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Case Study: Improving Mental Health and Adolescent Sexual Health Services in Ghana (UNICEF)

Client: UNICEF Ghana, Ghana Health Services
Timeframe: May 2022 - June 2022
Team: Michael Coleman, Lydia Trupe, Phuthehi Masilo, Bwalya Chirwa and Samyuktha Sam

My Role: Design Researcher and Visual Designer
Goal: Develop behaviorally designed solutions to improve barriers surrounding mental health and adolescent sexual health services in Ghana

How can we effectively address and overcome the stigma and accessibility barriers surrounding mental health and adolescent sexual health services in Ghana?

Challenge

Index

Background

Short Film

The need for enhanced mental health and sexual health services for adolescents in Ghana was identified as a critical concern. A collaborative research project was undertaken by CT, in partnership with Ghana Health Services and UNICEF Ghana, to understand and address these issues.

This is a short film that captures the work we did in the filed, co-creating and testing solutions alongside Ghanian adolescents. The prototypes you see in the film are the ones I worked on at Common Thread.

PART 1
Research and Insights

The research team, comprising experts in public health, behavior science, and design, embarked on a comprehensive field study in various communities within Accra. We conducted interviews, focus groups, and observational studies involving healthcare providers, parents, adolescents, and community leaders.

Key insights included:

  1. Stigmatization and Misconceptions: Mental health counseling was predominantly associated with pregnancy among adolescents. This misconception, coupled with the stigma around sexual health, discouraged many from seeking necessary help.

  2. Emotional and Financial Support Challenges: The research uncovered that a lack of emotional and financial support from families led some adolescents, especially girls, to engage in risky behaviors, including transactional sex.

  3. Health Service Accessibility Issues: Adolescents expressed reluctance to visit health clinics due to fear of judgment and lack of privacy, which was exacerbated when mental health services were colocated with sexual health units.

  4. Educational Gaps: Health workers primarily focused on basic education and family planning, with little emphasis on mental health, leading to a lack of comprehensive health education for adolescents.

A young mother and her child at a health center
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PART 2
Design and Implementation of Solutions

Utilizing the insights gained, we applied Human-Centered Design (HCD) and Behavioral Science (BehSci) principles to craft tailored solutions:

1- Rebranding Adolescent Health Services

Efforts were made to rebrand and reposition health services to encompass a broader range of adolescent needs beyond sexual health, thereby reducing stigma

2- Redesign of Health Facilities

Clinic spaces were reimagined and redesigned to ensure privacy and comfort, creating a non-intimidating environment that encouraged adolescents to seek help.

3-Comprehensive Education and Outreach

The team developed and implemented educational programs in community centers, focusing on topics like self-esteem, stress management, and healthy relationships.

4-Community and Family Engagement

Specialized workshops and resource materials were provided to parents and community leaders to build a supportive ecosystem for adolescents, emphasizing the importance of emotional and financial support.

PART 3
Design Intentions

At every step of this project these were the intentions and guiding principles we kept in mind while designing proposals, recommendations and health services.

  1. A marked increase in awareness and reduction in stigma related to mental and sexual health among adolescents.

  2. Enhanced accessibility and utilization of health services by adolescents, as evidenced by increased clinic visitation rates.

  3. Strengthened support systems for adolescents within families and communities, leading to better overall well-being.

  4. A scalable model for integrating mental health services with broader health initiatives, applicable in other regions.

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PART 4
Conclusion

This case study demonstrates the power of a holistic, community-inclusive approach in tackling complex health challenges faced by adolescents. Through a combination of HCD and BehSci, the initiative successfully reformed mental and sexual health services in Ghana, creating a more supportive and health-conscious environment for the youth. The project not only improved immediate access to health services but also laid the groundwork for long-term, sustainable change in community attitudes and practices regarding adolescent health.

PART 5
Project Reflections

Understanding the Complexity of Cultural Sensitivity: This project profoundly deepened my understanding of the importance of cultural sensitivity in global health initiatives. I learned valuable lessons about engaging effectively with local communities, respecting cultural norms, and adapting solutions to fit the unique social dynamics and needs of Ghanaian adolescents. This experience highlighted the critical role of empathy and understanding in creating meaningful and sustainable health interventions.

The Value of Interdisciplinary Collaboration: Working with a diverse team of public health experts, behavioral scientists, and local stakeholders provided me with invaluable insights. This interdisciplinary collaboration enriched the project significantly, allowing us to develop more holistic solutions that address both the physical and mental health needs of adolescents. I saw firsthand how different perspectives and expertise can come together to create more impactful and well-rounded approaches to complex problems.