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HCD for Urban Health

A UNICEF-backed evidence and co-design initiative to build a scalable, user-centred model for primary health care delivery in urban Dar es Salaam.

The Challenge

Tanzania's health system was designed largely for rural contexts, leaving urban primary health care in fast-growing Dar es Salaam struggling with overcrowding, fragmented digital systems, staff shortages, and low trust between public and private providers — with no locally grounded evidence base to guide a Dar-specific PHC model.

Our Approach

We combined a systematic scoping review of 116 studies from across Sub-Saharan Africa with an extensive qualitative assessment — 45 key informant interviews and 14 focus group discussions across five municipalities — then brought this evidence into a multi-day HCD co-creation workshop with over 100 stakeholders, from health management teams and CHWs to pharmacists and people with disabilities, who prioritized barriers and prototyped solutions together.

The Outcome

The process produced a validated set of barriers unique to urban PHC and a portfolio of implementation-ready ideas — from a standardized CHW referral tool to space-reorganization plans and health-financing reform — now shaping Dar es Salaam's forthcoming urban PHC service delivery model and implementation roadmap.

Project Snapshot

Sector: Health

A UNICEF-backed evidence and co-design initiative to build a scalable, user-centred model for primary health care delivery in urban Dar es Salaam.

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