In 2022, the HCDExchange, in collaboration with its community members, developed a Quality and Standards Framework (QSF) to address the gap in evidence-driven approaches for integrating Human-Centered Design (HCD) into Adolescent Sexual and Reproductive Health (ASRH) programs. The QSF consolidates the best practices of that time, offering a set of eight guiding principles, along with practical tips and resources. These principles are designed to ensure the safe, effective, and inclusive application of HCD in ASRH interventions.
A quick preview of the QSF Principles:
To illustrate how, when, and why organizations might apply the QSF principles, the HCDExchange collaborated with Ipas in Kenya and Howard Delafield International (HDI) in India to document their experiences and insights. These insights were compiled into a technical brief that captures what they learned from applying the QSF principles. Additionally, HCDExchange hosted a virtual fireside chat to delve deeper into these reflections, providing a platform for the organizations to share their key takeaways. Our speakers included Steve Biko from IPAS-Kenya, Namita Mohandas, and Aparna Raj from Howard Delafield International (HDI).
This summary presents key highlights from the fireside chat
IPAS Kenya implemented the principles in a project that sought to develop a digital chatbot that provides information and support to women and girls seeking abortion and contraception services. The project also aimed to improve access to post-abortion contraception through pharmacies in Kenya, ensuring the highest quality of care and making it more acceptable for pharmacies to provide these services.
HDI applied the principles in developing a game called ‘Go Nisha Go’ for young girls in the context of sexual and reproductive health and rights (SRHR) in India. The goal of ‘Go Nisha Go’ is to delay early marriage and prevent unwanted pregnancies by building confidence and efficacy among girls.
Principles 1 and 2: Involving young people in the design process
HDI → The QSF principles proved invaluable in guiding youth involvement throughout the process, with the principle of iteration emerging as a crucial factor for ensuring effective engagement. For example, speakers from HDI shared their experience with “Go Nisha Go,” where they assembled a cohort of young girls who actively participated in the design and content decisions for the game. They also employed a peer-to-peer research approach during the formative research phase, recognizing that training young girls as researchers presented significant challenges. Initially, the girls were uncomfortable discussing SRH topics and hesitated to use words like ‘sex’ and ‘boyfriend.’ However, the team dedicated time to making the girls comfortable with SRH topics. Once the girls gained confidence, they were sent to the field to conduct research. Creating an environment where young people feel comfortable discussing sensitive issues was emphasized. The team also noted that young people are susceptible to power dynamics, making designing safe and welcoming spaces essential. HDI’s experience demonstrated that these approaches led to more honest and open feedback.
Principle 4: Value of iteration
HDI → Speakers from HDI emphasized the significant value of iteration, enabling continuous refinement and feedback responsiveness. Minor issues could be addressed by making incremental adjustments based on real-time user input, and the overall design could be improved. This iterative approach efficiently broke down problems, refined concepts, and incorporated user preferences, such as visual details or locally relevant terminology, into the product. While it was acknowledged that iteration can extend the process, especially when engaging with youth or community members, the team found that the benefits—such as increased relatability, enjoyment, and engagement—far outweighed the additional time required.
Principle 6: Engaging program participants and other stakeholders
IPAS Kenya → The speaker from IPAS Kenya highlighted that stakeholder engagement varied depending on the stage of the design process. During the initial phase, the team engaged program participants as equal partners, allowing them to share their perspectives and insights. This approach enabled the team to understand the participants’ world better. They ensured prototypes were responsive to the participants’ needs and challenges through testing and iteration. The speaker also noted that problems could evolve, and involving program participants and stakeholders in the design process increased the team’s accountability and encouraged participants to provide feedback on both the solutions and the design approach. Additionally, the speaker emphasized the importance of community involvement in the design and implementation phases to ensure the project’s sustainability. Engaging the community helps maintain and support the intervention beyond the project’s timeline, addressing challenges such as limited funding and short project durations.
HDI → The speaker from HDI emphasized that engaging with the community was crucial for anticipating and understanding potential adverse reactions to sensitive topics, such as sexual and reproductive health. This proactive approach aimed to mitigate potential harm and address concerns before introducing new products, ensuring that development aligned with community expectations and values. Community engagement also provided insights into the existing landscape of products and services, allowing the team to integrate new offerings seamlessly with current resources. This approach enabled the creation of comprehensive solutions where users could learn about contraception and menstrual products, access related services, consult with doctors, and purchase necessary items. Additionally, the speaker highlighted the value of collaborating with a network of 29 partner organizations working on sexual and reproductive health and rights. This collaboration ensured that product development was supported by a broader community effort and aligned with existing initiatives.
Principles 3 and 7: Safeguarding and security of program participants
IPAS Kenya → IPAS Kenya’s design process prioritized women’s safety and security, especially given the sensitive nature of abortion and post-abortion contraception. The team aggregated and anonymized research data to protect participants’ identities, ensuring no information could be traced back to individuals. Additionally, they engaged with women and girls in environments where they felt comfortable and secure, which fostered more open and honest information sharing.
HDI → HDI implemented a comprehensive safeguarding policy with multiple steps to prevent harm to participants throughout the design process. Risk mitigation mechanisms were embedded at every stage, ensuring participant safety. Research questions were carefully assessed for sensitivity and necessity, ensuring they were appropriate for the community. During formative research, field coordinators, known in the community, accompanied data collectors to provide immediate support and ensure safety. To minimize surprises or adverse reactions, community mobilization activities were conducted beforehand to explain the research purpose. Additionally, all Institutional Review Board (IRB) approvals were secured and strictly adhered to, ensuring compliance with ethical standards and guidelines.
Principle 8: Strengthening Documentation
IPAS Kenya and HDI speakers highlighted that the HCD process and the QSF principles provided a strong foundation for their work. These tools ensured a greater sense of accountability by involving the community throughout the process and strengthened the documentation process, making it easier to base decisions on well-documented outputs. This approach ensured that design solutions were responsive to the needs of the people being designed for and with. Additionally, improved documentation facilitated the collective interpretation and adjustment of results, leading to more effective outcomes.
What worked in applying the QSF principles
In the design process, intentionally treating users as active collaborators rather than merely as recipients proved highly effective. By positioning them as equal stakeholders, their needs and experiences were thoroughly incorporated, enhancing the relevance and impact of the solutions. This approach ensured that user challenges were comprehensively addressed, reducing the likelihood of potential oversights.
What were some challenges faced?
A significant challenge identified by IPAS Kenya was the limited availability of primary and secondary data on abortion, which hindered a comprehensive understanding of the needs and rights of women and girls. HDI speakers highlighted additional challenges in involving youth in the design process. The process was resource-intensive, requiring considerable time and effort to create an environment where the benefits of youth participation were evident. Substantial investment in youth training was also necessary, and the complexity of conducting sessions in remote areas underscored the risk of tokenistic participation, where the effort required for meaningful engagement often seemed disproportionate to the outcomes.
Conclusion
Both organizations underscored that the true value of the QSF principles lies in their ability to make the implicit aspects of the HCD process explicit within a well-organized framework. These principles make the HCD process more actionable and ensure that actions align closely with what teams can effectively leverage. The speakers in the fireside chat unanimously agreed that while the QSF principles can be adapted to different contexts, they consistently deliver the same high-quality results.
Click here to read a comprehensive review of what has been learned from IPAS Kenya and HDI’s implementation of the QSF principles.