Using Human-Centered Design to Improve Malaria Outcomes in Regions 7 and 8

Breakthrough ACTION Guyana is the United States Agency for International Development’s flagship social and behavior change (SBC) project designed to improve malaria outcomes among priority populations. The project uses innovative SBC approaches to address key behaviors related to malaria testing and treatment.

In Guyana, malaria is an issue in Regions 1, 7, 8, and 9, particularly among gold mining populations. In response, the Ministry of Public Health (MOPH), the Pan American Health Organization, and the Global Fund to Fight AIDS, Tuberculosis and Malaria have introduced malaria rapid diagnostic tests (RDTs) to provide services in hard-to-reach areas.

During the Define phase, two research teams conducted qualitative research in Regions 7 and 8 to better understand care-seeking behaviors around malaria testing and treatment among miners. Eleven insights were developed from the initial findings, which were used to inform the Design & Test phase. The Design & Test phase was a highly iterative process that translated problems into solutions through idea generation and prioritization, prototyping, user testing with key audiences in context, learning, and improving. More than 790 ideas were initially generated from a cross-section of stakeholders. These ideas were ultimately categorized into eight broad concepts under which various low-fidelity prototypes were developed and tested with 145 people in Regions 7 and 8.

Rapidly building and testing tangible, low-fidelity versions of each concept provided valuable, early user feedback that helped to refine or abandon design ideas. This resulted in savings in time and money on solutions that did not meet the needs of users or deliver on intended outcomes.

Five design prototypes that showed the most merit during user testing will be reviewed for a pilot and then considered for implementation in the Apply phase.

Source: Johns Hopkins Center for Communication Programs

Date of Publication: July 12, 2019

Rights-based HIV Prevention and Treatment for Key Populations in Mozambique

In Mozambique, key populations for HIV prevention include female sex workers, men who have sex with men, incarcerated individuals, and people who inject drugs. While Mozambique has reduced the number of new HIV infections over the past decade, HIV prevalence among Mozambique’s key populations is disproportionately high, when compared to the general population.

This brief describes how the U.S. Centers for Disease Control and Prevention- and Anadarko-funded Increasing Access to HIV Prevention, Care, and Treatment for Key Populations in Mozambique project (2015-2018), led by Pathfinder International, contributed to a reduction in HIV incidence by increasing access to clinical and community services that protect and respect the human rights of key populations. This technical brief explores implementation of Pathfinder’s rights-based approach in the context of VIDAS II project.

Results from the VIDAS II project shed light on some of the persisting challenges as well as the opportunities that exist for reaching key populations and retaining them in HIV treatment programs.

Source: Pathfinder International

Date of Publication: July 4, 2019

Transforming Masculinities

Transforming Masculinities is an evidence-based approach used in the Democratic Republic of Congo (DR) to promote gender equality and positive masculinities within faith communities.

This approach is based upon the understanding that spiritual beliefs and faith leaders are part of the structure that shapes social and gender norms, and focuses on prevention and response to sexual and gender-based violence.

Known locally as Masculinité, Famille, et Foi, the intervention adapts the Transforming Masculinities approach to include reflection on normative environments and the acceptability of family planning. It consists of a series of trainings, group discussions called ‘community dialogues,’ and diffusion activities that guide faith leaders, young couples, and congregations to identify, create, and embrace positive masculine identities and gender-equitable behaviors.

In addition, an enabling service environment provides a foundation of high-quality, youth-friendly health services across both experimental and control sites. Working with newly married couples and first-time parents, the intervention encourages reflection, dialogue, and action to build norms that condemn violence and enable access to family planning services.

Source: Institute for Reproductive Health

Date of Publication: June 25, 2019

SIMILIAR RESOURCES

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Manhood 2.0: Program Overview and Final Results

Manhood 2.0 is a gender-transformative curriculum adapted from Promundo’s flagship program, Program H (for “hombres” or “homens” in Spanish and Portuguese, respectively), by Promundo and the University of Pittsburgh.

