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Background: It is estimated that 225 million women worldwide have an unmet need for family planning, and more than half live in low- and middle-income countries. Increasing the choice of contraceptive methods available can reduce this unmet need. Microneedle drug delivery systems represent a new technology for minimally invasive self-administration of contraceptives. We explored stakeholders’ views on different aspects of a proposed microneedle-based hormonal contraceptive delivery system. The feedback was used to iteratively develop this delivery system.\udMethods: Focus group discussions and semi-structured interviews were conducted with potential stakeholders (women and trans males of childbearing age, their partners, and health professionals and organisations that provide family planning advice and contraception services) in Uganda, The Gambia, Malawi, and the UK, exploring concept acceptability and gathering feedback on different aspects of design and usability of the proposed delivery system.\udResults: Participants viewed the concept of a new, microneedle-based contraceptive favourably. In Uganda, participants were presented with 7 different prototype applicators and identified desirable features of a preferred delivery device; their input reducing the number of prototypes that were subsequently evaluated by stakeholders in The Gambia and the UK. Participants in these countries helped to identify and/or confirm the most desirable characteristics of the applicator, resulting in design consolidation into a refined concept applicator. The final, optimised applicator prototype was validated during user research in Malawi. This human-centred design approach was also used to iteratively develop an information leaflet for the device. During these user studies, other preferred aspects of a contraceptive delivery system were also evaluated, such as anatomical site of application, duration of action, and return to fertility.\udConclusions: A new microneedle-based contraceptive delivery system was iteratively developed using a human-centred design approach and was favourably received by potential stakeholders. The product is now being refined for testing in pre-clinical studies.

In this paper, quantitative and qualitative measurements of maternal psychosocial wellbeing were utilized in three districts in Malawi that guided decision-making to increase the wellbeing of adolescent mothers and promote the healthy upbringing of their children. The 1-year design stage of the study relied on several sources of information: literature search, prior project implementation of similar projects, discussions with officials at the Malawi Department of Social Welfare, and observation visits in the targeted districts. The approaches for collecting data mentioned were triangulated for the development of a baseline survey. The baseline survey generated systematically collected data of the experiences and recalls as well as the missing data from the preliminary evaluation of the existing data. The baseline data gave the Young Women's Christian Association (YWCA) insight on the type of intervention required in order to give a greater and more holistic effect on the beneficiaries. We also discuss the lessons we learned as to whether the assumptions we had made at the onset were correct. If they were not correct, we explained the measures we took to correct the design or implementation of the project. Finally, the data provided benchmarks for project monitoring and evaluation.