Uganda hosts one the largest refugee population on the African continent. Refugee adolescent girls in Uganda refugee settlements are extremely vulnerable, face high rates of unintended pregnancy which can have devastating health, social and economic impacts.
Self-managed family planning has the potential to reach vulnerable refugee adolescent girls who never before have been able to access FP and/or face multiple barriers to accessing facility-based FP services. The She Cares Initiative aims to use self-managed FP to reduce unintended pregnancy amongst refugee adolescent girls and young women in Yumbe and Lamwo, Uganda.
Design Research: We spoke to girls individually to understand their lived experience of seeking contraception and mapped barriers across their journey from deciding upon a contraceptive and provider, accessing the contraceptive and using it until they stop or switch the method. We verified and prioritised these identified barriers through a participatory workshop with our youth advisory board.
Generate solutions: We then pivoted the barriers into opportunity areas and invited the project core team to brainstorm ideas in response to each ideation prompt. We contextualised the ideas with the help of team members based on field, and consulted the technical advisory board to learn from other projects tackling similar problems around the world.
Prototype: Finally, we built 7 tangible prototypes to get feedback on these ideas from girls and providers and discarded, combined and iterated the prototypes to better meet their needs and align with their understanding.
Through this process, we designed the Forgiving Pill and the FP Eligibility Card as well as a program model that improves the quality of SRH self-care while ensuring the privacy and dignity of our clients.
A front and back printed A6 card - provided by a midwife after counselling and screening
<aside> 🔇 Adolescent girls don’t need to be screened or asked questions each time they seek a self-managed contraceptive. The FP Eligibility Card enables girls and women who have been counselled and screened to access contraceptives from community health workers and drug shops - without needing to provide any other information
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She visits a midwife at a health outreach session where the midwife teaches her about the different FP methods
The midwife then individually screens all attending girls for all FP methods
She assigns her an FP eligibility Card crossing out methods she is not eligible for
The midwife gives the card a unique number, writes the name of the health centre, and contact details of people she can get the contraceptive from
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She decides to take a self-managed contraceptive from one of the dispensers listed on her card
She shows her card at the drug shop and points at the method she wants
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The drug shop assistant gives her 3 packs of the method she is eligible for
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She may visit the midwife in the future in case of any concerns or unmanageable effects