Using Experience Based Co Design to Develop an AI-Powered Digital Learning Platform for Immunization in Pakistan
This study utilized an Experience-Based Co-Design (EBCD) process involving 103 diverse stakeholders in Sindh, Pakistan, to identify critical training gaps and operational barriers among frontline immunization workers, ultimately translating these insights into a blueprint for an AI-powered digital learning platform tailored to low-resource settings.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
Imagine trying to teach a group of people how to navigate a complex, winding maze, but you've never actually walked the maze with them. You might guess where the dead ends are, but you'd likely miss the real obstacles: a slippery patch of mud, a confusing sign, or a locked gate that only opens with a specific key.
This is exactly the problem the researchers in this study wanted to solve. They weren't just guessing what immunization workers in Pakistan needed; they invited the workers themselves to help draw the map.
Here is the story of how they built a new digital learning tool, explained simply.
The Problem: The "One-Size-Fits-None" Training
In Pakistan, the people on the front lines of immunization—vaccinators, community workers, and supervisors—face a tough job. They have to convince families to vaccinate their children, deal with digital reporting systems, and track down children who missed shots.
Think of their current training like a static textbook. It's useful, but it's often:
- Out of date: It doesn't cover the latest rumors or fears families have.
- Hard to reach: Workers can't stop their daily jobs to go sit in a classroom for a week.
- Disconnected: It doesn't teach them how to handle the messy, emotional reality of talking to a worried mother or a skeptical father.
The researchers realized that to fix this, they couldn't just build a "better textbook." They needed to build a smart, interactive guide that fits into the workers' actual pockets and daily lives.
The Solution: Co-Designing the "Digital Compass"
Instead of experts sitting in an office designing a platform, the team used a method called Experience-Based Co-Design (EBCD).
Imagine a group of architects trying to design a new house. Instead of drawing blueprints alone, they invited the future family living there to the table. They asked: "Where do you trip in the hallway? What light do you need in the kitchen? How do you actually move through your day?"
That is what happened here. The researchers gathered 103 people—from the vaccinators walking the streets to the managers running the districts—and held workshops in different parts of Sindh (including Karachi and rural areas).
They used creative tools to get the story:
- Journey Maps: Like drawing a comic strip of a worker's day, highlighting where they felt stressed or stuck.
- Empathy Maps: A way to visualize what workers see, hear, think, and feel when they knock on a door and are told "no."
- Storyboards: Sketching out how a new app should look and feel.
What the Workers Said (The "Aha!" Moments)
Through these workshops, three main themes emerged, acting as the blueprint for the new tool:
1. The "Talk" is Harder than the "Shot"
The biggest struggle wasn't knowing which vaccine to give; it was knowing how to talk to a parent who is scared or angry. Workers felt they lacked the "soft skills" to handle vaccine hesitancy. They wanted a tool that could role-play these difficult conversations, like a flight simulator for tough chats.
2. The "Digital" Gap
Many workers found the digital reporting systems confusing. They felt like they were trying to drive a car without a steering wheel. They needed training that didn't just say "use this app," but showed them exactly how to do it, step-by-step, in their local language.
3. The "Offline" Reality
This was crucial. The workers operate in areas with spotty internet, like trying to stream a movie on a dial-up connection. They insisted that the new tool must work without the internet. If it needs a strong Wi-Fi signal to open, it's useless to them.
The Result: The AI-Powered Digital Learning Platform (AI-DLPI)
Based on these conversations, the team designed a blueprint for a new platform. Think of it as a smart, pocket-sized mentor that never sleeps.
- It speaks their language: All content is in Urdu (and local dialects), not just English.
- It's a "Chatbot" Coach: Instead of just reading a manual, workers can ask the AI a question like, "What do I say if a mother says the vaccine will cause infertility?" The AI gives them a real-time, empathetic answer based on the best training.
- It works anywhere: It is designed to run on low-bandwidth networks and can be used offline, so a worker in a remote village isn't left behind.
- It's scenario-based: Instead of boring lectures, it uses short stories and scenarios that mimic real life, letting workers practice their responses.
The Bottom Line
The paper concludes that you cannot build a successful digital tool for the real world by sitting in a lab. You have to walk the path with the people who use it.
By letting the vaccinators, supervisors, and managers design the tool themselves, the researchers ensured that the final product isn't just a piece of software; it's a practical tool that fits the messy, beautiful, and difficult reality of immunization work in Pakistan. It's a digital compass built by the people who actually need to navigate the maze.
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