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Royalty rewards to address Barriers to effective uptake and provision of immunization for ECDE centers caregivers in Kiambiu Nairobi slums

Incentives for caregivers to increase immunization and address immunization apathy due to after effects arising issues after immunization

Photo of Keneth Mitambo
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Describe what you intend to do and how you'll do it in one sentence (required 250 Characters)

ICRI Africa/STAMP CLEANTECH intends to intensify a royalty program that builds caregivers levels of understanding and acceptance of routine immunization, address fears and misinformation, and re-establish trust in the routine immunization program

Explain the idea (less than 2,000 characters)

In the previous years the Government of Kenya and other stakeholders intensified immunization for Polio and other diseases. In 2017/2018 many caregivers reported adverse effects following Immunization (AEFIs), including fever, injection site swelling, skin rash, abscesses, convulsions and cough. Due to lack of knowledge regarding the AEFIs from the different vaccines, bad attitude and arrogance from government health workers it resulted in decline in the uptake of immunization and apathy. The Researcher observed that many caregivers with children in the ECDE developed anti-vaccine sentiments. To mitigate this the researcher designed a royalty program to reward parents for vaccinating their children, secure health records, document adverse effect of the vaccines to inform future interventions. Caregivers were encouraged to name the AFIs using a language they best understand (local dialect) communally spoken. For each record the caregiver earned 10 points redeemable as a discount for school fees in the ECDE supported by ICRI. The Royalty card success will be expanded to cover partner ECDE programs, loop in early childhood service products providers where caregivers will get discounts for diapers, art and play materials. Caregivers will be awarded a recognition certificate which will lift their self-esteem, earn respect within the community and team intends to train them as Royalty card champions. The royalty Program is enabling development of I.E.C s through community participation in form of visuals and documenting the same in future in a cloud based system. A caregiver traveling anywhere will be only be required to use biometrics to enable any health service provider access photos showing child immunization history. The royalty card is being refined to be pendant that is worn as a necklace, or a bungle by the child and the caregiver. And a badge for the children. The innovator and end-users are working at using waste paper sludge to develop an eco-friendly pendant.

Which part(s) of the world does this idea target?

  • North Africa
  • Eastern Africa
  • Middle Africa
  • Southern Africa
  • Western Africa

Geographic Focus (less than 250 Characters)

Initial target was Kiambiu slum (Nairobi) where the pilot was run. In future will roll out to other communities in different African settings to facilitate other data collection that will inform mobilization for total adherence to immunization.

Who are your end users and how well do you know them? (750 characters)

ICRI has operated ECDE centers and programs through partnership in various Nairobi informal settlements in Kenya and has a strong working relationship with the host communities. Key assets and strength:-Community good will, Human capital (youths, gatekeepers) Innovators and artists in the slums, a community that has always being responsive when it comes to Being empowered through capacity development and skill transfer. ICRI / innovator pro poor policy is empowering the caregivers to be part of the solution a design thinking process rather than trying bringing solutions designed elsewhere. The community takes lead in all ICRI initiatives in an elaborate stakeholders engagement and support of the government’s early childhood development.

How is the idea unique? (750 Characters)

The uniqueness of the royalty program is the community involvement in design work, capturing of the child development, data is captured and responses done using a commonly understood language by each caregiver. Photos enable health service provider have a pictorial view of immunization after effects and health bio data. The royalty card is in form of a necklace pendant that are widely accepted and are locally made from waste paper sludge by the caregivers. It enables caregivers get discounts for services and products in a royalty kiosks. Caregivers earn points becoming community health champions, caregivers get recognition certificates as health champions. Caregivers and children participation in the design process is core.

Idea Proposal Stage (Select 1)

  • Prototype: We have done some small tests or experiments with prospective users to continue developing the idea.

How many months are required for the project idea? (140 characters)

12 months to fully develop and test the prototypes and acquire quantitative results. This will involve improving the design process.

Organization Name (less than 140 characters)

International Child Resource Institute -Africa and STAMP CLEANTECH LTD

Type of Submitter

  • We are a registered NGO or Non-Profit Organization

Organizational Characteristics

  • Female-led organization
  • Women’s health/rights focused
  • Indigenous-led organization
  • Youth-led organization
  • Locally/community-led organization
  • International/global organization (implementing in multiple countries)

Organization Location (less than 140 Characters)

ICRI Africa is registered in Nairobi Kenya with a local board and local staff. It's also related to ICRI based in California USA

What is the current scale of your organization’s work?

