September 2025 — Adolescents aged 10–19 years comprise 23 percent of Tanzania’s population, representing a pivotal group for the country’s health and development priorities. Yet, outreach services for this age group have often remained fragmented, limited in scope, and poorly adapted to their lived realities.

Human-Centered Design (HCD) is addressing these challenges by positioning adolescents not as passive recipients but as active co-creators. This participatory approach builds ownership and motivation, while also creating services that are practical, relevant, and more trusted by those who need them most. 

Why Human-Centered Design?

Traditional outreach models, delivered mainly through schools and communities, face persistent challenges. Adolescents encounter barriers such as limited access to health education, lack of youth-friendly communication, negative provider attitudes, long waiting times, and inadequate inclusion of young people with disabilities. Opportunities for adolescents to provide structured feedback are also limited. HCD addresses these challenges by involving adolescents as active co-creators, collaborating with policymakers, providers, and community stakeholders to generate solutions that reflect their lived realities.

Insights from the HCD Process

The HCD process engaged more than 300 adolescents across Dar es Salaam, Kigoma, Songwe, and Zanzibar. Through participatory workshops, adolescents identified over 120 barriers to accessing services and generated more than 1,500 ideas for improvement.

Key insights included:

• Timing and Accessibility: Adolescents emphasized that outreach should be scheduled on weekends and at least once a month, making it easier for both in- and out-of-school youth to attend.

• Health Education and Engagement: Young people called for school health clubs, peer-led dialogues, and debates as platforms for ongoing health learning. They also recommended that teachers and peer educators be trained to deliver reliable health information.

• Communication Channels: To expand reach, adolescents proposed leveraging social media, radio, television, community events, and sports activities. These channels were seen as vital for raising awareness, especially for out-of-school adolescents.

• Respectful and Inclusive Care: A recurring concern was the need for providers to deliver services in a respectful, non-judgmental manner. Adolescents also stressed the importance of disability-inclusive services, including sign language interpreters and accessible health facilities.

• Community Anchoring: Adolescents recommended creating community health hubs and establishing outreach desks in schools, as well as stronger linkages between parents, schools, and health providers.

• Feedback and Accountability: Young people highlighted the importance of a structured feedback mechanism to hold service providers accountable and ensure continuous improvement.

Towards an Integrated Package of Services

Through this process, adolescents co-designed a comprehensive service package encompassing 12 essential categories, including sexual and reproductive health, HIV and STI prevention, nutrition, mental health, immunization, eye and dental care, cancer screening, and access to health insurance. This package reflects a holistic vision for integrated and adolescent-responsive primary health care.

Policy and System Implications

The HCD approach is being institutionalized through implementation research and the development of a digital client feedback mechanism via the Mama na Mwana platform, enabling real-time adolescent engagement and accountability. Embedding HCD within national strategies such as the One Plan III, the National Adolescent Health Agenda, and the Social and Behaviour Change Strategy reflects a deliberate shift toward more participatory and evidence-driven health system strengthening.

By systematically integrating adolescent perspectives into service design and delivery, Tanzania is laying the foundation for a more inclusive, equitable, and resilient primary health care system. This commitment not only advances the health and well-being of adolescents but also contributes to broader national goals of universal health coverage and sustainable development.