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System Design for Campaign Effectiveness

Understanding how various systemic factors can impact effectiveness and drive behavior throughout the global ecosystem for infectious disease management campaigns.


The Bill & Melinda Gates Foundation

My Involvement

16 months

My Contributions

Primary & Secondary Research, 

System Mapping,

Program Development


Gwen Gage, Caroline Garry, Taylor Cook,  Stephanie Morgan, Lauren Gardner, Stacey Chang,

Caroline Kusi

The Problem

The Bill & Melinda Gates Foundation provides more than a billion dollars in funding for global health intervention campaigns aimed at managing infectious diseases. These campaigns are planned and delivered by a vast ecosystem of global organizations and country-level partners.The current situation results in the delivery of these health interventions being highly fragmented and leading to missed opportunities for efficiency gains and the ability to share best practice across global and country-level partners.

The Grand Goal

This Systems Design for Campaign Effectiveness work-stream was part of the broader Systems Design for Global Health effort by the Gates Foundation including project partners: The Task Force for Global Health, Linksbridge, R4D. Each project partner had their own scope but contributed towards the launch of the Health Campaign Effectiveness Coalition.

Our Scope

Our team at the Design Institute for Health was brought on to:

• Understand how various tangible and intangible factors can impact effectiveness and drive behavior throughout the system.

• Identify and investigate collisions and points of friction between stakeholders.

Surfacing System Dynamics

During the initial phase of the project, our main goal was to comprehend

the ecosystem of the top 10 annual infectious disease intervention campaigns.

We achieved this by mapping the global landscape for each health intervention, analyzing the relationships and interactions among the key actors in the ecosystem. This process allowed us to observe intriguing system feedback loops. The early patterns we discovered in this phase helped us identify areas for further investigation in the next phase of the project.

Refining the Research Focus

Two Disease Categories

After getting an overview of the global ecosystem for the top 10 infectious diseases, we chose to focus on one Vaccine-Preventable Disease (VPD) and one Neglected Tropical Disease (NTD). Polio was selected as the VPD and Schistosomiasis as the NTD.

Two Country Archetypes

We then chose to compare those disease across two different country archetypes, one representing a weaker national health system and one a stronger more developed national healthcare system.

Liberia was chosen as the lower capacity context and Ghana as the higher capacity.

Throughout this phase we interviewed 88 subject matter experts and engaged stakeholders across different levels of the system.

Juxtaposing Different Contexts

We analyzed and compared the stakeholder landscapes and annual campaign process cycles for Ghana (strong health system) and Liberia (weak health system) for both Schistosomiasis and Polio. These system maps that we created became one of our key deliverables, a tool for alignment during stakeholder convening and campaign planning.

We also created a revised global ecosystem map for Schistosomiasis and Polio showing the various value exchanges of the global health organizations involved in these disease campaigns.

Planning & Launching a Global Coalition

Our team contributed to the grander goal of the Health Campaign Effectiveness Coalition in 3 ways:

The Final Systemic Insights Report

Our systems research culminated to several opportunity areas that the global health partners can pursue to catalyze systemic change towards a more coordinated and effective campaign ecosystem. The Health Campaign Effectiveness Coalition is still thriving to this day, providing systemic best practices to Ministries of Health from all around the world.

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