Transforming maternal health in Ethiopia

Leveraging human-centered design to co-create innovative behavioral interventions

Bibliographic Data

ID19594367
AuthorsYihunie Lakew (0000-0002-1520-0844, Johns Hopkins University, corresponding author), Biruk Melaku Ayalew (Johns Hopkins University), Habtamu Tamene (0009-0003-7531-7352, Johns Hopkins University), Simon Heliso Kuka (Johns Hopkins University), Tewabech Tesfalegn (Johns Hopkins University), Danielle Piccinini Black (0000-0002-8188-1676, Johns Hopkins University), Bee-Ah Kang (0000-0002-1124-2481, Johns Hopkins University), R N Rimal (0000-0003-1413-9305, Johns Hopkins University)
EditorsJulia Robinson (0000-0003-0719-3995)
Year2026
Volume6
Issue2
Pagese0006021
Publication date2026-02-24
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0006021
PMID41734173
OpenAlexW7131304475
LanguageEN
References cited24

A significant number of maternal and child births in Ethiopia are at elevated risk because they occur at home and/or because of low rates of antenatal care visits. This study applied a human-centered design (HCD) approach to develop contextually appropriate solutions that can promote institutional delivery and a greater number of antenatal care visits. The HCD approach (a five-step design-thinking process) was conducted in two rounds of workshops. The first-round included pregnant women living with vulnerabilities and their husbands, while the second round engaged healthcare providers and community influencers. The second round of workshops were anchored on findings from the first round. Facilitators trained in the HCD conducted these workshops. A total of 204 participants —pregnant women, husbands, healthcare providers and community influencers, organized into 16 design teams, participated in the workshops and prototype testing. Prototypes were tested and iterated to ensure feasibility and acceptability. The design teams produced stakeholder maps, personas, journey maps, and affinity clusters to deepen their understanding of the challenges and foster stakeholder empathy. Key insights harvested from both round of workshops guided the refinement of the design challenges, resulting in the formulation of twelve “How might we...” statements to facilitate ideation. The resulting prototypes —a self-paced audio program interventions featuring real-life stories and visual print materials—were implemented over four months in two Oromia districts, with Women Development Armies playing a pivotal role in facilitating the rotation of home-based audio interventions. This participatory and iterative process, guided by design thinking, emphasizes the potential of human-centered design to develop contextually appropriate and feasible solutions aimed at enhancing maternal health service utilization in resource-constrained settings

Citizen journalism · Community-based participatory research · Health care · Participatory action research · Participatory design · Program evaluation · Psychological intervention · Stakeholder · Global Maternal and Child Health · ICT in Developing Communities · Innovative Human-Technology Interaction

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