PDF(Pubmed)
Abstract：
We present a case study describing the use of human-centered design (HCD) to determine how to adapt intervention components from an existing contraceptive uptake program for adolescent girls in 4 geographical contexts (Ethiopia, northern Nigeria, southern Nigeria, and Tanzania) for use in Kenya. First, we prioritized existing intervention components to be tested in Kenya using sacrificial concepts. Through these concepts, we identified key insights and behavioral archetypes from which to build higher-fidelity prototypes, leveraging existing program knowledge and resources while responding to unique opportunities for Kenyan adolescent girls. After 2 rounds of prototyping, we launched a high-fidelity intervention designed to improve contraceptive uptake among girls. We used program experience to identify strategies for improvement during early implementation. The resulting model, Binti Shupavu, is designed to tap into girls\' aspirations and connect them with contraceptive use, build their trust in the health system, and work with influencers to build support for adolescent contraceptive use, following the global user journey. In the first year of implementation (January-December 2022), the intervention was scaled from 90 facilities to 360 facilities and reached 60,111 adolescent girls aged 10-19 years. Of these, 21,698 were new voluntary contraceptive users (36%) and an additional 3,873 (19%) were continuing users.Our design process suggests that HCD is a promising tool for navigating replication. The emphasis on users\' perspectives, testing to learn, and collaboration facilitated a deep understanding of the new user population, thus guiding program designers to balance using existing components with developing new ones based on the population\'s unique needs. Finally, HCD has potential to support the localization agenda if design teams are supported by national, regional, and global experts to be aware of and use the evidence and implementation experience from earlier work.
摘要：
我们提供了一个案例研究，描述了以人为中心的设计（HCD）的使用，以确定如何在4个地理环境中从现有的青春期女孩避孕摄取计划中调整干预成分（埃塞俄比亚，尼日利亚北部,尼日利亚南部,和坦桑尼亚)在肯尼亚使用。首先,我们优先考虑在肯尼亚使用牺牲概念进行测试的现有干预组件。通过这些概念，我们确定了构建更高保真度原型的关键见解和行为原型，利用现有的项目知识和资源，同时应对肯尼亚少女的独特机会。经过两轮的原型制作，我们启动了一项高保真干预措施,旨在提高女孩的避孕能力.我们利用计划经验来确定早期实施过程中的改进策略。由此产生的模型，BintiShupavu,旨在挖掘女孩的愿望，并将它们与避孕药具的使用联系起来，建立他们对卫生系统的信任，并与影响者合作，为青少年使用避孕药具提供支持，跟随全球用户之旅。在实施的第一年（2022年1月至12月），干预措施从90个设施扩大到360个设施,惠及60,111名10-19岁少女.其中,21,698名是新的自愿避孕药具使用者（36％），另外3,873名（19％）是持续使用者。我们的设计过程表明，HCD是导航复制的有前途的工具。强调用户的观点，测试学习，协作促进了对新用户群的深刻理解，从而指导程序设计者根据人口的独特需求来平衡使用现有组件和开发新组件。最后,如果设计团队得到国家、区域,和全球专家了解并使用早期工作中的证据和实施经验。