Manhood 2.0 aims to engage young men in questioning, challenging, and transforming harmful gender norms, with the goal of reducing intimate partner and sexual violence and unintended pregnancy. It is a male-only group-level intervention delivered in several sessions based on social cognitive theory, social norms theory, the theory of gender and power, and the theory of reasoned action.

The intervention promotes critical reflection and awareness on gender norms and stereotypes and on power dynamics that drive health, relationships, violence, and sexual health behavior. Sessions include group discussion, role-playing, knowledge-sharing, and skill-building. The purpose of these interactive activities is to challenge young men to think critically about social expectations and restrictive norms, engage in dialogue about these gender norms, and then assess the way these norms impact sexual and intimate relationships, violence perpetration, substance abuse, unhealthy sexual risk-taking, and contraceptive use.

Previous evaluations of Program H have been shown to have the most impact when implemented in groups of 10 to 12 young men, for a longer duration (three months or longer), and including multiple components such as youth-led behavior change campaigns and/or advocacy initiatives.7

Ths report provides a description of the Manhood 2.0 program, challenges and lessons learned, and key evaluation findings. It is intended to be a summary of experiences piloting and evaluating an adolescent pregnancy prevention program for young men.

Source: Promundo

Date of Publication: June 24, 2019

Transformer les initiatives : Utiliser le continuum de genre pour comprendre le public cible / Transforming initiatives: Using the Gender Continuum to Understand the Target Audience

À Abidjan, en Côte d’Ivoire, le projet Transform/PHARE utilise l’approche centrée sur l’humain (HCD) pour cibler les jeunes hommes de 15 à 24 ans travaillant dans le secteur informel. HCD a été utilisé pour mieux comprendre le contexte dans lequel vivent et travaillent ces jeunes hommes, ainsi que pour apprendre à les aborder de manière pertinente. Le projet visait à les engager dans des discussions avec leurs partenaires sexuels sur la contraception et la planification familiale.

Transform/PHARE s’est également engagé à travailler à la conception d’interventions visant à transformer, ou au moins, à intégrer le genre. La feuille de route fournie par l’USAID, l’Outil d’intégration du genre, mis au point par le Groupe de travail sur le genre, a été intégrée à la stratégie du projet sur le genre et a été adaptée pour identifier les étapes au cours desquelles différents segments du public cible se sont retrouvés dans le spectre comme exploitant, accommodant ou transformant le genre.

Il est devenu évident que le public cible n’était pas immédiatement prêt à engager des discussions sur la contraception, le nombre ou le calendrier pour faire des enfants. Le projet a révélé qu’il était au contraire nécessaire de faciliter un changement progressif en prenant comme référence le modèle des étapes du changement (Protchaska & DiClementi), afin d’aider les jeunes hommes à passer du stade des inhibiteurs au stade des adeptes à long terme avec comme objectif de les aider à jouer le rôle de facilitateurs (de comportements de santé de la reproduction équitables en matière de genre). Selon le modèle, le changement se produit progressivement, étape par étape, et un individu modifie rarement de façon spectaculaire son comportement ou ses croyances avant de passer par une série d’étapes.

Le document ci-joint comprend les versions française et anglaise.

In Abidjan, Cote d’Ivoire the Transform/PHARE project activity used Human Centered Design (HCD) to target young men, 15 – 24, working in the informal sector. HCD was used to better understand the context in which these young men live and work, and to learn relevant ways to approach them. The project aimed to engage them in conversations with their sexual partners about contraception and family planning.

Transform/PHARE also made a commitment to work towards designing gender transformative, or at a minimum, gender accommodating interventions. The road-map provided by USAID, the Gender Integration Continuum Tool, developed by Inter-agency Gender Working Group was incorporated into the project’s gender strategy, and through brainstorming the tool was adapted to identify the stages in which different target audience segments fell on the spectrum as either gender exploitative, accommodating or transformative.

