Prioritizing User Needs To Accelerate Contraceptive Innovation

Challenge

Access to voluntary family planning is a cornerstone of public health, empowering women to decide if and when to have children, which leads to healthier families and communities. Yet, in many underserved regions, women face barriers to accessing effective contraceptives that align with their needs. Contraceptive options are limited, often relying on hormonal methods that can bring side effects that lead many women to discontinue use despite a desire to prevent pregnancy.

Beyond One Size Fits All sought to explore how non-hormonal contraceptives could be designed and communicated to resonate with women of reproductive age in global majority contexts, ensuring these options are both effective and appealing. Catapult Design partnered with Spindle Design, Open Knowledge Framework, DODO Design, YUX, and Alt Unfold to better understand and prioritize the unmet needs of women as they relate to modern contraceptive methods. In regions like Kenya, Nigeria, and Senegal, contraceptive choices are often developed without sufficient input from women. This disconnect leads to solutions that may not fully address the nuanced and diverse preferences shaping women’s contraceptive decision-making.

By working alongside our local partners, we focused on capturing and amplifying women’s voices, helping inform the development of contraceptive solutions that are inclusive, accessible, and closely aligned with the realities of women’s lives.

Work

The work from diverse teams relied on a human-centered approach to bring women’s voices into every stage of the design process, with the Gates Foundation at the forefront of this mission. Our work focused on connecting with women directly to understand their unique needs and preferences, especially regarding non-hormonal contraceptive options, which have traditionally been underrepresented in family planning solutions.

To achieve this, our teams engaged with over 900 women across Kenya, Nigeria, and Senegal. These women represented a wide range of ages, socioeconomic backgrounds, and living environments, including both urban and peri-urban areas. Recognizing the diversity of experiences among women in these regions, we prioritized reaching women from vulnerable groups through the Pathways vulnerability segmentation model. This approach ensured that our sample reflected those with the most limited access to family planning resources. Beyond One Size Fits All connected women of reproductive age with non-hormonal contraceptive developers, creating options that address evolving needs, foster shared understanding of product attributes, and present concepts through visualizations, value propositions, and decision-making journeys. The voices of these individuals led the conversation on shaping solutions that work for them.

Through more than 1,100 hours of interviews and focus groups, women were engaged in in-depth conversations about their experiences, needs, and preferences when it came to contraception. The discussions covered a variety of topics, from preferred contraceptive attributes (such as efficacy and ease of use) to challenges with existing options, including side effects and accessibility. A recurring theme was the need for products that were effective, reliable, and minimally disruptive to their daily lives and well-being. Women also shared a desire for contraceptive choices that offer a suite of options.

Results

Beyond One Size Fits All provided a nuanced understanding of how women approach contraceptive choices, revealing that choosing a contraceptive method is a deeply personal decision influenced by factors like pleasure, peace of mind, relationship dynamics, and financial circumstances. Across Kenya, Nigeria, and Senegal, most women of reproductive age did not distinguish between hormonal and non-hormonal methods initially; rather, their preferences were shaped by their specific experiences with available products. When given a choice, however, many women expressed a preference for non-hormonal contraceptives, provided they were as effective as hormonal methods, assuming these options would bring fewer side effects.

Efficacy emerged as the non-negotiable foundation for all women of reproductive age considering non-hormonal contraceptives, but adoption is influenced by region-specific priorities. Side effects are a universal concern, though the specific types women prioritize vary by region. While menstrual bleeding concerns were common, other side effects, such as weight gain or skin changes, carried different importance depending on cultural, social, and religious factors. Women’s choices were influenced not only by physical side effects but also by how these might impact their social roles, cultural practices, and beliefs.

This research highlights the need for product development to start with the lived experiences of women of reproductive age rather than technical constraints. By understanding these decision-making journeys and addressing the specific needs of each vulnerability segment, contraceptive solutions can better support women’s evolving needs, encouraging broader adoption.

Looking Forward

One of the most valuable outcomes of this project is the comprehensive data captured and stored for future use, creating a resource to guide ongoing and future contraceptive research. Although this research was not intended to define specific product features, it provides insights into how women of reproductive age’s decision-making patterns can inform the development of non-hormonal contraceptive options that align with their diverse needs. Moving forward, success lies in developing a range of choices that allow women to select options that meet their unique needs and fit their lives at every stage.