Learning to Listen to Adolescents

Human-Centered Design (HCD) introduces an innovative approach for how global health partners can actively listen to adolescents to drive hyper-tailored sexual and reproductive health (SRH) solutions. As Margot Fahnestock says, “It’s a design prescription for a revolution.”

Margot, a program officer in the Global Development and Population program at the William and Flora Hewlett Foundation, sat with Manya Dotson, the project director for PSI’s flagship and HCD-based Adolescents 360 program, to explore how HCD sparks a new way of listening to inspire a powerful way of designing.

Manya Dotson: What role does listening play in design?

Margot Fahnestock: Design is about translating what people say they want into offerings that account for what people need. HCD forces us to really listen to what clients love to create an environment that motivates them to use our services and return for more.

MD: The Hewlett Foundation entered adolescent and youth SRH work through HCD. Why is HCD a good fit for adolescents?

“HCD is not about breaking down a system but finding small things, like design quality, that can fundamentally change how people experience a service” — Margot Fahnestock, Program Officer, Global Development and Population, William and Flora Hewlett Foundation

MF: We found ourselves observing countries that were once making SRH progress for youth, no longer reaching impact. HCD was our attempt to apply a new methodology to better understand what adolescents needed. It was never about creating a totally different system, but about teaching people to respond to young peoples’ needs in an adaptive way.

MD: What challenges do adolescents face in accessing adolescent and youth SRH care?

MF: Stigma, quality and cost. Traditional adolescent and youth SRH programming fails to address what it means to present for health services in environments that don’t believe young, unmarried women are eligible for contraception. Youth corners and youth clinics are not effective if they don’t correspond with high quality care in highly relevant settings. Cost remains a pervading barrier. Not all services for adolescents must be free, but we can’t expect young people to pay if we aren’t delivering quality and relevant care.

MD: Why is it hard to listen?

MF: It takes work to decipher what someone is saying. HCD gives our partners the creative confidence to know what to do with the information they hear. It takes practice. Just keep trying.

MD: How can we better listen to adolescents?

MF: Listening is not just hearing but showing that you value what young people say. Put adolescents on your staff. Pay them. Try different ways of translating what you hear into outputs that resonate for clients.

MD: How can donors support partners to integrate listening into design?

MF: We can encourage curiosity, stop prescribing interventions, and give implementers the freedom to experiment.

MD: How can partners join this revolution?

MF: Start small. Be curious. There are many ways that current programs with work plans and funding in place can be more adaptive. HCD is not about breaking down a system but finding small things, like design quality, that can fundamentally change how people experience a service. See what works. The more we try and the more we listen, the further we can get in revolutionizing the future of adolescent and youth SRH programming.

This interview first ran in PSI’s Impact Magazine No. 23. To read the full issue, click here.

Adolescents 360 (A360) is a four-and-a-half year initiative co-funded by the Bill & Melinda Gates Foundation and the Children’s Investment Fund Foundation (CIFF). The project is led by Population Services International (PSI) together with IDEO.org, University of California at Berkeley Center on the Developing Adolescent, the Society for Family Health Nigeria, and Triggerise. The project is being delivered in Ethiopia, Nigeria and Tanzania, in partnership with local governments, local organizations, and local technology and marketing firms. In Tanzania, A360 is building on an investment and talent from philanthropist and design thinker Pam Scott.