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Hi Ashley, thank you!

Happy to tell you a little more about how we collected feedback from users. In our innovation we have two sets of users: a) Community Health Volunteers (CHVs) who will use the calendar wheels to personalise immunization wall calendars for caregivers and provide support and advice; and b) caregivers, who use immunization wall calendars to adhere to their child's immunization schedule.

In relation to CHVs, we have existing programming in Malawi, in collaboration with our partner - the MaiKhanda Trust - and have been working with CHVs for many years. Through these experiences we have trained CHVs to support caregivers, particularly women, to overcome barriers to uptake of antenatal, delivery, postnatal and immunization services. For example, they have been successfully trained to identify and track pregnant women, provide reminders on key health service contacts, bring them together in self-help groups and provide emotional, tangible and informational support. These are very similar tasks to those required to support the delivery of the PERCY system, with the key difference being the addition of the calendar wheel tool to help them more accurately provide reminders. These historic programmes have been rigorously evaluated, including through interviews and focus groups with CHVs, and the findings have shown that they are motivated and capable of providing tailored support to pregnant women and mothers. More recently, through an ongoing programme in Salima District, we have conducted small scale group discussions with caregivers to explain the PERCY system in detail, share the calendar wheels and gather specific feedback on this tool. Both historic and recent feedback has been used to refine the concept further.

In relation to caregivers, we have not been able to directly gather feedback to date, but this is planned now that we have secured the essential buy-in from the Ministry of Health (confirmed last week) and have raised the required funds to complete pilot test PERCY on a small scale. In the meantime, we have gathered feedback from 'proxy' users - Malawian technical experts in maternal and child health. We presented the PERCY system in a workshop setting, asked them to imagine they were Mary Banda (our 'ideal user') and walked them through the system. At each step we stopped to answer questions and gather their feedback. This feedback has helped to refine PERCY, but feedback from actual users will still be gathered to triangulate and refine further.

Thank you also for your second query in relation to logistics of how the clock will work. I think you may have confused PERCY with 1-Clock, another innovation that has been submitted to this challenge by Conrad Tankou. I am sure he will be able to provide more detail on this.

Thanks again for your questions.
Best wishes,
mikey

Hi Manish,

Thank you for sharing the link to the 1-Clock innovation. There are clearly some similarities and it has been interesting to see how the idea was originally developed and has subsequently evolved. I look forward to learning more from the 1-Clock team.

Best wishes,
mikey

Hi Estela,

Thank you very much for taking the time to read about our concept and send some queries. In response:
1. We do have a basic calendar template in mind, that is familiar to the majority of Malawians as they will have seen and/or used a similar template either at school, in church/mosque or home. We anticipate that this will be further tailored to the local context with the addition of visual immunization messaging, that draws on local visual norms and understanding. After prototyping and beneficiary feedback we will also be adding: a) national, religious and other events as known milestones against which caregivers can track immunization dates; and b) a checklist of recommended immunizations so caregivers can check those received/ outstanding.
2. Yes to wiggle room! The calendars will be personalised with immunization 'windows' - recommended 1-2 week date ranges in which immunization would be ideal. The caregivers will also receive ongoing visits from community health volunteers, including to provide support if any immunization windows have been missed. The community health volunteers will 'edit' the calendars, if needed, to account for these issues and provide support, if needed, to overcome any challenges that may have prevented adherence to the schedule.