  • Global (within 2 or more global regions)

Website URL and

Tell us more about your organization/company (1-2 sentences)

ICRI operates early childhood education, water, sanitation and health, and nutrition programs in some of the most challenged settlements in Kenya urban informal settlements. Key is a child and Family Park, expansion of our early childhood and child health programs, improvement of water and sanitation systems, and utilization of ICRI locally developed early childhood centers as community center buildings. STAMP Cleantech is a Kenyan award winning innovation startup in Health and water

Who will work alongside your organization in the project idea? (750 characters)

Kiambiu slum caregivers and ECDE center run through a CBO. STAMP Cleantech in developing the technology, social enterprise model, Training caregivers through a design thinking process and currently caregivers developing pendants from waste paper and charcoal briquettes. Elerai global services for provision of Solar Wi-Fi for the E-Smart drums , Health service providers from government , private and community based , Local artists, Last Mile entrepreneur’s (caregivers) , Ma-Herbs IT and data analyst. Caregivers will be linked to NHIF and ICRI will subsidize NHIF rebate for those with high royalty points. FBOs and community opinion leaders who play a critical role will be trained in mobilization, sensitization for entry and sustainability.

How many people are on your team?


Tell us more about you and your team

Keneth Ndua :- ( Social Impact Specialist). Award winning global innovator in health and social impact and advises ICRI Kenya Country director in strategy and programs. Leading design thinking processes. Ann Rubia: - ICRI Kenya CD. Been part of the ICRI team since 2006, first as a volunteer receptionist, later worked as Finance and Program Officer. She holds a Diploma in Community Development and Social Work. Ken Jaffe: - Founder $ Global Director. Author of numerous articles on international early childhood education, child advocacy and family policy issues. Has assisted in the improvement or establishment of family health, programs worldwide. Rachel Wairimu Social worker specializing in converting waste into viable products. Trainer, outreach. Linkage with caregivers Mary Ndawa; - Final year Medical student Nairobi University. Health educator and community outreach. Beatrice Wangeci. Social procurement and value chain expert. Training LMEs on e-smart drum. LMEs /caregivers

Overview of How Your Concept Has Evolved (5-6 sentences):

Caregiver’s feedback informed widening the scope of royalty points to cover to redeem points for food items. They also requested if possible to integrate of the royalty program to enable caregivers monitor ARV adherence process. App will be redesigned with ease of access and a USSD for those without smartphones. The data collection tool would also be expanded to cover their livelihoods ventures, feedback loop and growth monitoring in ECDE and for children at home aged 0-2 years. The E-Smart drums will now be owned by caregivers in groups to generate income. The idea is clearer and understood caregivers are now incorporated in the design process particularly in the paper Mache conversion into pendants.

Viability (3-4 sentences and activity upload): The business Model Canvas will enable the project to run a social enterprise model which will lead to sustainability. The same model will be developed for the LMEs for ease of follow up and business growth. This will also make easy the MEL process and replication. The BMC will also inform the social enterprise model for partner Organisation.

Feasibility (3-4 sentences):

Initial plans tested the royalty card and a simple e-smart drum. From caregivers feedback on the design on the project changes has been effected to improve the process. Caregivers will have more ownership E-Smart drums with commodities, distribution of the Royalty cards, mobilization process, and building of a larger network. Caregivers will be the last mile entrepreneurs and will be trained in MEL. The design team was expanded to include local artist in redesigning the program processes. A collaborative design process will be done biannually to evaluate and feedback on the project.

Desirability (3-4 sentences and activity upload):

Caregivers expressed misgiving with the current government of Kenya immunization process which was closed and non-responsive when questions arose through defending flaws. Involvement and suggestions on community education, mobilization is vital and response from health service providers to address apathy towards immunization was lacking. The pilot observed a community that’s close, have a localized coded language that's not understand easily by outsiders. They also have diverse cultural, religious, social and family beliefs. These lessons have informed greatly the intervention, future expansion and sustainability. The team will record and use emerging issues to improve the process and have team conduct scientific studies on the same.

Community Focus (2-3 sentences):

Missed and double vaccinations for lack of records exposed children to preventable viral / bacterial infections. The community identified cost of treatment of children costly and resulted to death in some instances yet this was preventable if vaccinations were administered correctly. The health cost depleted their assets and livelihoods exposing them to shocks. Encouraging immunization reduced child mortality and morbidity. This would mean more income, increased wellbeing, reduced vulnerability, and improved food security, more sustainable use of natural resource base.

Community Impact (2-3 sentences):

The Royalty program as an intervention presents an opportunity to record additional information related to the health of the families/mothers of the children being immunized e.g. on ARVs for HIV management , increased adherence to immunization schedule up-to-date HMIS, reduced health costs, low morbidity among children. Improved HH wellbeing and secured livelihoods. From initial 25% to 75% acceptance rates was an achievement. Sustainability through community led design to improve the innovation, income from e-smart drums /pendant, licensing as a source of income and MEL system synced daily.


Join the conversation:

Photo of Estela Kennen

I forgot I had one more question. What data are you planning on selling, and what is your process for obtaining consent to do that? Thank you!

Photo of Keneth Mitambo

This was an oversight. We will relook at it. Should have read sharing of analyse data on health and immunisation uptake for learning purposes.

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