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Maternal Health Adaptation (PSI Ethiopia)
- Emnet Woubishet
- Ethiopia
- February 1, 2026
Situation
Since 2017, PSI Ethiopia has implemented Smart Start—an approach funded by the Bill & Melinda Gates Foundation and the Children’s Investment Fund Foundation—to help married adolescent girls and their husbands understand how delaying and spacing births can support financial stability and shared life goals. Yet many girls still aspire to early motherhood, with roughly 10% already pregnant at mobilisation, underscoring the need for tailored support throughout pregnancy and after birth.
Assignment
The mandate was to design a component that could be integrated into Smart Start to help married adolescent girls pursue healthy pregnancies through stronger utilisation of maternal health services and sustained continuity of care.
Approach
Following ethical approval, qualitative research engaged girls, husbands, community leaders, Health Extension Workers and woreda MCH coordinators using interviews, vox pops and card-sorting tools. Rapid prototypes were tested with girls, influencers and providers to assess desirability and feasibility. A synthesis workshop co-led with IDEO.org and Youth Innovation Champions refined insights into an MVP, which was then tested live to simulate real system conditions.
Result
The live prototype validated a set of solutions supporting adolescent girls through pregnancy while maintaining pathways back to fertility-preference counselling after birth—strengthening Smart Start’s ability to promote healthy pregnancies and sustained reproductive autonomy.