Usinisunde Nichapie

Field Work/Human Centred Design/ Education

Problem

HMW. . . (how might we) improve adolescents' access to sexual reproductive information and services.

Solution

Partnered with the Nairobi Design Institute, and worked with a team of international engineers and designers, through ideation, concept, design development, and final design assets. Designed a service to increase access and engagement with reproductive health services for young adults.

Team

This is a collaborative project with Hugo Richards, Khulood Alawadi, Wei Haw Huang, James Maina and Jerry Santo done in Nairobi Kenya. 

Role

Design Researcher

  • Interviewed young adults and practitioners about reproductive health, and utilised insight to steer design direction

  • Hosted co-creator workshops to involve the community in design evolutions

  • Created a suite of user research tools that improved insight capture

Partners

Solution

 

Summary

Usinisunde Nichapie, is swahili for "Don't hide from me, tell me." It seeks to increase and encourage access to existing reproductive health services. We utilized human centred design techniques, such as fieldwork interviews, ecosystem maps, user journeys, and our own bespoke tools. We interviewed health care professionals and young adults to identify the barriers and merits of existing services. We synthesized these experiments into quantitative and qualitative data to drive the projects forward. We co-wrote a romantic play and designed a workbook to create a relaxed environment for sparking candid discussions around sexuality and consequences. This process required agile research techniques with limited time to create a deliverable within 3 weeks

Challenge

Design Brief

 

The Nairobi Design Institute worked for three weeks doing field research, arranging partnerships, scheduling interviews, and constructing a research plan. 

From their research, they kicked of our collaboration with a presentation on their research, and a research question. More than half (51%) of all new HIV infections in Kenya in 2015 occurred among adolescents and young people (aged 15-24 years). (1)

 

HMW. . . (how might we) improve adolescent's access to sexual reproductive information and services.

HIV 

In 2015, 51% of all new HIV infections in Kenya occurred among adolescents and young people aged 15-24 years.  (2)

Teenage Pregnancy

According to the last Kenyan government health survey from 2014,18% of women aged between 15 and 19 were mothers or pregnant with their first child. Teenages are more likely to die from pregnancy related health complications than women in their 20’s, and are more likely to drop out of school. (2)

Low Use of Protection

There is a low usage of protection.

In 2014,  only  32% or urban women were using condoms regularly.  In rural settings, only 21% of young women used condoms

(4)

Process

Our research began by speaking to clinicians, healthcare providers and adolescents to identify barriers preventing youth from accessing Sexual health facilities. ​The interviews were primarily conducted in English, with some Swahili. The interviews focused around Nairobits centres that served as young adult centres offering football fields and reproductive health clinics. 

Our research tools included:

  • constructing discussion guides for clinicians and young adults

  • eco system maps

  • planned group and individual interviews

  • unplanned "guerrilla interviews" in markets

  • card sorting

  • co creation workshops

  • user journeys

  • service journey

  • insight grouping 

  • Conducting Workshops: Writing and performing skits around sexual reproductive health.

We conducted "guerrilla," (unplanned) interviews at a local market frequented by local university students to get a broader understanding with a larger demographic of young adults. ​

  • We presented three sceneries for possible venues, as a aid to learn about preferences and difficulties around sexual health clinics. 

We took copious notes during each interview, always interviewing with at least one person taking notes. This allowed us to pull out quotes, insights, identities, attitudes, beliefs, and new questions from each interview. We then grouped the key takeaways from each interview into   categories to identify themes. ​

Grouped Insights:

  • Identities 

  • Experiences from Services

  • Trust

  • Stigma

  • Delivery of Information

  • Motivations

We went to a high school in Kibera to run a workshops with young adults to  Write and perform skits around sexual reproductive health.

Workshop Structure:

  • Instructions about who we are

  • Warm up Game: we stood in a circle, and each person said one word to create a (funny) story.

  • We designed cards with quotes from our previous interviews, to serve as writing prompts. 

  • We prepared and performed a short example skit

  • They broke into pairs to write skits

  • A few groups performed their skit wonderful skits!

  • We wrapped up with a discussion

To decrease stigma around sexual health, we created a play to bring SRH issues into the light. We held four creative workshops, and collected 25 stories.

 

With five of the young adults we co-wrote these skits. The play allowed the participants to shine as individuals while decreasing community stigma around SRH.

Deliverables:

  • Handover Presentation

  • Workbook

  • Skit

  • Video of performance

  • YouTube Channel

  • Business Proposition

 

Insights

The silence surrounding SRH topics creates a psychological barrier preventing youth from visiting SRH facilities.

Call a spade a spade, not a big spoon.

Adolescents are driven by a promise for a brighter future. 

 I want to brighten up.

Community stigma is a big barrier

for accessing SRH facilities.

It kills you before you're dead.  

 

Learnings

I love Design Research: Before working as a designer I was a teacher for seven years. I always loved the personal connection to my students. Design Research amplified the empathetic and social elements of teaching with my strategic love for design. We all had flexible roles that played to our strengths, but also gave us each an opportunity to grow. We all created illustration assets, formed interview questions, developed business propositions and wore different hats depending on the needs for a given day. 

DEFINE HMW

Define your HMW Early:

This illuminates the design process, and provides clarity for the whole team. 

SCRAP

Create "Sacrificial Ideas" 

It's great to leave an interview teeming with ideas and ready to develop them into solutions. However, it's equally important to be ready to pivot, and work flexibly as a team.​

Commit

Know when to commit 

Put away the sticky notes, and take out the computers and develop the final materials. It can be hard to step away from the research part, but it's crucial to know when to begin development.

TEAM

Team Comes First

Every action requires flexibility for the ever-changing needs of the group. When the group focuses on the success of the project in unison it can function like a well oiled machine. 

Citations

  1. Kenyan Ministry of Health/National AIDS Control Council (2016) ‘Kenya AIDS Response Progress Report 2016’

  2. Kenyan Ministry of Health/National AIDS Control Council (2016) ‘Kenya AIDS Response Progress Report 2016

  3. Kenya National Bureau of Statistics Nairobi, Kenya Ministry of Health Nairobi, National AIDS Control Council, Kenya Medical Research Institute, National Council for Population and Development, The DHS Program, ICF International Rockville, Kenyan Demographics and Health Survey (2015) https://dhsprogram.com/pubs/pdf/fr308/fr308.pdf 

  4. Tavrow, P., Karei, E., Obbuyi, A., & Omollo, V. (2012). Community Norms About Youth Condom Use in Western Kenya: Is Transition Occurring? African Journal of Reproductive Health / La Revue Africaine De La Santé Reproductive, 16(2), 241-252. Retrieved December 7, 2020, from http://www.jstor.org/stable/23318032