It became evident that the target audience was not ready to engage in discussions about contraception and number or timing of children right away. The project found that instead it was necessary to facilitate a progressive change, using the stages of change model (Protchaska & DiClementi) as a reference, to help young men move from the stage of inhibitors, into the stage of supporters with the long-term goal of helping them move into the role of enablers (of gender equitable reproductive health behaviors). According to the model, change happens gradually, step-by-step and an individual rarely changes behavior or beliefs dramatically before going through a series of stages.

The attached document includes French and English versions.

Source: Transform/PHARE

Date of Publication: June 13, 2019

SIMILIAR RESOURCES

Tools

Examples

Human-Centered Design in the Jungle

Since 2015, Liberia has been rebuilding the country’s health system, which was devastated by a civil war that ended in 2003 and again by the Ebola epidemic that ended in 2015. But improvements in the remote clinics are a ways off. Partners In Health staff and local nurses led an HCD program to improve health care in 19 of the facilities.

For two months beginning in April 2016, the team recorded baseline data — on how often nurses washed their hands during births, for example. Then they gathered county health officials, clinic staff, and locals who had been patients for a breakneck HCD session.

Members of the group interviewed each other and shared their experiences. Challenges were presented and agreed on. Participants spent hours ideating potential solutions to a variety of challenges. For example, one reason why only 37% of clinicians wash their hands correctly seems to be simply heedlessness.

Between May and December 2016 the improvements included a wall calendar with portraits celebrating the best handwashers of each month. The number of clinicians who correctly washed their hands increased from 37% to 72% .

Source: Partners in Health

Date of Publication: March 25, 2019

Kuwa Mjanja Project for Adolescent Girls, Tanzania

Kuwa Mjanja is a girl-powered call to action that seeks to reframe the narrative about girls, and contraception, in Tanzania.

In Tanzania, A360’s Kuwa Mjanja delivers entrepreneurial skills and contraceptive counseling sessions— tailored to and branded for the unique needs of the girls we serve. Across disciplines and in partnership with girls, Kuwa Mjanja supports girls aged 15-19 to explore the role contraception plays in helping them achieve their life dreams, today.

Kuwa Mjanja taps into girls’ priorities: finding ways to make money, managing growing responsibility and navigating the transition to adulthood. This framing helps girls figure explore how they might achieve these goals, of which includes contraception.

A360 flips traditional family planning messaging on its head— building from what girls say they want to deliver reproductive health services when and how they need.

Source: PSI

Date of Publication: March 25, 2019

Saath-Saath Bulletins

FHI 360 implements the Saath-Saath (Nepali for together) Project in 33 of 75 districts in Nepal. The project supports the Government of Nepal in its efforts to reduce the transmission and impact of HIV and improve reproductive health among female sex workers and their clients, transgender sex workers, migrant workers and their spouses and people living with HIV.

Over its life of five years, USAID-funded Saath-Saath Project mobilized 48 formal partners and collaborated with the Government of Nepal to implement extremely focused and well aligned interventions.

These bulletins describe the progress of the project and results as it progressed over five years. For more information, go to https://www.fhi360.org/projects/saath-saath-project.

Source: FHI360

Date of Publication: March 25, 2019

3 Ways to Engage the Private Sector against TB

TB is second only to HIV as a killer infectious disease, with more than 10 million new infections in 2015 and an estimated 1.8 million deaths mostly in low- and middle-income countries.In many countries, the private sector represents a major and growing source of services for suspected and active cases of TB. This often presents a challenge for national health systems that are ill-equipped to ensure that private providers provide safe and effective care.

In India, which is home to more people ill with tuberculosis and multi-drug resistant TB (MDR-TB) than any other country, PSI’s Project Axshya is improving case detection and management of drug susceptible TB through the private sector, where studies show most people first seek care. The project works with private providers in three important ways.

  • Engaging with mid-level providers
  • Building capacity of qualified private healthcare providers
  • Leveraging information technology to bridge the gap

Source: Population Services International

Date of Publication: March 25, 2019