Improving Contraception Outreach through Human-Centered Design: A Pilot Study of the Ndingathe ("I Can") Intervention...

Area of Science:

• Global Health
• Reproductive Health
• Health Systems Strengthening

Background:

• Community health workers, Health Surveillance Assistants (HSAs), in Malawi facilitate rural contraception access.
• Self-injectable contraception (SI) offers a promising method for increased contraceptive autonomy.
• The Ndingathe intervention was developed using human-centered design to address workflow challenges for HSAs and improve SI counseling.

Purpose of the Study:

• To assess the feasibility and acceptability of the Ndingathe intervention.
• To evaluate the potential effectiveness of Ndingathe in improving contraception access and reducing fear of SI.
• To understand stakeholder perspectives on the intervention's components and impact.

Main Methods:

• Mixed-methods approach including pre- and post-surveys with HSAs and clients.
• Interviews with clients, HSAs, health system stakeholders, and experienced SI users.
• Observations of community outreach clinics and quantitative/qualitative data analysis.

Main Results:

• Intervention components like bicycles and allowances improved HSA outreach frequency and duration.
• HSAs reported reduced role conflict and overload.
• Clients showed decreased fear of needles after SI counseling and support from experienced users.

Conclusions:

• The Ndingathe intervention is feasible and acceptable to stakeholders in rural Malawi.
• Pilot findings indicate potential for improved contraception accessibility.
• The intervention may effectively reduce fear associated with self-injectable contraception.