Using a Human-Centered Design Approach to Determine Consumer Preferences for Long-Lasting Insecticidal Nets in Ghana

"Our human-centered design approach yielded consumer insights and preferences for novel LLIN designs for the private-sector retail market in Ghana."

This research paper, published in the Global Health: Science and Practice journal, describes how a human-centred design (HCD) approach paired with traditional research methods was used to explore consumer preferences of middle-class Ghanaians for long-lasting insecticidal nets (LLIN). Conducted as part of the Private Sector Malaria Prevention Project, the aim of the research was to design a net for the private-sector retail market, as well as to get a better understanding of some of the reasons for lower use of LLINs despite access within this population.

The paper describes the research process in detail and how the researchers used HCD in conjunction with traditional methods of quantitative and qualitative research (e.g., household surveys and focus group discussions [FGDs]). To contextualise the research, the researchers first conducted a literature review, a market analysis, and a series of supplementary interviews with key stakeholders. The main HCD research was undertaken in March 2017, where researchers conducted 9 FGDs with urban and rural middle-class Ghanaians across Ashanti, Greater Accra, and Western regions. A total of 78 participants (51 adults and 27 boarding school students) were involved in the focus groups. Participants were asked for their input on topics related to malaria prevention, LLIN perceptions and use behaviour, and general consumer preferences related to the home and bedroom. They participated in a variety of exercises, such as rank ordering their preferences of various accessories that might be bundled with an LLIN, and interacting with actual LLINs of different sizes and designs. The data were gathered and analysed, using micro-interlocutor analysis framework to capture emergent themes.

The paper outlines the series of steps followed as part of the HCD process: Empathise (engage with stakeholders to understand their circumstances and thinking), define (identify insights to refocus and redefine the challenge at hand), ideate (generate ideas and solutions), prototype (create low-fidelity prototypes of ideas for testing), and test (test prototypes and use information to continue to refine ideas and solutions). It describes how the use of the HCD approach allowed researchers to tap into or discern latent preferences for a consumer product that does not yet exist and that still needs to be developed. As explained, "HCD was especially helpful because it encouraged individual participants to express thoughts and feelings about their experiences related to LLINs and malaria that would be more difficult to capture in other ways. For example, exercises and activities were designed to allow participants to brainstorm, imagine, and share intimate details regarding their domestic behaviors and routines. The result was a rich mix of data and the identification of key consumer insights regarding middle-class Ghanaians' perceptions of self, their behaviors and attitudes related to malaria prevention, and their use of LLINs."

Research results showed that LLINs are currently available through free distribution channels, but in most accounts, participants reported that the nets were inconvenient, uncomfortable, and not aesthetically pleasing; thus, they were undesirable to use. For example, several participants described the process of hanging, entering, and exiting the LLIN as challenging, stressful, and/or tedious. In addition, use of LLINs was considered to make people feel even hotter in an already warm climate and to leave users feeling confined within a small space. Finally, many participants discussed how to improve the look of LLINs, including suggestions for additional colours, shapes, and hanging mechanisms to make the LLINs more compatible with their desired bedroom and home décor. Based on the participants' responses, the researchers concluded that middle-class Ghanaians would prefer LLINs that better reflect contemporary sensibilities. They therefore devised and tested different LLIN attributes to address these points, focusing on a more convenient way to hang the net, a more attractive silhouette, and a zipper that allows the user to enter and exit with ease while still maintaining a sealed, mosquito-free space. A separate discrete choice experiment confirmed the attractiveness of these attributes by capturing the population's willingness to pay for LLINs with these preference-congruent attributes.

In conclusion, the paper explains that the consumer insights and preliminary ideas for the new design features were shared with global manufacturers who supply LLINs in Ghana. The researchers hope that these partners will take this information into consideration as they make decisions about current and future LLIN supply, demand, and marketing and that they will pursue pilot testing of new net designs for the private-sector retail market in Ghana.