ArticleBMC women's health2025
Development of a community-based peer-support intervention to improve contraceptive agency and diffuse self-injectable contraception in Uganda: Application of the human-centered design approach.
Article in BMC women's health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Understanding clients' and providers' perspectives on the implementation of subcutaneous depot medroxyprogesterone acetate (DMPA-SC) for self-injection programming in Nigeria.BMJ global health · 2026Article
- Validation of a measure of contraceptive self-injection self-efficacy in Uganda.BMC women's health · 2025Article
- Introduction to the special supplement, unlocking the potential of self-injectable contraception: evidence from coordinated investments.BMC women's health · 2025Article
- Improving contraceptive agency through peer social support: findings from a longitudinal qualitative evaluation of the I-CAN intervention in Uganda.Frontiers in global women's health · 2025Article
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Authors and funding
14 authors.
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Abstract
backgroundThe low use of self-injectable contraception, coupled with the recognition that many individuals need support beyond training to use self-care technologies successfully, suggests the need for innovative programming. We describe the participatory human-centered design process we used in two districts of Uganda to develop a community-based peer support intervention to improve women's agency to make and act on contraceptive decisions and help diffuse self-injectable contraception.
methodsThe design team included multi-disciplinary researchers from Uganda and the United States, representatives of local community-based organizations and village health teams, and local women of reproductive age. The research group conducted 21 in-depth interviews, 12 observations, and six focus group discussions to understand women's social support needs, contraceptive-seeking experiences, and communication channels. From these data, the design team derived insights into needs and opportunities to improve contraceptive agency and support self-injection use among interested women, spurring a creative idea-generation process to develop a large set of potential solutions. We collectively prioritized the most promising ideas into an integrated, theoretically informed intervention and subsequently prototyped, tested, and refined the intervention.
resultsDesign insights included: women value information from experienced peers and want support to navigate uneven partner dynamics, conflicting contraceptive information, concerns about contraceptive-related side effects, and unreliable contraception services. The final intervention-called I-CAN (English), Nsobola (Lusoga), An Atwero (Langi)-engages experienced self-injection users as 'mentors' to support other women ('mentees') they recruit in community-based settings. Mentors provide informational, instrumental, appraisal, and emotional support tailored to the individual needs of mentees. This support is designed to improve mentees' knowledge, consciousness of their rights related to contraception, self-efficacy, and perceived control related to contraceptive decision-making, self-injection self-efficacy, contraceptive access, and ability to act on preferences.
conclusionsOur iterative human-centered design process incorporated diverse, lived experiences and scientific expertise and resulted in a peer support intervention with the potential to fill an important gap in contraception service delivery in Uganda. Our approach demonstrates that creating complex interventions to prioritize support for women's agency related to contraception in line with a human rights-based approach and to spread new contraceptive methods is feasible.
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