Submission ID 130606
| Issue/Objective | Adolescents in Nampula, Mozambique face persistent barriers to sexual and reproductive health and rights (SRHR) services, including stigma, judgment, and provider bias. Concurrently, health providers operate within constrained systems shaped by community pressure, unclear accountability, and fear of backlash when delivering care. This abstract examines how Human Centered Design (HCD) was used to centre and value the voices of both adolescents and health providers as equally important forms of expertise to inform more equitable, context responsive SRHR service delivery in Nampula Province. The objective was to explore how locally led, participatory approaches can shift power, rebuild trust, and support change within health systems. |
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| Methodology/Approach | The Todas Avante project applied HCD principles to adapt an existing provider bias intervention in Nampula Province. Design research used interviews and focus group discussions with youth, providers, facility managers, and community health workers to surface how bias manifests in everyday service delivery. Providers co-designed the intervention by testing materials, sharing feedback, and identifying barriers to care and informed the iterative testing of intervention components. Youth researchers and local practitioners led data collection and adaptation processes. HCD activities were intentionally designed to position adolescents and providers as knowledge holders shaping program decisions. |
| Results | Equal prioritization of adolescent and provider voices through HCD led to tangible changes in openness, trust, and accountability and shifted how bias was understood and addressed. Adolescents' lived experiences were treated as legitimate evidence and providers' constraints were validated rather than minimized. Providers openly acknowledged the presence of bias, articulated how age, appearance, and gender norms influenced their decisions and committed to actions for improvement. This reframed bias as a complex social challenge rather than an individual moral failure. |
| Discussion/Conclusion | These findings demonstrate that equity in SRHR service delivery requires valuing adolescent and provider voices equally for health system change. By rejecting narratives that position providers as obstacles and adolescents as passive beneficiaries, the HCD process redistributed power and built mutual trust. It made adolescents' experiences and provider constraints visible, informing adaptation and fostering shared accountability. This case offers practical lessons for scaling community centered, locally led, youth inclusive approaches to advance equitable SRHR service delivery. |
| Presenters and Affiliations | Janani Vijayaraghavan Plan International Canada Andrea Lacorazza Ylabs Raissa Umutoni Ylabs Célio Monteiro José Ylabs Noelle Rancourt Plan International Canada Nina Yengo Plan International Mozambique |
