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ORIGINAL ARTICLE
Open Access

IMPACT: A Structured Human-Centered Design Process for Integrating Community Health Worker Insights Into Program Policy in Pakistan

Svea Closser, Marium Sultan, Erin Finley, Sue Gerber, Muhammad Shafique, Saeed Ahmed, Imtiaz Ali Shah, Naveed Khurshid, Farah Naz, Sadaf Nayyab, Celena Fei and Ali Sohail
Global Health: Science and Practice June 2026, https://doi.org/10.9745/GHSP-D-24-00050
Svea Closser
aJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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  • For correspondence: sclosser{at}jhu.edu
Marium Sultan
aJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Erin Finley
bThe University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
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Sue Gerber
cIndependent Consultant, Truchas, NM, USA.
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Muhammad Shafique
dSohail Inc., Islamabad, Pakistan.
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Saeed Ahmed
eSohail Inc., Peshawar, Pakistan.
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Imtiaz Ali Shah
fKhyber Pakhtunkhwa Emergency Operations Center, Peshawar, Pakistan.
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Naveed Khurshid
gWorld Health Organization, Peshawar, Pakistan.
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Farah Naz
eSohail Inc., Peshawar, Pakistan.
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Sadaf Nayyab
eSohail Inc., Peshawar, Pakistan.
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Celena Fei
hJohns Hopkins University, Baltimore, MD, USA.
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Ali Sohail
iSohail Inc., Karachi, Pakistan.
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  • Photo caption and credit: During a brainstorming session, community health workers prepare a poster describing their idea to improve polio vaccination. Photo: Sohail Inc., 2021.
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    PHOTO

    Photo caption and credit: During a brainstorming session, community health workers prepare a poster describing their idea to improve polio vaccination. Photo: Sohail Inc., 2021.

  • IMPACT Process Steps
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    FIGURE 1

    IMPACT Process Steps

  • Key Foundational Activities in the IMPACT Process
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    FIGURE 2

    Key Foundational Activities in the IMPACT Process

  • Question Guide to Help CHWs Develop Ideas to Improve Polio Vaccination
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    FIGURE 3

    Question Guide to Help CHWs Develop Ideas to Improve Polio Vaccination

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    TABLE.

    Community Health Workers’ Ideas to Improve Oral Polio Vaccination, by Theme

    No. of Teams Submitting Idea
    Tackle Community Fatigue35
    Hold fewer campaigns and fewer household visits per campaign21
    Streamline data collection and improve data management6
    Other8
    Strengthen Primary Health Care39
    Provide health camps6
    Improve government clinics23
    Improve water and sanitation1
    Implement co-delivery of additional services during polio campaigns9
    Engage the Community38
    Engage religious influencers7
    Manage refusals by doctors and government workers5
    Introduce educational videos7
    Create a polio dial tone3
    Other16
    Improve the Workplace77
    Reduce overtime work10
    Improve processes for receiving workplans5
    Hire more selectively10
    Enhance skills training5
    Implement longer-term contracts7
    Create space to discuss workplace issues4
    Address violence from the community5
    Other31

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Global Health: Science and Practice: 13 (2)
Global Health: Science and Practice
Vol. 13, No. 2
December 31, 2025
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IMPACT: A Structured Human-Centered Design Process for Integrating Community Health Worker Insights Into Program Policy in Pakistan
Svea Closser, Marium Sultan, Erin Finley, Sue Gerber, Muhammad Shafique, Saeed Ahmed, Imtiaz Ali Shah, Naveed Khurshid, Farah Naz, Sadaf Nayyab, Celena Fei, Ali Sohail
Global Health: Science and Practice Jun 2026, DOI: 10.9745/GHSP-D-24-00050

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IMPACT: A Structured Human-Centered Design Process for Integrating Community Health Worker Insights Into Program Policy in Pakistan
Svea Closser, Marium Sultan, Erin Finley, Sue Gerber, Muhammad Shafique, Saeed Ahmed, Imtiaz Ali Shah, Naveed Khurshid, Farah Naz, Sadaf Nayyab, Celena Fei, Ali Sohail
Global Health: Science and Practice Jun 2026, DOI: 10.9745/GHSP-D-24-00050
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  • Article
    • Abstract
    • BACKGROUND
    • COMMUNITY HEALTH WORKERS IN POLIO ERADICATION
    • DESIGNING THE IMPACT PROCESS
    • METHODS FOR EVALUATING THE PROCESS
    • THE IMPACT PROCESS
    • PLANNING FOR SUSTAINABILITY
    • FEEDBACK FROM CHWS AND POLICYMAKERS
    • POLICY DESIGN FROM THE BOTTOM UP
    • Acknowledgments
    • Funding
    • Author contributions
    • Competing interests
    • Notes
    • REFERENCES
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