projects / supplement adherence research
Global health foundation (under NDA) × Ideate
Maternal health research - Why women stop taking the pill.
Qualitative research into why low-income pregnant women in Pakistan start, skip, or stop prenatal supplements, and what it means for the products meant to help them.
Client
Global Health
Foundation
under NDA · via Ideate
Role
UI/UX Design Lead &
Researcher
Scope
Qualitative research ·
Synthesis · Personas
& Journeys
Year
2026
Methods
FGDs · Interviews ·
Home observation
Delivered through Ideate Innovation for a global health foundation under NDA. The end client and research partner are not
named. All participant data is anonymised — no real names, ages, photographs, or identifying details are shown, in line with
the study's confidentiality terms. Personas are composite archetypes drawn from aggregated findings.
Most women didn't refuse the supplement.
They started, then the days with a dose ran
out.
dose taken
dose missed
the REFRAME.
Skipping a supplement isn't
forgetfulness. It's a decision shaped by money, fear, and who holds.
The easy assumption is that women miss doses because they forget. The research found something harder. A missed dose is usually a rational response to a real constraint: the clinic gave three days' supply and the next dose costs
money the household doesn't have, the iron tablet causes a burning that taking it with milk only hides, an elder believes the pills will make the baby too large, or there is simply no energy left after a day of labour.
So the question for the product wasn't how to remind women. It was how to fit a supplement into lives defined by financial strain, medical fear, and family decision-making, so that taking it stops being a thing to decide.
The study
We went into homes, not surveys.
grounded in research.
36
in-depth interviews with
pregnant women
4
co-creative focus groups
10
influencer interviews —
husbands, mothers-in-law,
sisters
10
community health worker
interviews
10
in-home observations of
real routines
To start off, we ran an internal heuristic audit, interviewed stakeholders, and spent 20 hours testing the app in the field with 15 customers. The same problems came up again and again.
four kinds of user.
Three women the product has to work for.
Composite archetypes, built from the interviews. No real individuals are shown.
The Over-Burdened Labourer
Keep functioning so the household doesn't fall
apart.
"I force myself to take my supplements so my
health doesn't fail, but the workload and the
money make it hard."
Pains
A meagre income makes food and medicine a
luxury.
Labour doesn't stop for fainting spells or pain.
Deep anxiety from a traumatic obstetric
history.
Gains
Anything that lets her keep doing her work.
Nominal-cost clinic meds that feel
manageable.
Reassurance the baby will be born healthy.
The Influenced Skeptic
Avoid complications and harsh pain.
"I'm scared of medicines, so I try to keep my
diet healthy, but it's hard to afford meat and
fruit."
Pains
Belief that supplements make the baby "too
large".
Stops the moment she feels any side effect.
Decisions sit with a mother-in-law, not her.
Gains
Natural substitutes she trusts, like milk or
lemon water.
Formats that feel like a drink, not a "scary pill".
Rest, when an elder is supportive.
The Anxious First-Time Learner
Get through a first pregnancy safely.
"I try to follow medical advice so I know things
are going well, but money and the walk to the
clinic are hard."
Pains
Can't swallow large pills; iron smell triggers
nausea.
High fear of loss and of a traumatic delivery.
Too shy to ask the doctor direct questions.
Gains
An elder who manages her schedule and
explains things.
Strong motivation to protect the baby's
development.
Family involvement that lets her rest.
four kinds of user.
Where a dose has to fit.
For an experienced mother, health is managed reactively, around labour that never pauses. Mapping a real day showed the few narrow windows where a supplement could realistically land.
6:00 — Fajr
Wakes for prayer. Severe
morning sickness;
dreading the day.
no dose
7:00 — Breakfast
Cooks and readies the
children. Back pain,
weakness.
may take folic acid or iron
after eating, if she remembers and owns it
9:30 — Chores
Washing, sweeping.
Numbness, shortness of
breath.
no dose
2:00 — Rest
A short moment to
herself before the
children return.
no dose
4:00 — Clinic
Walks 20–30 min in heat
for an IV drip. Receives a
few days' supply.
collects 3–5 days of
supplements
9:30 — Night
Prepares to sleep. In-laws
"keep the pill in her hand"
as a reminder.
iron or folic acid,
prompted by family
Only two or three windows in a fourteen-hour day are realistic for a dose, and most depend on someone else remembering, or on supply she may not have.
how she decides.
Where a dose has to fit.
For irregular users, supplement decisions are reactive. Mapping the path showed where the product loses them: at the doubts, and at the moment the free supply runs out.
Triggers
Full exhaustion or weakness
A test showing low iron
A doctor's warning about the baby
Options
Home remedies — dates, fruit, milk
Short-term relief like an IV drip
Free clinic meds (folic acid, Calc-C)
Doubts
Cultural belief the baby will be
harmed
Side effects — heartburn, body heat
"When it runs out, who pays for the next?"
Decision
Choose immediate relief over a long
course
Lean on self-knowledge and what's
free
Weighed against cost and a
doctor's word
"When there is more trouble, one feels like taking medicine. But when there is
no reach, then I leave it."
— participant, anonymised
how she decides.
The path from symptom to dose, or not.
The findings pointed at the product, not just the messaging. The clearest opportunities sit in format, recognition, and cost.
01
Make it feel like a drink, not a drug
The effervescent sachet was loved because it
felt like juice, not medicine. Skeptical women
accepted it where they refused pills.
02
Design for colour, not names
Women recognise "the small yellow tablet" and
"the black one," never brands. Colour and shape
carry recognition and recall.
03
Treat price as a feature
The ~150 Rs folic acid was "one of the few they
can afford." Cost is the adherence gate, not an
afterthought.
04
Anchor to a ritual
Doses tied to breakfast or sleep stuck. Stored
out of sight meant forgotten, so visible storage
matters as much as the pill.
05
Shrink the pill, or pour it
Large capsules caused real fear of swallowing.
Smaller forms and syrups kept women on a
course they'd otherwise abandon.
06
Win the household, not just the
woman
Awareness was entirely family-driven. If a sister
or mother-in-law hadn't heard of it, she never
started. Endorsement is the activation lever.
the outcome.
Insight that became a design brief.
The findings pointed at the product, not just the messaging. The clearest opportunities sit in format, recognition, and cost.
66
+
participants across women, influencers and
health workers
4
behavioural segments and 3 personas to
design against
3
countries in the wider study; this is the
Pakistan arm
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