your training and field experience, you observed that healthcare workers spend valuable time on manual records instead of patient care. This gap is what drives you: you want to contribute to a stronger immunization system that helps protect every child and supports healthcare workers in delivering quality services. You are particularly motivated to improve childhood immunization coverage and reduce missed vaccinations for children in underserved and hard-to-reach communities in Kenya, where you want healthcare workers to have better access to timely, accurate information so they can identify children who need vaccines and manage immunization services more effectively.
Your Project's Purpose
Help children in underserved and hard-to-reach communities in Kenya move from missed immunizations and delayed follow-up toward complete vaccination coverage. You want healthcare workers to have timely, accurate information so they can identify which children need vaccines, manage immunization services more effectively, and ultimately improve health outcomes for families. This change matters because preventable diseases continue to affect children when immunizations are missed, and because healthcare workers currently spend valuable time on manual records instead of direct patient care.
Your project can influence immunization record management, identification of children who miss scheduled vaccines, healthcare worker access to better data, and strengthened follow-up and decision-making. What lies outside your control includes vaccine supply shortages, government funding, transportation challenges, natural disasters, community beliefs, and parents' personal decisions about immunization—all of which require collaboration among government, health facilities, communities, and other partners.
What You Bring
Experience and knowledge: You have studied public health and gained practical experience through community work and health facility attachments, and you have observed that immunization services in your context still rely heavily on paper-based records, making it difficult to track children who miss vaccines, monitor vaccine stock, and generate timely reports.
Prototype and user insight: You have developed a working prototype and gathered feedback that has helped you understand the needs of healthcare workers and immunization programs.
Relationships and access: You have access to participation from healthcare workers, parents and caregivers, community health promoters, health facility managers, immunization program coordinators, county and national Ministry of Health officials, and technology partners.
Understanding of scope: You can identify which parts of immunization system strengthening your work can influence—improving record management, identifying children who miss scheduled vaccines, supporting healthcare workers with better data, and strengthening follow-up and decision-making—and you recognise what lies outside your project's control, including vaccine supply, government funding, transportation, natural disasters, community beliefs, and parents' decisions about immunization.
User-centred approach: You are prepared to involve healthcare workers, parents and caregivers, and community health promoters in deciding which features are most useful, how reminders should be delivered and timed, how the system fits into existing workflows, what information should be displayed, and how to make the platform simple and accessible.
Capability to refine: You expect to refine your approach as you continue testing and receiving feedback, and you recognise that many aspects of your solution may still change, including specific features, user experience, implementation methods, and integration approaches.
Where You Must Begin
ConstraintWhat it means for where I startAccess to people and communitiesYou depend on participation from healthcare workers, parents and caregivers, community health promoters, health facility managers, immunization program coordinators, and county and national Ministry of Health officials. You must begin by confirming you can meaningfully engage each of these groups; their knowledge and feedback are essential to ensure the system is practical and addresses real challenges in immunization service delivery.Technology partnersYou depend on access to technology partners. You must begin by establishing what capabilities and constraints they bring, and confirm their involvement before proceeding with design decisions about automated SMS reminders and platform features.User-led feature prioritizationYou must begin by having healthcare workers, parents and caregivers, and community health promoters help decide which features are most useful and how the system should work. This feedback must guide improvements throughout development and testing rather than being sought after decisions are made.SMS delivery and timing decisionsYou must begin by working with users to determine how SMS reminders should be delivered and timed, rather than making these choices based on assumptions about what will work in practice.Workflow integration and accessibilityYou must begin by understanding how the platform fits into existing workflows and what information should be displayed, and by ensuring the solution is made simple and accessible based on user input rather than designer assumptions.The participant did not specify constraints related to time, funding, materials, testing environments, data and evidence, or safety and regulatory support.How You Think the Change Happens
Chain of steps: You believe that if healthcare workers have a simple and reliable system to register children, monitor immunization schedules, identify defaulters, manage vaccine stock, send automated SMS reminders to parents and caregivers, and access accurate reports, they will provide more timely and efficient immunization services; SMS reminders can reduce missed appointments; and together these improvements could reduce missed vaccinations, increase immunization coverage, strengthen decision-making, and ultimately improve child health outcomes in Kenyan communities.
Greatest uncertainty: You identify the greatest uncertainty as whether healthcare workers and caregivers will consistently use and respond to the system and its SMS reminders, and you note that successful implementation also depends on adequate training, reliable mobile network coverage, internet or power where needed, integration with existing health systems, and continued support from health authorities — all assumptions that will need to be tested and refined through pilot implementation and user feedback.
Key actors: Your pathway depends on the experience and participation of healthcare workers, parents and caregivers, community health promoters, health facility managers, immunization program coordinators, county and national Ministry of Health officials, and technology partners, whose knowledge and feedback you consider essential to ensure the system is practical, easy to use, supports automated SMS reminders effectively, and addresses real challenges in immunization service delivery.
User decisions: Healthcare workers, parents and caregivers, and community health promoters should help you decide which features are most useful, how SMS reminders should be delivered and timed, how the system fits into existing workflows, what information should be displayed, and how the platform can be made simple and accessible, with their feedback guiding improvements throughout development and testing.
What You'll Test First
First assumption: You will test whether healthcare workers, parents and caregivers find the LMICIS system easy to use, useful in their daily routines, and whether automated SMS reminders help caregivers bring children for scheduled immunization appointments, and whether the system fits into existing healthcare workflows without increasing the workload of healthcare workers.
What you need to learn: You need to learn whether the system improves immunization follow-up, reduces missed vaccination appointments, and is accepted by healthcare workers and caregivers, and you need feedback on usability, accuracy, reliability, and the effectiveness of SMS reminders.
Your decision rule: You will continue the project as planned if these tests show the system creates meaningful value for the people it is intended to serve; you will revise it to better meet users' needs, pause it until key challenges are resolved, or stop it if it does not create meaningful value, based on what the feedback reveals.