An application of humancentered design to facilitate access to HIV selftesting and contraception Lauren Hunter Sandra McCoy Aarthi Rao Agatha Mnyippembe Kassim Hassan Prosper Njau Rashid Mfaume Jenny Liu ID: 1043934
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1. Designing “girl-friendly” drug shops in Tanzania: An application of human-centered design to facilitate access to HIV self-testing and contraceptionLauren Hunter*, Sandra McCoy, Aarthi Rao, Agatha Mnyippembe, Kassim Hassan, Prosper Njau, Rashid Mfaume, Jenny Liu*Contact: lahunter@berkeley.edu
2. In Tanzania:Background27%of girls aged 15-19 have begun childbearing1 46%of girls aged 15-24 have never tested for HIV2Community-based drug shops may be an effective channel to reach adolescent girls and young women with sexual and reproductive (SRH) health products, including HIV self-testing (HIVST) and contraception.We used human-centered design to develop an intervention to create “girl-friendly” drug shops where young women can access these products in Shinyanga, Tanzania.
3. TestEmpathizeDefine & IdeatePrototype Learn about latent needs and motivations of young women and drug shopkeepers Synthesize findings to inform intervention Brainstorm creative solutions Build representations of most promising solutions Refine leading solutions Implement leading solutions Finalize intervention Assemble Youth Advisory Board Interview 9 young women Shadow 9 young women Partner with 3 shops Interview 3 shopkeepers Conduct 6 shop observations Define key insights Generate 150+ solutions Systematically assess and narrow solutions based on constraints & design principles Create more complex, integrated solutions Consult with Youth Advisory Board and shopkeepers Share prototypes in: - 6 focus groups with 43 young women - 6 interviews with community stakeholders Map intervention elements to insights and behavioral economics principles 10-day pilot test at 2 shops Debrief with shopkeepers and Youth Advisory BoardActivities ObjectivesMethods
4. ResultsWe learned:Young women are cash-strapped and have limited agency and mobility. Many seek sexual health products only after engaging in risky behavior. For rural young women, shopping is often a mundane chore done at the behest of others that entails purpose-driven, fast interactions without browsing. Shopkeepers exert paternalistic control over young women and only deem some health products appropriate for them. Consultative screening can be used to enforce shopkeepers’ gatekeeping role.We designed: A loyalty program called the Malkia Klabu (“Queen Club”) in which young women at drug shops can:Earn increasingly valuable surprise gifts (e.g., lotion) by making purchasesRequest free HIVST, contraception, and pregnancy tests by pointing at discreet symbols on the back of their membership cardInteract with a hands-on display of SRH products, including long-acting contraceptives for which they can receive tailored referralUse a tablet to privately watch videos of young Tanzanian women talking about their preferred contraceptive methods
5. Conclusions ▼ LOYALTY CARD FRONT ▼ LOYALTY CARD BACKWe developed an intervention to stimulate demand for SRH products among young women at drug shops. We used an interactive design process to maximize the likelihood that it will address the needs of both young women and drug shopkeepers.We will evaluate the intervention’s acceptability and effectiveness at increasing HIVST and contraceptive provision in a randomized trial. ▼ MYSTERY BAG ▼ SRH PRODUCT DISPLAY
6. ReferencesTanzania Commission for AIDS (TACAIDS), Zanzibar AIDS Commission (ZAC), National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS), ICF International. Tanzania HIV/AIDS and Malaria Indicator Survey 2011-12: Key Findings [Internet]. Dar es Salaam, Tanzania: TACAIDS, ZAC, NBS, OCGS, and ICF International; 2013. Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) [Tanzania Mainland], Ministry of Health (MoH) [Zanzibar], National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS), ICF International. Tanzania Demographic and Health Survey and Malaria Indicator Survey (TDHS-MIS) 2015-16 [Internet]. Dar es Salaam, Tanzania, and Rockville, Maryland, USA: MoHSW, MoH, OCGS, and ICF International; 2016.