Our lives, our voices - leveraging human centered design for stronger SBCC

In Nepal, chhaupadi-a socio-religious tradition-mandates menstrual isolation and exposes women and girls to health and safety risks. There remains a gap in evidence regarding culturally grounded approaches to reduce harms associated with chhaupadi. This presentation draws on findings from SAMIP (Strengthening Actions in Menstrual Health and Hygiene Interventions for Promotion of Women's Health in Nepal), a five-year, community-engaged initiative designed to collaboratively develop and pilot a culturally resonant intervention.
Harnessing combined strengths of Intervention Mapping (IM), Human-Centered Design (HCD), and arts-based research, we conducted a 10-day workshop in Dailekh, where chhaupadi continues. Eleven women participated as community designers, using HCD and creative tools to articulate lived experiences and generate intervention ideas. Through iterative activities, including storytelling, photography, and visioning exercises, participants collaboratively shaped an intervention theme and sample activities such as dramas, folk songs, and short videos. Their final intervention concept, हाम्रो आवाज : छाउपडी अन्त्य परिवर्तित जीवन (Our Voice: Transforming Lives through Chhaupadi Ending) – presented on a co-designed poster – integrates culturally grounded elements including Natak (traditional drama), Deuda (duet folk song) performances, dance competitions, and social media videos.
Participants emphasized the need to engage diverse stakeholders, such as women and girls, police officers, healthcare providers, husbands, neighbors, local government, and religious leaders, to strengthen legitimacy and ensure sustainability. As global health moves toward equity and community ownership, SAMIP offers a replicable model for developing interventions that are contextually meaningful, collaboratively designed and rooted in lived experiences of those most affected.

Over 20,000 new cases of ovarian cancer are diagnosed annually in the United States. Ovarian cancer cannot be screened for, and the most common type is deadly-only half of women survive 5 years after diagnosis. The recent discovery that most ovarian cancer starts in the fallopian tubes, and that up to 80% of ovarian cancer could be prevented by a salpingectomy (surgical removal of the fallopian tubes), provides women a prevention opportunity. A salpingectomy is also a method of permanent contraception and is now recommended instead of tubal ligation. However, salpingectomy is not yet standardly offered, and very few women or non-OB/GYN providers know about it. The Johns Hopkins School of Medicine, in coordination with Break Through Cancer, engaged the Center for Communication Programs to lead a human-centered design process to co-create SBC materials for potential patients and non-OB/GYN providers about salpingectomy. Through a co-design workshop, survey, and in-depth interviews, CCP engaged with over 150 stakeholders to inform SBC materials and identify 14 points in a woman's health care journey that would benefit from information about ovarian cancer prevention and salpingectomy. The HCD approach elevated the voices of women of color, who unfailingly raised concerns about the history of reproductive abuses committed against black and poor women, and the distrust that remains between these communities and the health care system.  

MOMENTUM Safe Surgery partnered with Johns Hopkins Center for Communication Programs (CCP) to implement Human-Centered Design (HCD) workshops across four countries. The steps - empathize, define, ideate, prototype, and test enabled creative, user-centered solutions that were desirable, feasible, and viable. 
Each country addressed a unique challenge. Female genital mutilation/cutting (FGM/C) in Ebonyi State, Nigeria, emergency obstetric care in India, managing obstetric complications and post-natal family planning in Mali, and a focus on quality, facility-based deliveries in Senegal.
The HCD workshops revealed critical insights related to the challenges identified. In Nigeria, providers rarely counsel on the harms of FGM/C due to limited awareness and prevailing cultural norms. In India, providers struggle with heavy workloads, insufficient training, and resource shortages, resulting in burnout. In Senegal, poor clinic experience and community health actors' exclusion affected facility deliveries. In Mali, poor road conditions and a lack of trained staff for emergency referrals delay maternal care. 
The workshops surfaced thoughtful, context-specific solutions to challenges, rooted in community engagement. In Nigeria, strengthening information at service delivery points and integrating FGM/C into community education, alongside provider training on anti-FGM/C policies to about its dangers and legal implications. In India, counseling materials, leaflets, and an empathy-focused videos for pregnant women and their partners aided ASHAs. Senegal's community dialogues and safe delivery preparation programs, leveraged a blood drive, built trust, preparedness, and stronger links between communities and health facilities. In Mali, using flipbooks for awareness and WhatsApp for referral coordination and training of matrones. 

To recruit MSM and trans communities for a new monthly PrEP trial, 'raver' or sex-oriented rhetorics are often assumed. Project EXPrESSIVE challenged this by using a human-centered design (HCD) approach in 8 countries across Africa, Asia and South America to co-create recruitment materials which speak to the holistic humanity of our target audience. Partnering with in-country HCD teams and Nendo, a Kenyan digital marketing agency, the project engaged 64+ participants (MSM, trans, non-binary) through immersive dialogues aimed at capturing their unique desires and challenges. This process revealed that participants' core drivers were not parties and  sex, but family, success, and intimate connection- a desire to be seen as the people they are rather than the sex they have. These insights were used to create recruitment materials, which were tested with the same participants. Participants strongly rejected 'party pill' visuals, demanding authentic, localised materials that addressed their real-life concerns, particularly around their place in their social networks and touched on trans-specific needs like hormone therapy interactions. Feedback generated around these prototypes was used to develop the final recruitment material, encapsulating a co-creation process which trends away from a misaligned stereotype towards a trustworthy, community developed and vetted message.