Module C: Solve

Welcome to Module C!

Purpose

Module C focused on generating, refining, and prioritising innovative solutions to address immunization challenges identified in previous modules.

What You’ll Achieve

By the end of module C, you will have:

Generated multiple solutions to each priority barrier.
Refined and prioritised solutions for implementation.

What You Need

Room Set-up

Activity #1: Generate ideas

ℹ️ It's time to bring the energy! Generate multiple solutions to address the three to five prioritised barriers per community through a series of creative exercises.

Facilitation Tips:

During the first round of ideation, encourage participants to not overthink, and to generate a variety of ideas without worrying about the details.
As a facilitator, make sure you set a timer and support groups as they generate ideas. The goal is to move quickly. Although participants might feel rushed, encourage them that it’s natural.
If possible, use post-it notes to write ideas and ask everyone to write only one idea per post-it. This will make it easier to identify favourite ideas later.

How to prepare

If you haven’t already, put the Header Poster for Module C: Solve on the main wall.
Present the Inspiration Presentation on the screen or projector. If you are unable to present in the workshop, print a copy for each participant and yourself.
Give one set of Module C: Prompt Cards: Solve to each group.
Give one Table Worksheet: Solution Ideas to each group.
Ensure every participant has lots of post-it notes—they will need these to write their solution ideas.
1. If you don’t have post-it notes, you can give them blank pieces of A4 paper and ask them to draw eight boxes on the paper like this. They will use this to write down different ideas.

📝 If you have a group focused on health system barriers, they will complete the same activities as the other groups, but will focus on solutions for the prioritised health system level barriers.

Facilitation steps

Introduce the “ideation” mindset: use the Inspiration Presentation to introduce the Solve Module, which is all about generating as many ideas as possible to address the prioritised barriers.
- Slides 3 to 4: introduce what ideation is and the rules of ideation.
  - “Ideation is the creative process where you generate as many ideas and solutions to a problem as possible. We are going to use it to think of new and different solutions to address the immunization barriers we have prioritised for the demand strategy.”
  - “It is important to keep an open mind and avoid judging ideas while we are in the process of generating them. The goal is just to come up with as many ideas as possible—good or bad. We will review and refine these at a later stage.”
Explain the difference between a solution and an activity
Slides 5 to 6: explain the difference between a solution and an activity:
- A solution is the main or overarching big idea or approach to address a challenge. For example: “Mobile vaccination sites that travel between communities for key events”, or “Incentive scheme, providing community discounts to local businesses.”
- An activity is a specific action or task that you need to do to implement the solution. For example: “Organise a community workshop to understand where to place vaccination sites” or “Develop communication materials including posters to raise awareness of the incentive scheme.” Activities are essentially the steps you need to do during implementation.
- In our Immunization Demand Strategy, we will be focusing on ideas for the overall solution to increase immunization, not the activity-level. Once we have the strategy, it will be important to think of activities to support implementation planning, but for the immunization demand strategy we will focus on solutions.
- Provide examples to help participants understand how to break down a solution into actionable steps. For example, for the solution ”Have vaccine champions promote vaccines in the community,” activities can include:
  - Identifying trusted influencers within social networks for immunization information.
  - Developing and conducting a clear, jargon-free training curriculum for vaccine champions.
  - Creating mechanisms that allow champions to learn from each other’s experiences.
Lead an ideation game to encourage creative thinking
- Slide 7: use the “Fork” energiser game where everyone has to think of as many ways as possible to use a fork. They can make changes to the fork to adapt what it can do. Encourage them to be as creative as possible.
  - “Think of as many ideas as possible for the question: ‘What are the different ways we can use a fork?’ For example, we can use a fork as a hairbrush, or add speakers to it so it becomes a musical fork!”
  - “No idea is a bad idea! Come up with as many ideas as possible.”
- Set the timer for two minutes to allow everyone to write their ideas down.
- The aim of the game is to have some fun and encourage creativity.
Explain the importance of going beyond communications and awareness-raising
- Slides 9 to 11: explain why we need to go beyond communications solutions only.
  - “When trying to increase immunization demand, we often think of communication solutions, such as posters or TV ads, to increase awareness about vaccination and its benefits. However, a lot of communication solutions have been tried already, and can have limited impact. We need to think more creatively about different types of solutions to the priority immunization barriers.”
- Slides 13 to 14: introduce examples of solutions to increase immunization to inspire thinking. Explain to participants the five case study examples. Explain the problem, the solution, and how it goes beyond communications.
Facilitate “Ideation Round 1” where participants think of their own solutions to immunization barriers
- Slide 19: it’s time to start generating ideas! Use the following steps to facilitate Ideation Round 1:
  - Each group should select one of the prioritised immunization barriers for their community group.
  - Set a timer for two minutes.
  - Individually, each participant should generate as many ideas as possible to solve for that barrier.
  - They should write or draw each idea they have on one post-it note. Ensure they write one idea only per post-it note. If they don’t have post-it notes, they can draw eight boxes on a piece of A4 paper and write or draw a different idea in each box (see “How to Prepare” section of this module for a visual example).
  - Encourage them to think of new ideas or solutions that haven’t been tried, and to think of as many ideas as possible.
- Repeat the above steps for each of the prioritized barriers, until each group has generated ideas for all the barriers for their groups.

