Susan is a 2021 fellow with Grassroot Soccer and she is currently based in Kenya. She is passionate about social impact projects and has worked on Adolescent SRHR projects with LVCT Health Kenya and Ark Africa. With a masters degree in Human Computer Interaction Design from City University of London, Susan hopes to use her knowledge and skills to help Grassroot Soccer build a strong foundation in youth-powered design.
Find Susan’s first learning and reflection session here.
In our first learning and reflection session you told us about yourself, your practice as a human-centered designer, and your interest in ASRH. Today, can you tell us more about what attracted you to HCD?
What initially attracted me to HCD was this idea that sub-Saharan Africa always had outsiders coming in with the mentality that Africa’s problems can easily be fixed with solutions that have worked really well in other developing countries. These outsiders are people who are considered subject matter experts; however, they often fall into the trap of not spending enough time to understand the local context, and that leads to them lacking sufficient local knowledge. As a result, they often use tools and practices that are not adapted to the local market which may lead to massive project failures – not because the process is wrong, but because it doesn’t suit the local context. I thought about how that gap can be filled and what I can do to contribute to filling that gap. I think HCD is able to do that and that is what attracted me to it. Given my IT background, I had seen a similar kind of situation. You find a lot of projects and businesses investing in tech products that don’t work because they are just not suitable for that local context. I wanted to understand how to conduct research in order to get access to this contextual information, including how people make decisions, what their emotional and mental barriers are, and what are the behavioral issues around critical questions such as ‘why do end users do what they do?’, ‘what are the key cultural barriers that hinder the desired behaviors or goals that we want to achieve?’, ‘what is the gap in converting intention into action?’ and ‘what kind of behavioral triggers exist behind the end users choices?’ These are just some of the things that I was really curious to figure out how to answer, and I think that HCD and design thinking really helps that process.
From our previous conversation we heard about GRS’ work on the USAID YPE4AH project and the program design workshop with young people and experts to create a hub and spoke model for service delivery in Lagos. Can you tell us a little bit about what has happened since then? How has the project advanced?
The YPE4AH consortium completed the Program Design Workshop (PDW) and the Curriculum Development Workshop (CDW) in Lagos State, and the project is now in the implementation phase. Trained ‘Youth Coaches’ are now implementing the curriculum which GRS based on the stakeholder input during the CDW. Now, the consortium is focused on setting up project activities in Kano State, which is a much different context than Lagos. The consortium partners will carry out a similar process for the PDW and CDW.
Alongside what you have mentioned already, GRS also has a curriculum that uses Soccer to build awareness around SRH right? Can you tell us more about that?
GRS’ curriculum development process places an emphasis on consultation with relevant stakeholders, enabling the co-creation of curriculum content. So when we have curriculum development workshops, we engage with young adolescents and other project stakeholders to find out what topics are relevant for them. We then adapt the curriculum or modify some of the topics according to what we have found. For instance, we look at what we already have, and what are the gaps that have been identified from our engagement with the youth and other project stakeholders and then we come up with those specific topics that are not already part of the curriculum to bridge those gaps.
Innovative ideas and contributions to GRS curriculum have come from participants, coaches, donors, partners, board members, staff, and researchers. GRS has appointed specialized staff members to synthesize and refine these ideas, as well as to review, develop, and approve all curriculum materials.
The curriculum is also a key component of the organizational 3 C’s model: Curriculum, Coaches, and Culture. GRS Coaches deliver evidence-based curricula using a youth-centered approach. GRS uses the 3 C’s to achieve impact across the 3 A’s: Assets, Access, and Adherence. The curriculum is designed to build SRHR assets and the confidence to use that knowledge and skills, to increase access to health services, and to improve adherence to health-seeking behaviors and treatment. The curricula cover topics including sexual and reproductive health and rights, gender equity, gender-based violence, HIV/AIDS, and alcohol and substance use, while simultaneously building skills including communication, leadership, decision-making, and goal setting.
In terms of youth engagement, GRS tries to uphold key principles of youth participation in work with partners. In the YPE4AH project, all the activities that the consortium have done in Lagos are youth centered. The consortium held youth perspective sessions, dream programming sessions, and youth stamp of approval sessions, and created a Youth Advisory Committee (YAC) which continuously engaged in the workshops and throughout the project lifecycle. The consortium partners also provided guidance to adults on how to communicate and work with young people during the workshop. YPE4AH consortium partners prepared a ‘youth participation brief’ that was shared with all participants prior to the program design and curriculum development workshops. The brief outlined guiding principles such as intentionally sharing power, communicating in a way that does not alienate young people, and using language that is familiar to young people. Overall, consortium partners tried to ensure that they understood that the content and the method of communication can limit meaningful participation with the youth. YPE4AH consortium partners sent this brief to stakeholders before the workshop so that they could get familiar with it and point out any issues or concerns they might have on how to communicate or how to handle or work with young people.
