NDLI: Development of a community-based peer-support intervention to improve contraceptive agency and diffuse self-injectable contraception in Uganda: Application of the human-centered design approach

Content Provider	Springer Nature : BioMed Central
Author	Birabwa, C Phillips, B Amongin, D Atuyambe, L Turinayo, A Etap, J Kaudha, B Alum, S Agnes, K Kramer, J Sedlander, E Liu, J Holt, K Waiswa, P
Abstract	Background The low use of self-injectable contraception, coupled with the recognition that many individuals need support beyond training to use self-care technologies successfully, suggests the need for innovative programming. We describe the participatory human-centered design process we used in two districts of Uganda to develop a community-based peer support intervention to improve women’s agency to make and act on contraceptive decisions and help diffuse self-injectable contraception. Methods The design team included multi-disciplinary researchers from Uganda and the United States, representatives of local community-based organizations and village health teams, and local women of reproductive age. The research group conducted 21 in-depth interviews, 12 observations, and six focus group discussions to understand women’s social support needs, contraceptive-seeking experiences, and communication channels. From these data, the design team derived insights into needs and opportunities to improve contraceptive agency and support self-injection use among interested women, spurring a creative idea-generation process to develop a large set of potential solutions. We collectively prioritized the most promising ideas into an integrated, theoretically informed intervention and subsequently prototyped, tested, and refined the intervention. Results Design insights included: women value information from experienced peers and want support to navigate uneven partner dynamics, conflicting contraceptive information, concerns about contraceptive-related side effects, and unreliable contraception services. The final intervention—called I-CAN (English), Nsobola (Lusoga), An Atwero (Langi)—engages experienced self-injection users as ‘mentors’ to support other women (‘mentees’) they recruit in community-based settings. Mentors provide informational, instrumental, appraisal, and emotional support tailored to the individual needs of mentees. This support is designed to improve mentees’ knowledge, consciousness of their rights related to contraception, self-efficacy, and perceived control related to contraceptive decision-making, self-injection self-efficacy, contraceptive access, and ability to act on preferences. Conclusions Our iterative human-centered design process incorporated diverse, lived experiences and scientific expertise and resulted in a peer support intervention with the potential to fill an important gap in contraception service delivery in Uganda. Our approach demonstrates that creating complex interventions to prioritize support for women’s agency related to contraception in line with a human rights-based approach and to spread new contraceptive methods is feasible.
Related Links	https://bmcwomenshealth.biomedcentral.com/counter/pdf/10.1186/s12905-025-03614-5.pdf
Ending Page	15
Page Count	15
Starting Page	1
File Format	HTM / HTML
ISSN	14726874
DOI	10.1186/s12905-025-03614-5
Journal	BMC Women's Health
Issue Number	1
Volume Number	25
Language	English
Publisher	BioMed Central
Publisher Date	2025-03-10
Access Restriction	Open
Subject Keyword	Gynecology Maternal and Child Health Reproductive Medicine Human-centered design Contraceptive agency DMPA-SC self-injection Uganda Peers Contraception Intervention design Social support
Content Type	Text
Resource Type	Article
Subject	Obstetrics and Gynecology Reproductive Medicine
Journal Impact Factor	2.4/2023
5-Year Journal Impact Factor	2.9/2023

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

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