Facilitation Tips:

Go around the room and ensure:

Every person is writing their own ideas to solve the barrier.
Encourage everyone to write or draw as many ideas as possible, without thinking about whether the idea is feasible or not. Quantity is key!
Remind participants to only write one idea per post-it note, or one idea in each box drawn on a piece of paper—this will help to prioritise the solutions later.

Use the Solve Cards to develop new, more innovative solutions for priority barriers
- Slides 21 to 23: use the Prompt Cards: Solve to encourage participants to think of newer, more innovative solutions, or improve any of their existing solutions. If not done already, hand out one set of Prompt Cards: Solve to each group.
- Allow time for participants to read through all of the Solve cards. Explain to participants that there are three types of Solve cards:
  - The majority of the prompt cards provide examples of different solutions that could be used to address the immunization barriers. The card explains how the solution works and which of the key immunization barrier categories the solution helps to solve e.g. “Practical Barriers and Experience of Care.”
  - One solve card titled “When in a child’s life” helps participants think about which moment or when in a child’s life solutions should be designed for.
  - One solve card titled “Prioritising your Solutions” helps participants prioritise the solutions generated based on specific criteria.
  - There will be different exercises for each of the different solve cards.
- Ask groups to first look at the Prompt Card titled “When in a child’s life” solutions to each of their priority barriers might have the greatest impact:
  - In groups, go through each priority barrier one by one, and think about when in a child’s life there is an opportunity for solving this barrier.
  - Explain that to maximise impact, efforts to build demand for immunization can begin much earlier than the point of vaccination itself.
  - Ask participants:“When does a caregiver engage with an existing healthcare service that could provide an opportunity to address one of your immunization barriers? This could be:
    - During prenatal care: Are there prenatal appointments a caregiver attends? Are there peer support groups or networks mothers are connected to?
    - During the first month: Do caregivers access health sites for birth or is this typically done at home? Where does birth registration happen? What other health services are they accessing?
    - During 1 to 6 months: Are other family members or friends increasingly involved in care for the child? Are there any traditional or religious events where caregivers and the wider community caring for the child could be reached?
    - During 6 to 24 months: Are families accessing any other health or non-health related services? Is there any other follow-up service or outreach after the final postnatal visit?
    - The goal is to think about potential existing touch points or moments to design a solution around. For example, if during the first one to six months mothers are primarily at home with the baby, your solutions may focus around accessing mothers at home or through their peers.”
- Each group should write down when in a child’s life it would be most suitable to develop solutions for your prioritised immunization barriers. They should think about this as they complete Ideation Round 2.

Facilitation Tip:

Try walking around to each table and asking these questions to each group directly. </aside>

Slide 23:
- Facilitate Ideation Round 2: next, have the participants look at the Solution Solve cards (majority of the pack). Ask participants to discuss which Solve cards or ideas can be used in their context, and set aside any that seem relevant and interesting. Ask them to read each Solve card and think:
  - Could this solution or idea work for any of our prioritised immunization barriers?
  - What parts of this idea could we adapt or change?
  - What new ideas does this inspire?
  - Are there any moments in a child's life when it would be most suitable for a solution?
- Explain to groups: “Each card identifies which immunization barrier categories it is relevant to e.g ‘Trust.’ Use this to match the card to your immunization barriers.”
- Each group should write down any new or improved solutions on post-it notes or blank paper.
Document solution ideas and group similar ideas together
- Slide 24: discuss all ideas from each group, capturing similar ideas together and documenting all the main ideas.
  - Each group should discuss for each barrier:
    - Which ideas are new and haven't been tried before?
    - Are any of your ideas similar to other ideas in your group? For any similar ideas, think about how you can combine them into one main idea.
- Try walking around to each table and asking these questions to each group directly.
- If you haven’t already, give each group one copy of Table Worksheet: Solution Ideas.
  - On the left column, each group writes their three to five prioritised barriers.
  - On the right column, each group adds the post-it notes of all their grouped ideas matched to the barrier it will solve. If they don't have post-its, they can write their ideas in the box.
  - They can write as many ideas as they like, as they will prioritise these solutions in the next activity.