Can you give me an example of what an activity in the SKILLZ curriculum looks like?
I can give you an example of an activity from the GRS Relationship SKILLZ curriculum that was done during the Kicks4Kokoda project in Papua New Guinea. For that project we had Coaches from the Papua New Guinea Olympic Committee team who had been trained in the GRS curriculum. One of the Olympic Team members volunteered to lead the youth and other project stakeholders through the gender equality practice in the curriculum.
In this practice, players reflect on power, and men’s use of power over women. They do an activity that highlights how this impacts women and girls, and discuss how they can promote equal power in their communities. By the end of the game, players should be able to: (i) Describe ways that men use their power over women, (ii) Describe equal power between men and women in their own words, (iii) Describe ways that men and boys can promote equal power with women and girls in their community.
The rules for the Gender Equality Practice game are as follows:
Players play 2 rounds. In the first round, the coach ensures players know the rules for each line. In the 2nd round, the coach switches the line and players play a second round. Immediately after the 2nd round is over, the coach facilitates a discussion using the following questions:
- In rounds 1 and 2, how did it feel when only 1 person could score?
- In the first two rounds, you were UNEQUAL. How did it feel when you couldn’t shoot in these rounds? How did it feel to be able to pass and shoot?
- In this activity players in Line A represent Men and players in Line B represent Women. This is a picture of how society makes women play by different rules than men, and how women don’t get the same opportunities as men.
- In the game, what allowed some of the players to have an advantage over the others?
Players then play the 3rd round of football. Now, players in Lines A and B are able to pass AND shoot. Again, immediately after the 3rd round is over, the coach facilitates a discussion using the following questions:
- How did it feel in the final round when players in both lines could score?
- What is gender equality?
- What are the advantages if both lines can play equally?
- What can we do to make men and women equal or the same in our communities?
- How will gender equality improve your own life?
Other than a football game, we also use scenarios to aid conversations about gender equality and expectations.
Gender equality is when men and women are given the same rights, responsibilities and opportunities. Women and men should have equal rights and opportunities. Women and men have equal value.
I want to go back a little to talk about the YPE4AH workshops that you did in Lagos. You have mentioned previously that the workshops involve some level of iteration of modules that have previously been implemented by GRS in other locations? When we spoke last you had just completed the program design workshop and were in the process of synthesising all the data. Can you tell me a little bit about how the insights that came out of that program design workshop were used, to tweak the program or implement it differently?
The YPE4AH project centers around Youth Hubs—safe spaces for youth to seek and access FP and reproductive health (RH) information and referrals. The Youth Hubs will establish spokes to youth-friendly FP/RH and other social support services, including services for gender-based violence (GBV). The consortium partners used the insights from the PDW in Lagos to inform the set up of the Hubs and Spoke activities that workshop participants highlighted during the dream programming sessions. In addition, the PDW findings were used as a reference to identify sites with government facilities that could serve as Youth Hubs and/or Youth Centers.
Furthermore, the PDW findings were also used to inform the design of the Curriculum Development Workshop (CDW) and the SKILLZ curriculum. The CDW included 6 Youth Advisory Committee members, 2 Youth champions and 32 participants including representatives of Lagos state ministries, departments, agencies, and consortium partners. The workshop applied a youth-powered approach by placing youth at the center of the workshop. The consortium used formative research findings but also, for example, worked with youth and participants to create youth personas to help create a shared understanding of our target audience needs, challenges and pain points. The personas were also used as a point of reference when developing curriculum content. Workshop participants also participated in SKILLZ activities to experience learning through play methodologies and reflect on how these may apply to the topics and teaching methods of the curriculum.
Are there any challenges that you have faced in the persona development sessions? If Yes, then can you also tell me how you dealt with them?
So one of the key things to do if you have limited resources and you’re doing a persona development session is to have community experts like community healthcare workers in the room or people who have had 10 to 15 years experience working directly with the youth. These people go from house to house, they are used to doing SRH activities in the community, and they’re well known by the community. Even the young people know and talk to them, and so you know that they understand what’s happening on the ground. If you can have that sort of expertise available to you, then you’re headed in the right direction because they bring a wealth of contextual knowledge. They will tell you about the challenges they experience on the ground; they have access to the health care centers within that area so they also understand what challenges adolescents will have if they go to the healthcare centers, they will know about the services that are available to young people etc. Since they meet the youth on the ground, they also know what makes them open up and talk comfortably, the best practices to converse with the youth in that region, and how easy or difficult it is to have a conversation with a healthcare clinical personnel for a young person at the hospital. If there is judgement involved you also learn how they navigate through it. That experience is really really good to have in the room.
Can you talk to me a little bit about how evaluation of impact and outcomes happens in the work that you do? Is that something that you’re involved in?
