LIFE COURSE IN CORE
Women’s lives are complex, and their sexual and reproductive health is vital to their overall wellbeing.
The life course approach helps us better see and understand the connections between past experiences and future health outcomes. It lets us look at a woman’s sexual and reproductive health journey on a timeline on which we can map the critical transitions in a woman’s life, transitions that can have an enduring impact both on her own health as well as on the health of future generations.
These transition points are sensitive events or periods of change and disruption in the biological, psychological, and/or social world of a woman, that influence her identity, status, rights, responsibilities, and needs. The timeline also helps us pinpoint possible entry points for interventions aiming to reduce ill-health and improve well-being of women.
To gain insights into the needs of the women we aim to serve, Core developed the life course journey mapping tool. The tool grounds the design process in research, by ordering individual experiences to reveal larger patterns and correlations. It works to prompt sensitive dialogue with women, while identifying challenges that may be turned into opportunities.
The life course approach complements Core’s human-centered design process, offering insights into how one or more transitions influence a woman’s life, and enabling us to co-create and test tailor-made women-centered preventative solutions for critical turning points in her life.
Both systems regard the individual as integral to understanding the problem and developing the solution. Consequently, implementation costs are rationalised as the co-created solution is most likely to be taken up by the women and girls it is designed to serve.
The combination of the two approaches kindles forward-looking engagement with women and girls on family planning and associated sexual and reproductive health issues.
EMERGING FOCUS AREAS
Focus areas within project countries are guided by the life course approach, and based on extensive secondary research of national data, priorities and strategies for sexual and reproductive health. To further inform and refine our focus, we dialogue with technical experts and the foundation’s programme strategy teams as well as interact with girls and women directly in their communities during the design research Discover stage of the project.
India: Pre-marriage & marriage
Core’s focus in India is the adolescent ‘pre-marriage’ period, or the life course moments encompassing puberty, sexual initiation and the key transitions affecting women’s health and well-being around this period. Core has used the Discover design research stage to hone in on this critical period, to understand the challenges faced through an intergenerational lens. It seeks to collaborate with ongoing initiatives in the region, using human-centered design to co-create solutions.
Kenya: Family planning
In Kenya, Core seeks to better understand the drivers and barriers to trial and adoption of family planning methods from the perspective of both, men and women. Over the course of the two design research Discover phases, Core explored how family planning decisions are made, especially the role of men in decision-making as well as their influence on the sexual and reproductive health of their partners in general.
Nigeria: Collaborative learning platform
In Nigeria, Core will serve as a collaborative learning platform for implementing partners, the design community and the foundation’s country office. Core seeks to design a tailored learning journey with multiple learning modalities and engagement opportunities along the human-centered design stages of work. Our approach for Nigeria is informed by an extensive landscape analysis, discussions with technical experts and partners at a workshop conducted in November 2018, as well as a grounding field trip in early 2018.
Tanzania: Adolescence
Core seeks to explore adolescent transitions among women and girls in Tanzania. Both phases of design research for the Discover stage were carried out in late 2018. Core developed and employed bespoke design research tools to gain nuanced insights into adolescent behaviour with the aim to better understand the sexual and reproductive health needs of adolescents in order to help inform the government’s new strategy on adolescent health.
Motherhood can be the most trying period in women’s lives. Although the social role and experience of motherhood varies, maternal age, educational attainment, nutritional status and socioeconomic level, universally impact health outcomes.
Adolescence is marked by rapid brain development and the attainment of new cognitive abilities, such as complex abstract thinking, and leads to several significant changes in terms of identity and relationships. Health behaviours developed during this period can have significant impact on outcomes later in life, making this a sensitive life course period.
The start of life, however different risk factors make it one of the riskiest transition points on the life course.
The end of life.
Family planning involves a range of activities, products and services which enable women, including minors, to protect against disease, prevent pregnancy or even determine the timing, number and spacing of offspring and the means by which this may be achieved, influencing biological, psychological and social outcomes.
The nutritional status and health of the mother and other factors affecting the environment of the womb during the foetal period has profound lifelong consequences for health, making this a critical transition on the life course.
Grandmotherhood often gets cited as one of the happiest periods in a woman’s life, marked by fewer responsibilities and greater respect, autonomy and decision-making powers than before.
An important life course period, as infancy along with early childhood involves children attaining a number of important developmental milestones relating to their physical development, along with social and emotional development.
Complications during childbirth claim the lives of thousands of mothers and newborns each year. The quality of care can determine health outcomes for mothers and children, making this one of the riskiest transition points on the life course.
A turning point on the life course, marriage and partnerships can affect the health and self-efficacy of women and girls. At an early age, it can also disrupt their education and development of key skills and social networks, all of which can undermine their future health and well-being, along with the health of their children.
Puberty is the life course moment in young women's lives marked by rapid somatic growth, brain development, sexual maturation and attainment of reproductive capacity, with the onset of menstruation in women. Changes during puberty can also affect the clinical manifestation and incidence of diseases.
Menopause marks a critical moment of change in the life course of women as menstruation ceases. It usually occurs naturally, most often after age 45, and brings with it key physical changes including the end of fertility. Symptoms, however, can show up some years earlier and in some cases require medical attention or treatment.
The postnatal period is the most critical, yet the most neglected phase in the lives of mothers and babies; most maternal and newborn deaths occur during this period. Besides physical complications, mothers can experience mental illness that requires early detection and adequate treatment.
Also known as pre-teens or ‘tweens’, preadolescence is the life course moment when children demonstrate a ‘realist’ view of life which is affected by and imparted through families, peers and schools distinct from children in middle childhood and adolescence phases of development.
Pregnancy is a sensitive experience for women and careful preparation for pregnancies can reduce risks that can influence the early development of foetuses as well as health and wellbeing of mothers. Unplanned pregnancies in women in their 20s are associated with higher risk of maternal mortality and morbidity, making this an especially critical period in the life course.
Prenatal care is an important stage in the life course, both, for the pregnant mother as well as the developing foetus. Adopting healthy habits prior to conception and staying healthy during pregnancy ensures healthy growth in utero, and reduces the risk of chronic diseases being passed on to the next generation.
An important life course moment as the dynamic interaction between physical development, evolving identity and changing social groups leads to exploring and developing behaviours that can pose a significant risk to the health of young women, if not well-informed during adolescence.
