Human-centred sexual health services forTanzanian youth
Reaching out to adolescents was an important task that Marie Stopes Tanzania, the largest specialized sexual and reproductive health (SRH) and voluntary family planning organisation in Tanzania, wanted to explore.
Marie Stopes had launched rural outreach services that target poor and vulnerable women, adolescents and men, especially those living in rural and peri-urban underserved areas. They asked ThinkPlace to help them gain greater uptake for these services – specifically family planning and sexual health services – from Tanzania’s population of young rural people.
Marie Stopes and their staff understand on a personal level what adolescent girls in Tanzania go through. For their staff, the importance of building connections with adolescent girls begins very close to home.
“My passion for adolescents started with my own upbringing,” staff member Lorraine says.
“My family couldn’t afford to pay for me to go to secondary school and I met my first boyfriend who promised he would talk to his parents to help once I accepted to be with him. I did and got pregnant.
My father chased me out of home. I was considered an embarrassment … My mother pleaded with her sister’s family to take me in. My life in school was very difficult. Everyone laughed at me. But I was empowered through education, that is why today I am supporting other girls.”
Lorraine’s experience and the environment she grew up in signifies the reality of many adolescent girls living in Tanzania today, a fact that has been instrumental in Marie Stopes setting up their outreach services.
Marie Stopes strongly believed that engaging adolescents was not only possible, but a unique entry point for their outreach services. And they turned to ThinkPlace Kenya to help them create and drive greater demand for family planning among adolescents.
Marie Stopes’ Outreach program is built upon an ambitious goal of reaching about 2 million new users by 2020.
Through intensive user-centered research, Thinkplace Kenya sought to understand adolescent’s behaviors, drivers, attitudes and needs that would encourage uptake of family planning.
ThinkPlace designers spent considerable time on the ground, turning interactions with young people into insights about their views on family planning and their behaviours in relation to the services and information on offer.
Quite often, we found, family planning services were a last resort for adolescents who were at times influenced by cultural traditions that stigmatised early childhood sex education or terrifying tales of the side effects of family planning heard anecdotally from their peers.
Having no control of their future was a recurring idea voiced by young people, signifying the importance of designing interventions that allow adolescents a feeling of self-determination and help provide them with what they ultimately desired: A sense of security.
As a result of the insights derived from this research phase Marie Stopes Tanzania were able to implement immediate changes to their services that resulted in significant increases in adolescent interest around family planning.
In addition to designing interventions for adolescents, Thinkplace tested each intervention to determine the most desirable that would articulate the adolescent’s needs.
Evidence shows that many of those interventions are working. But the capacity-building impact of introducing human-centred design methods within adolescent communities has been just as powerful.
“I am now an expert in HCD! I enjoyed seeing the transformation from research,” Marie Stopes Tanzania staff would utter in delight. Following the project, at least seven members of the Marie Stopes team have advanced their careers applying knowledge and tools gained during this work.
The biggest success has been the elimination of bias by influencers around family planning within the communities. This has been achieved by engaging influencers like parents and religious leaders and by better tapping into adolescents’ imaginations via entrepreneurship activities such as soap-making, henna-painting and batik.
Pilot outcomes indicated a significant increase in client visits for adolescents. In the first pilot location clinics improved from 27 clients a day (pre-intervention) to an average of 70 clients a day afterwards. In the second location, client visits increased from an average of 13 to an average of 50.
Adopting the interventions in their service model has enable Marie Stopes to generate more demand for family planning and build capacity within the outreach team, while also allowing team members to gain additional entrepreneurship skills. Success is not only evident in the increased need for family planning, but also through adolescents’ restored confidence and acquired skills, much of it the result of the actions that have been part of this project.