I’m not involved on the monitoring and evaluation side, but GRS has a robust M&E system, with a number of Key Performance Indicators (KPIs) around SRHR that are aligned with global standards in adolescent health. The Monitoring, Evaluation, and Learning (MEL) team takes part in programme design workshops and all parts of the project cycle in order to adapt indicators and tools as needed to measure the project outcomes. So for example, we just finished a SKILLZ Holiday Camp program design workshop in Malawi. The MEL team at GRS contributed indicators to measure for the specific project. For example, we can look at the percentage of adolescents who make their own informed decisions regarding sexual relationships, contraceptives, reproductive health etc. We can also see the percentage change in attitudes and beliefs regarding gender norms and the percentage change of adolescents with comprehensive knowledge about SRHR and how they access those services. In addition, the MEL team are also involved in program analysis and work with program managers to provide recommendations for changes or improvements to the SKILLZ curriculum and other GRS innovative products/services.
What would you say has been your most significant moment since we spoke last in March?
I think the most significant thing that has happened to me is the opportunity to work on international projects within Africa and beyond. I think this is quite awesome. I’ve also had opportunities to facilitate workshops outside of GRS such as the Self-care Learning and Discovery series hosted by White Ribbon Alliance and associated partners. The session title was, In Our Words: Re-Defining Self-Care from the Perspective of a Young Person.
How has your mindset or your practice shifted during the course of the fellowship, and your engagement with GRS?
I try my best to consider the ways in which young people can be engaged more consistently and more authentically in the design of the system, the solution or structures that will ultimately impact them. I have become very conscious of what meaningful youth engagement really is. I’m also very conscious now of what being youth-centered versus being youth-driven versus being youth-led means, and I recognize how they often overlap. For instance, at GRS we often consult and engage young and old adolescents in the design process, either as participants or via a Youth Advisory Committee. We also enable young people’s voices to be heard and empower them to give feedback that drives decision making across the design process. So whatever we come up with in the field during the PDW or the CDW those decisions include young people, and that is used in the curriculum development process. We also engage in youth participatory research methods whereby the youth actually receive training, support and coaching from older adults with specialized technical or design expertise.
I also recognize the importance of monitoring and evaluation metrics. I just don’t know how to come up with metrics that are HCD friendly and still make sense to the SRHR implementers. That’s my issue.
What is your one big takeaway from your fellowship experience?
The HCD approach, process, and the tools we use everyday are relevant and very necessary. They are particularly useful in conducting meaningful youth engagement, especially when addressing sensitive topics like SGBV, HIV, family planning, and contraceptives.
The one thing that I find that is really key to doing HCD and SRHR is to find out what the SRHR implementers’ expectations are with regard to the HCD process. Sometimes there can be misalignment between the HCD and ASRH process, which might lead to unrealistic expectations. You really need to iron this out at the beginning of the project so that everyone is on the same page. Otherwise, as the designer you may risk being blamed.
I also think getting an understanding of when to measure and what to measure in the context of HCD in ASRH is very critical.
I also find it challenging when someone asks how we include the HCD process in proposals. When you’re doing a proposal for a funder, you have to have numbers and quantify things, and I’m at a loss there. We can talk about the HCD process within the project with examples of outputs like personas, scenarios, customer journey maps, behavioral triggers or something like that but how do you quantify that? Also, how do you make them interested in what you’re doing, and see the value of the HCD process in that project?
What’s next for you after the fellowship?
I’m very privileged to have had my contract extended by GRS. My focus will be to continue working on the youth powered design toolkit as well as other technical support to GRS global partners in terms of the application of the HCD process in various projects that they have.
What advice would you give to emerging designers in the ASRH field?
I would say you need to be an advocate for meaningful youth engagement. It’s not enough just to have a few youth representatives in a room full of adults. No! You must question if the youth representative actually has a voice, and if he/she doesn’t, then you need to figure out how to give him/her a voice. By this, I mean you may have to brainstorm ideas on how to empower young people to speak up in public gatherings in front of adults who might hold very high positions in government or private companies. One effective way to do this is by holding a closed workshop group with young people and letting them express their needs and challenges and then allowing them to come up with ideas on how to mitigate those challenges. I think that you have to be very intentional about meaningful youth engagement. You might even have to go the extra mile and come up with practical exercises, or activities for skill building, or even invite professional experts to come and teach various topics that are of interest to the young people. But you have to really be an advocate for meaningful youth engagement. Don’t let it just be tokenistic. We need to do this because a lot of the work within ASRH is going to involve young people. We will be designing for them. So you have to figure out a way to give them a seat at the table, and let them talk and let them give their opinions and express their desires because you’re coming up with solutions for them. You have to understand them.
- Twitter: @teetondigital
- LinkedIn: https://www.linkedin.com/in/stowett/
- Organizational website: https://www.grassrootsoccer.org/
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This interview was conducted by Rimjhim Surana.