One out of every five children don’t live to their fifth birthdays in the Democratic Republic of the Congo (DRC), a country torn by years of war and extreme poverty. The American Refugee Committee (ARC) engaged IDEO.org to help design a way to get better health care to the young children of the DRC, and together we designed Asili, a sustainable business that offers agricultural services, clean water, and a health clinic to its members. By addressing an entire ecosystem of need, from potable drinking water to better seeds to vastly improved health care for children under five, IDEO.org helped ARC impact an entire community. And after an incredibly encouraging start, ARC is already thinking about how Asili might scale.

Asili launched in July 2014 and in the span of mere months had already served a great number of people at its clinic, water point, and agricultural center. Just a few harvest cycles in, farmers are reporting a better yield of potatoes, peas, and beans thanks to the seeds purchased from Asili. Despite their severe poverty, locals are buying into Asili because it works for them. Fittingly, “Asili” means “foundation” in Swahili, and we’re seeing the people of Bukavu build on it. A restaurant, vendors, even preliminary groundwork for electricity have cropped up near the clinic, a clear sign that designing with direct input from a community leads to solutions that are adopted and embraced. Just as importantly, ARC has internalized human-centered design and taken the design principles that IDEO.org devised and brought them to life.

The key to the Inspiration phase, as is so often the case, came from immersing in the context in which the team was designing. That meant weeks of coming to understand the people who live there. The design team knew that of the 20 percent of children who don’t see their fifth birthdays in the DRC, many die preventable deaths from diseases like pneumonia, diarrhea, and malaria. But before they could figure out how to get those kids the health care that they need, they had to better understand the social dynamics around health itself.

Thanks to scores of interviews with the residents of Bukavu, the team came to insights that would guide Asili’s design. One insight came from a woman who said that she used to seek prenatal care for her child, but she stopped because she never knew how much it would cost. The team realized that her child’s future could be drastically improved with a little more clarity at the clinic, and from there, they knew that transparency and reliability had to be core to the solution. 

Because the design team talked to lots of people, and because they knew that they’d have to anchor the service model deeply in the community, they decided to learn more and test some of their ideas with a co-creation session. While conducting interviews in the Inspiration phase, the team met with dozens of people, but seven women in particular stuck out.

So the team invited them to a two-day workshop where the women joined the process and helped design the service, brainstorming a name, a logo, and more. The two days were incredibly fruitful, with the women quickly jumping into the roles of designer, prototyper, and problem solver. By inserting these community members directly into the design process itself, the team came to grasp so much more than it could have by simply interviewing them. They learned about social dynamics in Bukavu, how power should be balanced throughout the community, and how a service that treats people like consumers might have a chance at sustainability.

Armed with the desires and ideas of the community, the design team returned to San Francisco with a clear vision of how Asili should work, how it should communicate, and how it might make money. So after a few more furious weeks of designing the system, service, business, identity, and more, the design team turned an Asili roadmap over to ARC.

Together with ARC, IDEO.org’s design team devised a full-on sustainable business tailored to meet the realities people in the DRC face every day. It extended from a business model to a staffing structure, launch plan, and all components of the service.

As ARC set Asili in motion, bringing it to market in one of the world’s poorest countries, they went far beyond the playbook that IDEO.org laid out. Instead, ARC took a human-centered approach to implementing the vision for Asili. A perfect example is how ARC continued to build on the design principle that transparency is key. Though the team designed clear signage with posted prices, ARC realized that the Asili clinic could even better serve the community if it had a patient’s bill of rights. Through close collaboration with IDEO.org, ARC deeply understands how to implement, adapt, and grow Asili as it continues to build out the multi-offer service.