❗Remember, this is not a final list of solutions. We will prioritise again later.

Activity #2: Prioritising Solutions

ℹ️ In this activity, you will guide groups to prioritise the top solutions their strategy will focus on to solve each of their priority barriers.

How to prepare

Ask participants to find and read the Prompt Cards: Solve titled “Prioritising Your Solutions.”
Ensure every participant has a marker or dot sticker to enable them to vote on the top solutions on their Table Worksheet: Solution Ideas.

Facilitation Steps

Prioritise solutions
- Next, ask participants to look at the “Prioritising your Solutions” card. Explain to participants that they will now prioritise their solutions based on these criteria:
  - Acceptable: Will the priority community and healthcare workers like this solution?
  - Effective: Does the solution address the barrier identified? How much impact can it have?
  - Practical: Is the solution realistic in your context? Is it affordable? Can it be implemented with available resources?
  - Sustainable: Will the solution work in the long-term?
  - Equity-focused: Will the solution reach the groups that need it most?
  - Number of barriers solved: Are there any solutions that solve multiple barriers at once?
Thinking about the questions above, each group will vote on their top one to three favourite solution ideas for each of their priority barriers. To help them vote:
- For each barrier, every participant should mark their favourite two solutions.
- Give participants pens or markers or dot stickers so they can add a mark to their favourite solutions for each barrier on their Table Worksheet: Solution Ideas.
- After voting, they should select the top one to three solutions for each barrier.
Ask groups to document their prioritised solutions by writing them down or placing them on the Strategy Summary Poster 3.

❗Remember: To ensure your strategy is focused, it’s recommended to only prioritise one to three solutions per barrier. If groups prioritise more than three solutions per barrier, they may face challenges in, 1) accessing funding for so many ideas and, 2) developing an implementation plan for each of their solutions on Day 3 of the workshop.

Activity #3: Present solutions and identify common solutions

ℹ️ In this activity, you will guide groups to present their prioritised solutions and identify if there are any common solutions across groups.

How to prepare

Give one copy of the Strategy Summary Poster 3 to each group.

Facilitation Steps

Present prioritised solutions and get feedback
- Invite each group to present their prioritised solutions to the larger group, explaining why they chose each solution and how it addresses the key barriers. Ensure each group only presents their prioritised one to three solutions per barrier. The maximum number of total solutions should be 15 per group (three solutions for a maximum of five barriers = 15).
- Other groups should provide feedback to how each group could improve or add to their solution ideas.
- Facilitate a discussion around any common solutions across groups:
  - Make a note of any solutions that are similar across the different groups, e.g. two groups may suggest a mobile vaccination site, or multiple groups may suggest a healthcare worker incentive scheme.
  - If two groups share a similar or the same solution, ask them to combine the solution into one idea for the strategy, or discuss how the solution needs to be further tailored to ensure it's designed for the priority community's specific needs.
  - To encourage discussion between groups, you can try asking:
    - “Are any of the solutions or ideas presented across the different groups similar or the same?”
    - “Could we combine any of our solutions into one idea for the strategy? So instead of having the same solution for different communities, we develop it as one solution.”
    - “Could any of the solutions be tailored to be more unique to the particular needs and barriers of the priority community?”
- If you identify any common solutions across the different groups, either:
  - Move this solution to the Health System group
  - Or, choose one of the community groups who will focus on this solution.
  - The key is to prevent multiple groups developing different implementation plans for the same group in Day 3 of the workshop.
- Each group should document their final one to three prioritised solutions for each of their group's barriers on their group's copy of Strategy Summary Poster 3.
  - The Health System Barriers group should capture the system level solutions using the same poster, mapping the system barriers to the prioritised solutions.
- Once the final list of solutions has been identified for each group, ask participants to discuss within their groups whether the solutions identified could also be used to address any of the other prioritised barriers. Ask them:
  - “One solution can sometimes address more than just one barrier. For example, a healthcare worker's recommendation may primarily aim to address caregivers misconceptions and concerns around vaccine safety. However, if healthcare workers are properly trained, they may also increase trust in the healthcare system among the community, or use their authority in the community to signal increasing cultural acceptance of vaccines.”