Strengthening Interpersonal Relationships in Maternal and Child Health Care in Rural Tanzania: Protocol for a Human-Centered Design Intervention

Kahabi Isangula, Constance Shumba, Eunice S. Pallangyo, Columba Mbekenga, Eunice Ndirangu-Mugo

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


Background: Evidence indicates that clients' dissatisfaction with providers' competencies within maternal and child health (MCH) continues to impact trust in formal health care systems, service uptake, continuity with care, and MCH outcomes. A major problem with existing interventions is the failure to address all the complexities of provider-client relationships necessitating targeted, contextualized, innovative solutions that place providers and clients at the forefront as agents of change in optimizing intervention design and implementation. To improve the provider-client relationship, the Aga Khan University is piloting a human-centered design (HCD) intervention where MCH nurses and clients are invited to partner with researchers in the intervention design and evaluation process. Objective: The objective of this research is to co-design an intervention package (prototype) for improving nurse-client relationships in the rural Shinyanga region of Tanzania using a series of iterative HCD steps, involving key stakeholders to tailor solutions for complex problems impacting provider-client interactions in MCH care. Methods: The following 5-step HCD approach will be implemented: (1) community-driven discovery through qualitative descriptive research methods using focus group discussions and key informant interviews; (2) co-design of an intervention package through consultative ideation and cocreation meetings with nurses, clients, and other stakeholders; (3) prototype validation through qualitative insight gathering using focus group discussions; (4) refinement and adaptation meeting; and (5) documentation and sharing of lessons learned before the final prototype is tested and validated in a broader community. Results: A prototype characterized by a package of interventions for improving nurse-client relationships in MCH care in rural contexts is expected to be developed from the co-design process. Conclusions: An HCD approach provides a novel entry point for strengthening provider-client relationships, where clients are invited to partner with providers in the design of acceptable and feasible interventions.

Original languageEnglish
Article numbere37947
JournalJMIR Research Protocols
Issue number7
Publication statusPublished - 1 Jul 2022


  • Africa
  • Tanzania
  • child
  • co-design
  • community-based
  • focus group
  • human-centered design
  • human-centred design
  • maternal
  • maternal and child health
  • maternity
  • mother
  • nurse
  • nurse-client relationship
  • nurse-patient
  • nursing
  • primary care
  • primary health care
  • prototype
  • provider-client
  • provider-patient relationship
  • rural
  • user-centred design
  • validation


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