(P24-059-24) Integrating Formative Research and Human-Centered Design to Design Strategies to Achieve High Adherence to Prenatal Supplementation in Burkina Faso, Pakistan, and Zimbabwe

Objectives: To design context-specific strategies to enhance prenatal supplementation adherence through existing antenatal care (ANC) platforms.

Methods: We conducted in-depth interviews (N = 93) and focus groups (N = 22) in Burkina Faso, Pakistan, and Zimbabwe with pregnant women, health care providers, and community members to understand knowledge and perceptions towards pregnancy-related health conditions; experiences with prenatal supplements and medications; opinions about making pill-taking more attractive and convenient during pregnancy; and the daily lived experiences of women and midwives/nurses, particularly in their interactions with ANC. We analyzed data collected to create Human-Centered Design outputs (i.e., personas, journey maps) to stimulate empathy among various stakeholders for those receiving (i.e., women) and delivering (i.e., midwives/nurses) prenatal supplements. Participating in a multi-day workshop, these stakeholders designed prototype strategies to address the identified challenges women face in adhering to pill-taking. Prototype strategies were iteratively tested and refined.

Results: In Burkina Faso, to improve community awareness about the importance of ANC and medication compliance during pregnancy, an intervention package was developed that included home visits and counseling by community health workers (CHWs) and research staff, mother-led learning groups, and radio broadcasts. In Pakistan, a multi-compartmental, waterproof bag was designed to allow women to safely store and carry study drugs, as well as a poster/brochure with key messaging to address misconceptions about ANC and prenatal supplements. In Zimbabwe, four prototypes were tested to promote early ANC booking and pill adherence: counseling tools delivered by CHWs, a calendar to track pill intake and SMS reminders, an appointment system to reduce wait times during ANC visits, and a “host package” including a concierge, refreshments, and entertainment to make women feel welcomed at clinics.

Conclusions: Harmonizing qualitative research methods with design thinking approaches facilitated the design of interventions that addressed the unique constraints, needs, and preferences of pregnant women when taking prenatal supplements in each context.

Funding Sources: Bill and Melinda Gates Foundation and The Children’s Investment Fund Foundation