Themes From Insight Synthesis and Design Opportunities to Address Barriers to Adolescent Girls' Contraceptive Use and Autonomy
| Insight | Description | Illustrative Quotes | Design Opportunities |
|---|---|---|---|
| Wayfinding amid an ocean of misinformation | Despite girls' curiosity to better understand contraceptive options, accessing information often felt overwhelming and confusing without clear support in navigating misinformation. | “If the methods don't work with your blood… you can easily get pregnant.” —Adolescent girl in Migori “When I hear contraception… it means the user doesn't want to get many children.” —Adolescent girl, Kajiado | How might we design approachable and convenient access points for girls and their surrounding communities to receive accurate information? How might we frame education around myths and misconceptions as a community-wide goal and not just a burden on girls? |
| Experiencing fear at the forefront | Girls experienced fear, shame, and uncertainty when learning about contraceptive methods and thus did not feel empowered to explore their bodies or their choices. | “When you adopt a contraception method you must hide it so that your parents & friends won't consider you as a person with loose morals.” —Adolescent girl, Narok | How might we equip girls to identify, express, and overcome the fears that they are experiencing when learning about contraceptive methods? How might we support the community surrounding girls to understand the impact they have on how she feels about her body and choices throughout adolescence? |
| Discretion and privacy | Girls valued access points to discuss their concerns and options but required more discretion than was often offered to feel safe in expressing themselves openly. | “I tell or ask my family or a friend because then it remains private.” —Adolescent girl, Homabay | How might we create opportunities for girls to discreetly engage in conversations about SRH on their own terms? How might we design SRH programming that offers girls both the support of an encouraging community alongside the right amount of discretion and privacy? |
| Enabling the community to support and champion girls | The community surrounding girls significantly impacted her beliefs and concerns; although most mothers, fathers, and partners wanted to help, they lacked the information and exposure needed to guide the adolescent girl on her SRH journey. | “Boyfriends & men don't know much & also don't want to hear that you have adopted contraceptives because they also have similar concerns about its negative effects.” —Adolescent girl, Homabay “Nani kama Mama –who is better than mum” – she won't fear to tell you the truth and she wants the best for you in life.” —Adolescent girl, Kilifi | How might we enable role models and influencers to support girls in accessing supportive information when making SRH-related decisions? How might we build awareness with role models and influencers as to the importance of their role and the potential of their influence on a girl's life and decision-making power? |
| Her experience in facilities, her relationship to providers | Health facilities were where girls needed to go to get access to information and services, but they didn't trust providers, nor did they feel like these spaces were for them. | “I was in the hospital and the doctor told me that these methods are being phased out because of the side effects. Especially the injection method.” —Adolescent girl, Migori | How might we engage and equip health facilities and providers to strengthen their youth and girl-friendly services and offers? How might we support girls in understanding their rights, building a practice of open expression of concerns and shameless desire for informed decision-making about their bodies? |
| Building her confidence for the future. | Adolescent girls' dreams were bound by their exposure to what was possible. Girls were well aware of the difficulties and challenges of building toward nontraditional goals, like continuing education or entrepreneurship. She needed a “reality check” but also belief from those surrounding her that she was capable, despite the challenges, and that she could learn and grow toward more. | “We are a digital generation and you should consider upskilling us with sophisticated skills -not the usual basics.” —Adolescent girl, Migori “The boy child should also be included in the education, so that they [support us and] don't idle around and get us into temptation.” —Adolescent girl, Homabay | How might we ensure programming includes resources and tools that equip the adolescent girl to dream forward for herself – whether that's starting a family, continuing her education, or becoming a businesswoman? How might we consider dissolving the gender barrier in future-forward programming, including the perspective of the adolescent boy and seeking to transform adolescent boys into supporters, collaborators, and advocates? |
| Self-expression, optimism, and ownership | She was excited and curious about her future; she craved support to build her confidence and take ownership over her own story. | “Girls would like to have the ability to make important choices that affect their lives and would like to be empowered enough to avoid overdependence on their communities, who could impose their decisions on them.” —Service provider, Kilifi “Having girls themselves take on a visible leadership role within the community and a sense of responsibility can be positive forces for change in the lives of young girls.” —Community influencer, Kilifi | How might we create an environment in which girls are confident to take up space, speak up, claim ownership of their decision-making and feel fully engaged in intervention activities? How might we prioritize components that are cocreated with girls, integrating their perspectives and preferences into the final product? |
Abbreviation: SRH, sexual and reproductive health.