One of the first initiatives the Bill & Melinda Gates Foundation launched in Africa was supplying contraception to women who couldn’t otherwise access it.

After distributing a huge number of condoms to the women of the towns and villages in their target locations, they went to check in on how their initiative had fared [1].

The women said they weren’t using them. 


After all, during the research phase, many women had requested better birth control.

The thing was that HIV was a big worry in several of the countries the foundation wanted to support.

By supplying women with condoms (and thus the women being responsible for getting their husbands to use them), the foundation had unwittingly put the women in a very difficult position.

A woman suddenly proffering a condom to her husband suggested either the husband had HIV (and was thus cheating on her), or she had HIV (and was cheating on him).

Neither of these insinuations were appealing, and so the women didn’t use the condoms.

The foundation changed tack. 

Instead of a condom, they provided the women with female contraceptives; discreet and under their own control. 

You can guess what happened – the initiative started working.

All of which is to say: the solution you come up with may well be a perfectly reasonable solution.

But if you don’t understand the culture, the human behaviors, the way people do things, the hidden needs – it probably won’t be.

[1] I heard this story told by Melinda Gates at this Oprah Winfrey event I attended in NYC.

[2] You probably won’t be surprised that Bill & Melinda used data to help them with this.

Design Thinking: Culture and Contraceptives

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