Emma, Yoko, Kate, Summer, and Christian

Welcome! We are the birth control team for UNV 392; a group of Cal Poly students working on a design for a cheap, appropriate, culturally sensitive birth control option for women. Birth control in countries such as Burkina Faso in West Africa can be hard to come by, whereas we as Americans tend to take for granted the ease of access to a variety of birth control methods. However, there are millions of women that are not as fortunate. As you see below, the prevalence of birth control access is extremely inadequate in many areas of the world. Our project is a work in progress and currently we are exploring, designing and prototyping several ideas that could work as possible solutions to the issue of birth control in third world countries. Our challenges include: 1) comfort 2) discreteness 3) safety 4) longevity of product 5) effectiveness and 6) cost

Fall 2014: Development Stage References
Family Planning in Malawi
Family Planning- Bill & Melinda Gates

Note: Egypt has a lower number for children per family because they had a population control policy that only allowed each family to have 2 children. Although that policy has been removed today, women in Egypt believe that they have the control in reproductive decisions. Many women choose to not have any additional children, or to delay the next birth for a couple years. For more information, visit these websites: Egypt’s Birthrate Rises as Population Control Policies Vanish Population Growth in Egypt – A Continuing Policy Challenge

This link will take you to an interesting article on the struggle women face to prevent pregnancy in Burkina Africa:
http://www.takepart.com/article/2014/11/07/africa-contraception-child-populatio

Below are a few examples of birth control commonly used in the US and foreign countries.

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An example of a hormonal IUD as sold and used in the United States

This image shows how an IUD fits into the Uterus. IUDs must be inserted and removed by a physician, as it requires proper measurement to be placed in the appropriate location in each woman’s body.

An example of a NuvaRing, another popular form of birth control in the United States. Low levels of hormones are released into the vagina and the device can be easily removed by the user.

This picture shows how the NuvaRing fits into the vagina.

A representation of historical methods of birth control.

A representation of the evolution of IUDs and how they have dramatically changed through their existence.

Below you will find our thought processes as they progress through each week in lab: please note that our most recent ideas and findings are at the bottom.

Week 3
Initial Idea: We want to make something that is self-inserting. Preferably reusable.
1. NuvaRing with copper: Would it last long like the copper IUD? Does copper still act like a natural spermicide in the vaginal area
2. Self-inserting device for the IUD: Can you self-insert IUD if there was an inserting device?
3. Upside-down Diva Cup: Will it protect the cervix and work as a contraception? Will the partner be able to feel it? Can we integrate copper materials to make the cervix a hostile environment?

Results Week 3:

1. 1. NuvaRing with Copper: Having copper in the vaginal area will definitely change the pH of the environment, which could prevent user from pregnancy. However, it is not as strong as a copper IUD, because that is directly inserted in the cervix, while the NuvaRing will be inserted at the top of the vagina. Copper may also change the ecosystem of the vaginal area, causing the bacteria to unbalance. This could be bad; it may cause Urinary Tract Infection or Yeast Infection.
2. 2. Self-Inserting Device for IUD: IUD insertion is not complicated, however, clinicians need to be trained to insert IUDs. Because everyone has a different-sized cervix, insertion with one single self-inserting device is not probable. The cervix is also a very sensitive area. You don’t want this to happen: New Intrauterine Device (IUD) Female Contraceptive
3. 3. Upside-Down Diva Cup: This idea was great, but it was very similar to something that already existed: the diaphragm.

Here is an example of a “Diva Cup”

Week 4

• Description of people: Our target audience are young women in 3rd world countries. Most cultures in 3rd world countries think highly of having large families. Therefore, we want to make sure that the user of our product will be able to flexibly remove whatever contraception when they want to.
• Problem statement:
• o insufficient knowledge about contraceptive methods
• o fear of social disapproval or perception of husband opposition
• o fear of side effects/concerns about health
• o problems with access and cost
• Our Approach:
• o IUD: make and sell inexpensively by an “undercover” health provider/clinic
• o Upside down Diva Cup: self insertable, reusable (but would they be able to wash?), not visible
• Challenges:
• o cultural stigma
• o distribution
• o science
• o cost/materials
• o many things have already been invented

Design Matrix (as of Week 4)

Design Concept	Cost	Effectiveness	Acceptance by community	Ease of Implimentation	Totals
Reverse Diva Cup/Cervical Cap	9	8	4	8	29
Copper Nuva Ring	4	3	5	8	20
Copper IUD & Clinic	2	10	10	2	24
Cycle Beads & Education	10	3	10	10	33
Implanon/Nexplanon	2	10	5	3	20
Depro-Provera (shots)	1	10	2	2	15

From the Design Matrix, we concluded that Cycle Beads can be a good option for third-world country women because of its cost and ease. Cycle beads are great because it is not a hormonal or barrier method, but one simply follows their cycle so that they know when they can have sex without contraception. However, cycle beads are only effective if women have the say in when they want to perform sexual intercourse. If the dominant males force them to have sex on the “white bead” days, it is highly probable that they will still get pregnant.

