One out of every five children won't live to his fifth birthday in the Democratic Republic of the Congo (DRC), a country torn by years of war and extreme poverty. Worse yet, they're dying of preventable diseases like malaria, malnutrition, and diarrhea.

The American Refugee Committee (ARC) engaged IDEO.org to help improve childhood mortality in the DRC, and together we designed Asili, a sustainable social enterprise that takes a holistic approach to giving kids a shot at seeing five. Because kids, parents, and whole communities in the DRC face systemic problems, we responded with a system of our own. Asili offers clean water, a best-in-class health clinic, and the seeds that local farmers need to feed their families and their livelihoods.

We knew that if we didn't tailor Asili directly to the people of Kabare's needs, we'd wind up in the same place as so many good intentioned people who have come before. So we dug in deep with the community to understand what it wanted, how it worked, what a successful business would look like, and how to get people to buy-in. By treating the citizens of Kabare like consumers, not charity cases, and reflecting their values in a community-owned service, Asili would fit into their lives.

Asili means "foundation" in Swahili, and we were determined to design something that the people of Kabare could build on.
We talked to scores of people across the community, and hosted co-design sessions with people to understand local power dynamics, how a subscription model could work, why people weren't taking advantage of current health clinics, and what kind of messaging could get the people of Kabare to invest their limited incomes in a life-saving service.

There was one story in particular that stuck with us. Our design team was talking with a young mother about why she didn't take her child to a local health clinic.

"I don't have any idea what will happen when I go there," she said. "I could wait for one hour or five. And who knows how much it will cost to treat my child."

From there we knew that complete transparency was crucial to success. At Asili, all prices are posted, people get a number when they wait in line, and ARC even went so far as to post a patient's bill of rights.

Today, Asili has 17 water points, is seeing a massive spike in farmer income, and the health clinic is at once a best-in-class clinic tending to the kids of Kabare and an emblem of hope. Visitors know what they're in for and what it will cost. As important, is how Kabare has responded to Asili itself. Where once there was nothing, a church and restaurant have sprung up. Locals have even erected electricity poles, a bet on the infrastructure that they're so ready to embrace. And as if Asili weren't foundation enough, ARC is ready to scale.

Twenty percent of children living in the Democratic Republic of the Congo don't live to see their fifth birthday. The underlying causes of this high mortality—malnutrition, diarrhea, and malaria—are largely preventable. A new sustainable social enterprise from the American Refugee Committee (ARC) and IDEO.org is changing that. It's called Asili. By designing a holistic new market-based approach to healthcare, clean water, and agriculture, co-created by the very community that will be using the service, Asili is ensuring many more children get the right start in life.

Displaced communities across the DRC face a host of systemic issues, which is why Asili took a different approach. The IDEO.org and ARC teams designed a business model that integrates and supports three different services: healthcare, water, and agriculture. Taking a multi-service approach to tackling the root causes of child mortality also propels forward the overall long-term health of the community.

Asili brings a wide range of services directly to thousands of people in the villages of the Kabare region. Though previous community-support models have been tried in the area, they have often lacked vital input and acceptance from the community to make them successful and more self-sustaining in the long term. But thanks to Asili, those same people now have clean water, better seeds, and a health clinic that serves them and their children. And by taking a holistic, community-led approach to under-five mortality, it addresses the long-term needs of the people of the DRC. Asili also proves that a social enterprise can succeed in one of the most difficult places on earth.

Asili confronts a broken system with a wholly new market-based approach to provide the citizens of Kabare what they need. Clean water, a health clinic, and high-quality seeds are all critical to helping children see their fifth birthday, while also lifting the prospects of an entire community.

What's unique about Asili is how it responds to the country's dismal record on aid by embracing transparency, community ownership, and a brand promise that is both essential and aspirational. Asili treats the people of Kabare as customers, giving them a predictable, valuable, and high-quality service in exchange for their money. And farmers are now reporting higher income thanks to the Asili vegetables they've grown.

Since the project launched in September 2014, we've seen remarkable results. Here are a few examples:

Asili customers who have never had access to clean drinking water have now consumed 600,000 liters of clean drinking water.
Farmers using Asili's seeds are reporting impressive income growth. Before Asili, farmers reported earning around $40 per harvest. Now they're reporting $246 per harvest—a massive boost in productivity.

Over 800 clinic visits have been sold.

Seventeen water points are operational and staffed by local Congolese.

One of Africa's most popular musicians, Papa Wemba, visited the Asili clinic, drank the water, and wrote a song about the service.

Asili is premised on a few key insight, those that our human-centered approach is ideally situated to unearth. The most important of which is that predictability in service and cost is paramount for building trust with the community. By taking transparency seriously—literally putting prices on the wall, handing people numbers when they come to wait, designing a patient's bill of rights for the clinic, and offering stable prices for crops—Asili is giving the people of the DRC something they haven't experienced in a long time: a chance to control their own destinies.

Arguably the most important aspect of our research came from an incredibly rich co-creation session with several women from the community. In addition to drawing on the fundamentals of human-centered design, the team identified a handful of women to participate in a special co-design session. It was astounding to see how they rose to the occasion, quickly helping us understand and create the branding, messaging, and attitude necessary to reach the Congolese people. The team learned about how power dynamics work in the DRC, why transparency of pricing and services is crucial to progress, and what kind of service people would actually pay for. By putting these exceptional women at the center of our research and prototyping their ideas, we found a fruitful path to make Asili work.

The design team at IDEO.org worked with American Refugee Committee to design all aspects of the Asili system. From the offer to the branding to the membership model to even a video that ARC would use to raise funds, IDEO.org was behind each piece of Asili. But as important as our design work on the project itself, we also helped ARC more fully embrace the human-centered design process. Instead of merely playing from an IDEO.org playbook, ARC is now evolving and scaling Asili from a human-centered perspective.

In addition to changing lives in the DRC, Asili is changing how international development gets done.