{
  "abstract": "Introduction Healthcare delivery should be based on evidence-informed decisions in the clinical, public health, managerial and policy domains. Data are gathered at the point of care via routine health information systems (RHIS). The Paper-based Health Information Systems in Comprehensive Care (PHISICC) project shifted the paradigm from data collection to decision-making, especially decision-making at the point of care by the frontline health workers. We used a human-centred design (HCD) approach to re-design a RHIS that is responsive to the needs of frontline health workers.Methods The PHISICC research programme took place in Côte d’Ivoire, Mozambique and Nigeria and included the design and testing of a suite of paper-based RHIS tools. We report here the results of the HCD process. This was structured into three phases: (1) setup of co-creation group, (2) concept exploration and (3) detailed design phase.Results The concept exploration included a brainstorming session and produced ‘quick paper mock-ups’, such as ideas to follow-up patients’ healthcare. The output of this ‘concept workshop’ was a design hypothesis of the health information system. A follow-up workshop identified the healthcare areas to prioritise. The first round of design developed a version of several tools. The second round consisted of user testing in the three countries. Several iterations were implemented, incorporating health workers’ feedback. Tools were pilot-tested and then produced and distributed for use in a cluster randomised controlled trial.Conclusion The design phase of PHISICC combined HCD with clinical and public health domains. RHIS should be designed by qualified designers, content experts and users who focus on aiding decision-making of frontline health workers, applying a user-centred approach, from problem identification up to solution testing, multidisciplinarity, flexibility, teamwork and trust. We call for researchers, designers, healthcare providers, healthcare authorities and funding agencies to propose and pilot quality standards for the implementation and reporting of HCD in global health.",
  "authors": [
    {
      "affiliations": [
        "Sonder Collective, Madrid, Spain"
      ],
      "name": "Damaris Rodriguez Franco"
    },
    {
      "affiliations": [
        "Sonder Collective, Madrid, Spain",
        "Swiss Tropical and Public Health Institute, Allschwil, Switzerland",
        "University of Basel, Basel, Switzerland",
        "Department of Community Medicine, University of Calabar Teaching Hospital, Calabar, Nigeria",
        "Centro de Estudos Interdisciplinares Lúrio, Universidade Lúrio, Nampula, Mozambique",
        "Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Lagunes, Côte d’Ivoire",
        "Centre de Recherche en Écologie, Université Nangui Abrogoua, Abidjan, Abidjan Autonomous District, Côte d’Ivoire",
        "Ministère de la Santé, de l’Hygiene Publique et de la Couverture Maladie Universelle, Abidjan, Côte d’Ivoire",
        "Université Felix Houphouët-Boigny, Abidjan, Abidjan Autonomous District, Côte d’Ivoire",
        "National Primary Health Care Development Agency (NPHCDA), Abuja, Nigeria",
        "Independent consultant, Abuja, Nigeria",
        "Population Services International (PSI), Luanda, Angola",
        "BCGI LLC / pivot-23.5°, Chapel Hill, North Carolina, USA",
        "Gates Foundation, Seattle, Washington, USA",
        "Department of Microbiology, Faculty of Medicine, Universidade Eduardo Mondlane, Maputo, Maputo City, Mozambique"
      ],
      "name": "Co-creation groups"
    },
    {
      "affiliations": [
        "Swiss Tropical and Public Health Institute, Allschwil, Switzerland",
        "University of Basel, Basel, Switzerland"
      ],
      "name": "Christian Auer"
    },
    {
      "affiliations": [
        "Swiss Tropical and Public Health Institute, Allschwil, Switzerland",
        "University of Basel, Basel, Switzerland"
      ],
      "name": "Meike-Kathrin Zuske"
    },
    {
      "affiliations": [
        "Department of Community Medicine, University of Calabar Teaching Hospital, Calabar, Nigeria"
      ],
      "name": "Angela Oyo-Ita"
    },
    {
      "affiliations": [
        "Centro de Estudos Interdisciplinares Lúrio, Universidade Lúrio, Nampula, Mozambique"
      ],
      "name": "Artur Muloliwa"
    },
    {
      "affiliations": [
        "Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Lagunes, Côte d’Ivoire"
      ],
      "name": "Richard B Yapi"
    },
    {
      "affiliations": [
        "Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Lagunes, Côte d’Ivoire",
        "Centre de Recherche en Écologie, Université Nangui Abrogoua, Abidjan, Abidjan Autonomous District, Côte d’Ivoire"
      ],
      "name": "Salimata Berté"
    },
    {
      "affiliations": [
        "Ministère de la Santé, de l’Hygiene Publique et de la Couverture Maladie Universelle, Abidjan, Côte d’Ivoire",
        "Université Felix Houphouët-Boigny, Abidjan, Abidjan Autonomous District, Côte d’Ivoire"
      ],
      "name": "Mamadou Samba"
    },
    {
      "affiliations": [
        "National Primary Health Care Development Agency (NPHCDA), Abuja, Nigeria"
      ],
      "name": "Abdullahi Bulama Garba"
    },
    {
      "affiliations": [
        "Independent consultant, Abuja, Nigeria"
      ],
      "name": "Anthonia Ngozi Njepuome"
    },
    {
      "affiliations": [
        "Department of Community Medicine, University of Calabar Teaching Hospital, Calabar, Nigeria"
      ],
      "name": "Nnette Ekpenyong"
    },
    {
      "affiliations": [
        "Population Services International (PSI), Luanda, Angola"
      ],
      "name": "Graça Matsinhe"
    },
    {
      "affiliations": [
        "BCGI LLC / pivot-23.5°, Chapel Hill, North Carolina, USA"
      ],
      "name": "David Brown"
    },
    {
      "affiliations": [
        "Gates Foundation, Seattle, Washington, USA"
      ],
      "name": "L Kendall Krause"
    },
    {
      "affiliations": [
        "Department of Microbiology, Faculty of Medicine, Universidade Eduardo Mondlane, Maputo, Maputo City, Mozambique"
      ],
      "name": "Jahit Sacarlal"
    },
    {
      "affiliations": [
        "Swiss Tropical and Public Health Institute, Allschwil, Switzerland",
        "University of Basel, Basel, Switzerland"
      ],
      "name": "Xavier Bosch-Capblanch"
    }
  ],
  "title": "How to design decision-support tools for primary healthcare using a human-centred design approach: the processes and experience of PHISICC in three Sub-Saharan countries",
  "uid": "6a264fdf-dbd2-5da6-8f35-3724ebcc40b9"
}