Starting at the Roots: Using Human-Centered Design to Develop a Sex and Pregnancy Education Curriculum for Adolescents in Kenya


  • Sean Buehler, BSPH Indiana University School of Medicine
  • Julie Thorne, MD, MPH University of Toronto School of Medicine, Faculty of Medicine



The rate of adolescent pregnancy worldwide remains unacceptably high. Sixteen million adolescent girls between the ages of 15 and 19, and 2 million under the age of 15 become pregnant each year. Ninety-five percent of these births occur in low-income countries, with four times the rate of adolescent pregnancy in the poorest regions of the world compared to high-income countries. There has been a shift globally to focus on the sexual and reproductive health needs of adolescents, including adolescent pregnancy. With increased awareness of this need has come a renewed call for evidence-based provision of adolescentfocused sexual and reproductive health (ASRH) services, as well as programs to prevent pregnancy in this age group.

“Human-centered design” methodology is emerging as an innovative, feasible, and effective participatory approach to program design and implementation in health care. The standard Human Centered Design format includes 5 steps: (1) Understand people’s experiences, challenges, and priorities; (2) Use existing knowledge and new research to define and clarify the problem; (3) Prompt creative thinking to design many different solutions; (4) Build and workshop prototypes of ideas to quickly learn how they can be improved; and (5) Deliver solutions that meet the needs of the target population.

Through this process, design team members identified a need to “help adolescents by removing the uncertainty that surrounds information on pregnancy and treatment choices”. To meet this need, we utilized participatory program development to build an adolescent-specific sex and pregnancy education program at Moi Teaching and Referral Hospital in Eldoret, Kenya.