Pharmacy Interventions Design
Pharmacy Interventions for Reproductive Health Self-care products
Year: 2019
Location: Kenya
Partners: Confidential
Role: Senior Designer
Approach: HCD Research, Rapid prototyping, Qualitative Research
Team: Sandra Waihuini, Jenny Liu, Aika Matemu
Context
Across many informal settlements in and around Nairobi, pharmacies serve as the primary—and often only—entry point for healthcare, where women seek advice and treatment for their households long before visiting a formal clinic. These outlets, though frequently operating off-grid and with limited resources, are trusted neighbourhood fixtures prized for their accessibility and affordability. This research project aimed to identify the drivers behind pharmacists' motivations to stock, sell, and educate end-users on self-care Sexual and Reproductive Health (SRH) products, with a specific focus on DMPA-SC.
A central goal of this work was to investigate how to transform these pharmacies into high-quality intervention points for women’s self-care. We sought to understand the barriers to service delivery and use those insights to prototype a commercially viable solution that motivates pharmacists to not only stock and promote these products but to effectively train end-users on self-administration for their contraceptive health needs. By centring the pharmacy as a formal point of reference, this study offers a pathway to improve the level of safety, care, and health services available to women navigating the complexities of informal urban environments.
Takeaways
1. For pharmacy owners to prioritise DMPA-SC, the delivery model requires a clear commercial value proposition that balances the time investment with long-term profitability and customer retention, especially with an integrated service delivery element such as guided administration or counselling.
2. While pharmacies are uniquely positioned to normalise self-injection behaviours and provide immediate information, they must first overcome prevailing mistrust regarding their role as sensitive contraception providers. Design interventions should focus on enhancing the "guided care" experience, ensuring privacy and professional standards that validate the pharmacy as a safe, credible healthcare destination for women customers.
3. Women currently rely on pharmacies as primary information hubs, yet a significant gap remains between seeking advice and using active services. To bridge this, interventions must facilitate a gradual behavioural shift, moving women from passive inquiry to active engagement through incremental trust-building touchpoints and low-friction service entry points.
Research Objectives
The project was designed to bridge the gap between retail pharmacy operations and high-quality reproductive health delivery in informal urban environments. Our approach focused on:
1. To identify insights around pharmacists' motivations to stock, sell and educate end-users on self-care SRH products, with a high focus on Sayana Press® (SP).
2. To utilise the insights to develop and prototype a commercially viable solution in Kenya, that ultimately motivates pharmacists to stock, promote and train end-users on effective reproductive health self-care and informational service support.
Creative Exploration
We spoke to 14 pharmacy owners, technicians and assistants and visited 3 private and 1 public healthcare facilities as well as 6 women aged 18- 40 and 4 men aged 20-40.
The research toolkit utilised a targeted suite of participatory activities to decode the complex landscape of women’s contraceptive health. We employed Jjourney mapping to trace the end-to-end decision-making process for women accessing SRH and family planning methods, surfacing the specific barriers and friction points that define their overall experience. This was supported by ecosystem mapping, which visualised the existing resources and support channels women rely on when learning about SRH products, providing critical data to inform the development of more effective pharmacist training modules.
To address the deeper social drivers of access, we interviewed men to explore societal norms, gendered assumptions, and male perceptions that impact a woman’s ability to seek care. These narratives were essential in identifying how men can transition from gatekeepers to advocates, supporting the uptake of self-care products. By integrating these multi-layered insights, the toolkit ensured that the resulting interventions were grounded not only in the practicalities of service delivery but also in the cultural and relational realities that govern reproductive health agencies.
Highlights
Our research revealed a complex landscape where the potential for self-care is often limited by structural and social barriers. While pharmacies are the primary, most convenient access point for women in low-income settings, they navigate a balance between commercial viability and the delivery of sensitive Sexual and Reproductive Health (SRH) services. We found that widespread social misconceptions and inconsistent service standards—driven by varied pharmacy capacity in privacy, staffing, and training—frequently undermine the safety and reliability of DMPA-SC delivery.
Furthermore, the tension between maximising product profit and maintaining affordable, high-quality care often exacerbates existing mistrust between women and providers. While pharmacies are uniquely positioned to provide critical aftercare and engagement, transforming them into effective intervention points requires addressing these misaligned incentives and investing in the significant resources needed to bridge the gap between simple retail and comprehensive contraceptive support.
Outcomes
With these insights, we identified some opportunities and recommendations for intervention, largely focused on women's experience in the pharmacy with DMPA-SC and the pharmacies' experience with purchasing and stocking products.
Click on the gallery below to view some prototype recommendations that we developed for testing and rollout.
This prototype mock-up calls out all potential interventions that could be made to the pharmacy environment and the points of interaction between attendants and customers.
These profiles describe the general set-up of a pharmacy in a low-income area.
A tiered suite of investment resources to support service delivery, itemised by preferred budget and needs.
This prototype mock-up calls out all potential interventions that could be made to the pharmacy environment and the points of interaction between attendants and customers.
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"We serve the people that don’t have the means to afford products otherwise. We all support each other in this community. They know that they can get medicine from me on credit."
Quote from a off-the grid pharmacy owner in Kibera.