Week 5:

Initial Idea: Producing copper IUDs at a more reasonable cost – instead of coming up with a new birth control method, focusing on implementing a current product in a way that is economically viable.

Questions:

1. What is the real cost of a copper IUD? What makes them so expensive in the U.S.?
2. What is the insertion process for IUDs? How expensive is the equipment? Is it reusable with sterilization?
3. Is this plan culturally appropriate for developing countries? Are they looking for long or short term birth control methods?

Research Results:

1. The IUD consists of copper, low-density polyethylene, and a small strand of string. The current price of copper: $2.55/lb, and the amount of copper used in a single IUD is 313.4mg. The total cost of copper for one IUD is $0.00176, so very cheap. In the U.S., IUDs are sold from the range of $0 (with insurance/resources) to $1000. It costs so much because people want to make money out of it.
2. Insertion and Removal of Intrauterine Devices
3. For many third-world countries, having large families can be encouraged by their culture as well as religion. Although it depends on which specific location we are providing these birth controls for, it is important for women to be able to easily remove their birth control when they want to.

“Modern birth control methods are available in some parts of the country but women do not always have the choice over whether to use them. For two years, under the persuasive intervention of health worker Nabila Nangarhari, Sadia secretly took birth control pills. When her husband, who works in a shop stacking shelves, found out he took the pills to his nephew, a local mullah (religious leader), to ask his advice. ‘The mullah said it was a sin to practice birth control measures as it was forbidden by Islam, so my husband stopped me from taking the pills and I have become pregnant again,’ Sadia recalls” (Afghanistan). AFGHANISTAN: Large families encouraged by culture as well as religion

Week 6:
*New Concept we are developing: an umbrella shaped “IUD” device

Benefits of our original design include:

• Safer design that doesn’t have pointed edges which can cause complication. *for more info on pointed edges being harmful, look at video link in Week 3*
• An “one size fits all” design structure, because the “umbrella” portion of the device will be made to fit even small uterus sizes
• The “umbrella” portion of the device will be made with flexible material but will have small, in-discrete metal balls which will act to irritate the uterus to the point that it creates a hostile environment for sperm (as does the current IUD design) and thus act as an effective birth control method
• The current IUD lasts for 10 years and this design will be made of comparable materials and will also last for 10 years
• Easy insertion into the uterus using a device similar to that used to insert the current IUD
• Easy removal because when the user (or physician) pulls on the string attached to the base of the device, the “umbrella” portion flips upside down and can be carefully pulled from the uterus – flexible material will make it a generally pain-free experience

Moderate Fidelity Prototype

The prototype of the umbrella shaped “IUD”device is still being constructed, but below is a picture of Yoko holding a medium fidelity prototype of the product (not to scale)

Week 7: No Workshop, Monday Holiday

Week 8: Continuation of Moderate Fidelity Prototype & Presentation Ideas

Moderate Fidelity Prototype:

Presentation Ideas:

1. Animated Video for insertion of “The Umbrella” and “Christian’s Ball”
2. Cultural Research= Burkina, Africa OR Malawi, Africa (choosing a specific area to showcase during the presentation)
3. Is it better for families to have less children and educate them so they can get better jobs? Or have many kids that work part time and support family?

Research Results:
3. Should families have less children so they can fully educate them? We read an article about education in third-world countries, and the answer seems to be NO, for now. Redefining Education in the Developing World
“Governmental agencies and organizations that support and promote quality education for all children must move beyond traditional models to help children develop the knowledge, skills, and attitudes that are relevant to their lives and that can lift them out of poverty.”

Comments:

It seems as though you didn’t finish week 8, 9, and 10; it seems as though the images for week 8 are those of the solar concentrator group? Did they put them there by accident?

Past correspondence:
Please put in links to last quarter’s webpages. I find your graph of fertility versus wealth for many countries interesting. Why is Egypt so low? Do they have a higher standard of education/income/employment? I find your website very adequate. Please distinguish your “moderate fidelity prototype” by labeling and give a tiny introduction. Is the preceding text part of that?

Overall good!