By Manya Dotson, Project Director, Adolescents 360
Next week I’ll be heading to Dar es Salaam, Tanzania to join my Ethiopian, Nigerian and Tanzanian A360 colleagues and many of the movers and shakers in the worlds of Adolescent and Youth Sexual and Reproductive Health and Human-Centered Design. Together we are going to grapple with some interesting questions and swap stories about using human centered design to re-imagine public health programs with young people.
I couldn’t be more excited. Not only do I get to escape the DC winter and experience the warmth and charm of one of the more beautiful countries on the planet, I get to hang out with my professional soul-mates. In different ways, no matter what organization we work for, we all aspire to deliver services that actually work for young people and support them to achieve their hopes and dreams. And the HCD-exchange participants are people willing to think outside of the box.
We will talk about what we are learning, what we know for sure, and what we still need to crack as a community of practice. I can’t wait to learn from them, and I also have some things I’m itching to share and discuss:
1. HCD-Friendly Problems
I’m starting to think there are certain problems that are a particularly awesome fit for the HCD approach to problem solving. HCD leads problem solving with empathy and is biased towards trying things out in the real world, observing how consumers react to them, and finding out how consumers feel about the experience. Since, neurologically speaking, adolescents are particularly emotional decision-makers, and since sexual and reproductive health issues and services are highly interpersonal and emotionally fraught for all involved, HCD provides a fantastic set of tools to deepen our understanding of the nuanced emotions surrounding these services. Is a full HCD process the answer to all problems? I don’t think so. But I do think HCD can be counted on to deliver beautiful and delightful experiences, brands, and communications products that make people feel curious, excited, seen, heard and understood.
2. HCD Changes People
I’m pretty sure I won’t be alone in noting that people who have a lived experience with HCD processes often emerge from them transformed into shiny-eyed evangelists using new words like “insight,” “craving” and “design energy.” A360’s independent external process evaluation, conducted by ITAD, has noted that HCD “transforms those who participate, as they learn new ways of thinking and behaviors that they apply in both the design and implementation of programs.” We hear it over and over from our staff: “HCD changed my way of thinking.” Even, speaking about government officials themselves: “[By connecting with girls empathetically] you find a lot more them become more open…” I have observed that HCD can be counted on to transform programmers into passionate advocates and deepen commitment to respectfully serving consumers. This alone transforms programs.
3. Designing with Young People
In A360 we believe young people can—and should—be investigators, meaning-makers, designers, and decision-makers within the HCD process. A360 departed from traditional HCD, by engaging young people as integral members of mixed research and design teams. We invested up-front in activities to prepare the adults and young people working together to share power and cultivate mutual respect and productive communication. In A360, the involvement of young designers led to some of our breakthroughs (like how to calculate the cost of a baby in terms of sacks of grain in Ethiopia, and the empowering 9ja Girls Brand Anthem in Nigeria). Meaningfully engaging young people as decision-making partners, as well takes work, flexibility and humility, but we believe it’s a best practice, and we’d love to help other folks in our field do it too with practical tools and hacks.
4. The Formula
At A360, we think we may have figured out a set of synergistic “active ingredients” that unlock rapid contraceptive service uptake among adolescent girls. For example, in Tanzania, A360’s Kuwa Mjanja clinic takeovers, which combine mini life-coaching and empowerment activities with contraceptive services provided by public health providers led to more than 2400 contraceptive adopters in December alone. More than 55% of the girls who came for these Kuwa Mjanja events left the event within a couple of hours having chosen to adopt a modern method of contraception. In Ethiopia, we are seeing that when married adolescents who are not already using contraceptives go through SmartStart—a guided conversation about what couples want, how they might manage their finances to get there, and what children cost – more than 80% of them leave the one-hour interaction with a modern method of contraception.
What’s our secret to this accelerated uptake? We think it’s that we make girls feel seen and heard through delightful brands and engaging activities that they find immediately valuable and that the community supports. In all three countries, across different segments of girls, A360s service packages make contraceptives immediately relevant. Where many girls see their big dreams (the kind of dreams many FP programs focus girls’ attention on—like school, health, security) as distant possibilities resting on shaky ground, we are finding ways to connect contraception with the immediate hopes and dreams they know they can achieve now. We remove all hassle, friction, and stigma associated with referral by offering all participants a private moment with a provider to talk about whatever she wants—right away. All our messaging about contraceptives emphasizes return to fertility, and counselling protocols start with HER wants and needs.
5. How To Talk About It?
In our line of work, we do a lot of thinking about how to innovate in a way that builds on former investments and honors what is tried-and-true. In this context, communicating about how HCD can contribute to public health has been fun and challenging. For us at A360, it’s a work in progress, and we’re looking forward to discussing it more with colleagues from other organizations. How do you define and describe “innovation” in a field where a lot of effective things have been tried? What is an insight, exactly? What makes an insight “nuanced” enough, or “fresh” enough and how do you know you’ve got a good one? How do you describe exactly when, how and why HCD adds value, when it is so different from traditional program design? What can HCD be predictably relied on to contribute to adolescent health, and what does it really take to work in a new way? What can HCD realistically promise—and consistently deliver? I’ll be leading a session exploring these themes as A360 continues to lead the way in asking and answering these essential learning questions.
(Spoiler alert: The session will involve an inflatable dinosaur, because that’s how we roll).
And the best part about my trip to Tanzania? I get to see the incredible A360 Tanzania team in action as they host site visits for the group in Dar. There’s nothing more inspiring to me than knowing that because of A360 girls are seeing a path to achieving their dreams and choosing to use contraceptives as a first step toward a brighter future.
