Facilitate couples in visualizing what a women’s body goes during acts of child-bearing, abortions and contraceptive use. Provide easy access to post contraceptive use support for couples that prepares them better to manage and mitigate side-effects i.e. anticipate side effects and seek high quality post care services through health system actors and frontline workers. The concept also aims to provide correct and complete information on contraceptive methods including possible side-effects to help prepare couples for use.
The field research pointed to a clear lack of knowledge on the various contraceptives for men and women that were available to couples to choose from, along with information on which of these were most suited to match their fertility preferences. There were several cases of couples encountering side effects, with limited avenues to seek advice or help. Women often reported continued endurance of side-effects due to lack of support from husbands, family and the health system.
Key Design Challenges
Enable couples to proactively mitigate side effects for women/ seek redressal pathways in order to facilitate a timely exit from the experimentation phase or switch to a more suitable method.
Ensuring informed discussions between couples and the health system actors on contraceptive use, particularly around side effects and health risks that women may incur and how to manage them.
Helping men empathize with the long lasting side-effects faced by women due to contraceptive use and provide men with emotional and mental capacities to support their wives.
Encouraging collaborative decision-making on contraceptive uptake in order to prevent/mitigate health risks for women. Further encouraging men to provide women with the necessary support to deal with side effects.
Key Design Decisions
The design needed to provide the core knowledge of what a women’s body goes during acts of child-bearing, abortions and contraceptive use. The basket of choice needed to be explained in an engaging and interactive manner to facilitate self-exploration along the lines of proper usage, associated side-effects and their management. A proactive engagement with informed HSAs to enable this process needed to be in place to further reinforce the initiative.
A digital tool that provides information about contraceptive basket of choices along with the associated side-effects. Couples will be provided with a medical point of contact to seek medical aid, help in choosing a contraceptive, effectively using it and seeking recourse if met with side effects. It will also provide details of places to procure contraceptives, keeping in mind differential points of access for both men and women. The ideal usage of this tool is facilitated by a frontline worker, however the design also accounts for self-use.
A non-digital tool that provides information on the various contraceptive options available within the Basket of Choice (BOC), along with the common side effects associated with each of them. The tool consists of an accordion style information leaflet, which the ASHA uses to engage couples. It is based on a choice-consequence logic, in which the couple chooses a method based on their fertility preferences and comfortability of use for both partners.
The couple has sufficient time available to engage with the FLW.
FLW is able to engage with husbands
For self-access, either of the partners possess a smartphone and have the requisite skills to access the digital platform online.
Couples have a WhatsApp account and know how to use it.
Couples possess basic reading skills in the language being used to access the smartphone.
FLWs/HSAs have received training and are adept at handling sensitive topics.
Health system actors are receptive to the fertility needs and suggest methods which align with their preferences
Health system actors acknowledge and are sensitive to the side effects faced by women from using contraception
Couples have a fair level of mutuality and communication for the man to empathize and acknowledge the health risks to women due to side-effects
Women’s complaints of side effects may be undermined by her husband and HSAs, if it’s outside the ones listed in the app/pamphlet.
The woman may face harsh consequences if she seeks contraception before she’s had her first child.
Recorded data can be held against the woman/couple.
Data uploaded on servers risk privacy breaches.
Considering and choosing from a basket of choices is a largely accepted and culturally approved norm, the practice of which is flawed. Hence encouraging a shared understanding of sex and contraception is an additional layer that will potentially make this conversation easier and still remain within contextual sensibilities.
The concept may build a gender equitable relationship between the husband and wife by providing them the various resources and supporting aid required to make the conversation about sex and contraception easier Shared responsibility of contraceptive use among couples would make the relationship gender equitable. Recognition of and understanding the side-effects faced by women may help men to share the burden and resort to methods which suit both partners. High risk perception may increase not just for unwanted pregnancy but also the health consequences of contraception and encourage couples to have safe sex.
The concept has the potential to bring the husband and wife together in a healthy way to experiment with and decide a contraception that suits both of them and caters to their needs, rather than solely burdening the women to take responsibility for contraceptive use, even at the cost of her own health and well being with men and other family members primarily as decision makers only.. It also provides an opportunity for husbands to visualize and acknowledge the health risks women face which may lead to greater mutuality and improve overall couple dynamics.