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Understanding user preferences is necessary to designing effective HIV prevention programs and enhancing demand. The Community Insights program element of the BPS model includes capacity building to systematically and routinely utilize human-centered design (HCD)-guided approaches to gather client and community insights to identify and address barriers to service access and use. BPS adopted and adapted the Community Lab Model as a central pillar of this approach. Grassroots community labs use HCD methods to solicit user preferences and community feedback, which informs better programming, improvements in client-centered care, and creation of feedback loops between communities, the district and city health offices, and facilities. This approach has been adapted in Lilongwe.

Elements of Blantyre’s collection and use of community insights to improve engagement and quality HIV prevention service delivery are:

 

  1. Use of a common data platform (PALMS) is a core element of Blantyre’s integrated community insights and QI approach. PALMS facilities identification of signals that require input from clients to problem solve or further investigate and turn into change ideas for improved service delivery.

  2. Capacitated human resources at district, facility, and community levels. The capabilities built through BPS, including in the Health Promotion Office and facility-based HCD focal persons, and among network committee members, support the governance, technical leadership, multisectoral partnership, and community engagement approaches that are critical to quality, accessible, and patient-centered service delivery

  3. Community lab model. Use of community labs to gather insights from communities and clients about barriers and enablers to service delivery and create solution prototypes has become a critical connective tissue between communities and service providers. Insights have informed delivery changes in Blantyre and national policies, including the PrEP guidelines.

BPS SYSTEMS

WHAT ARE COMMUNITY LABS?

Collection and use of insights from HIV prevention service users and their communities. Grassroots community labs use human-centered design (HCD) methods to solicit user preferences and community feedback, which informs better programming, improvements in client-centered care, and creation of feedback loops between communities, the district and city health offices, and facilities. This approach has been adapted in Lilongwe. Learn more >>

Richard Chilongosi,

Head of HIV Programs, Family Health Services

BPS has created a hybrid approach that brings HCD approaches together with QI. In 2024-25, Blantyre has seen closer collaboration between QI support teams (QIST) and HCD leads at facilities. QISTs now routinely identify issues requiring deeper analysis and channel them to HCD teams, ensuring that QI initiatives are directly informed by community perspectives. The growing alignment between QI efforts and community-derived data has made service improvements more targeted and meaningful.

 

The Network Model program element has been another way the BPS model has brought community insights into HIV prevention data review, program design, and implementation. Learn more.

Lessons learned:

 

  • Facilities can utilize their BPS-supported capabilities to personalize the community lab model and make linkages between their HCD work and other QI actions. They are utilizing skills learned through the community lab model to adapt existing prototypes to meet their context and ensure feasibility. Some facilities iterated the testing process based on the preliminary feedback they were getting from the data.

  • Clustering facilities together creates more efficient coaching and mentorship and enables shared learning and problem solving. Use of a cluster approach has facilitated community lab activities, QI, data use, and skill building.

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