At IDEO.org we design for a lot of taboo topics and today I’m going to talk about three of my favorites: sex, shit, and money.

For the past few years we’ve been working with an organization called Marie Stopes in Zambia trying to figure out how to increase access to reproductive health services for young women between the ages of 15 and 19.

At IDEO.org we use human-centered design to tackle the challenges of poverty, which means that we start every piece of work by spending a lot of time getting to know and understand the aspirations, desires, and needs of the communities we’re designing with.

Though this approach has proven to be pretty successful when asking rural farmers to talk about the ways in which they might get a better yield from their fields, you can't exactly just walk up to young women and start prying into their sex lives. In fact, it was pretty tough to learn about their romantic relationships and their sexual practices. Which is all to say that we failed when we tried talking to them in clinics and on the street, and especially when we tried to talk to young women in a Lusaka nightclub. We clearly needed a new approach.

Consider the Context

So we tried to dream up a low-key, pressure-free place where the girls we wanted to talk with could congregate with their friends and hopefully open up about their boyfriends, their sexual habits, and how contraception was or wasn’t a part of their lives. We landed on a set of pop-up nail salons where we invited young women to come in and sit down for a free manicure in exchange for a chat. It sounds a little crazy, but the conversation would go something like this:

We talked about their decisions about contraception and on and on until we were in a fully engaged and open conversation with these amazing young women. Those conversations, and the insights that came out of them ultimately led us to design a set of reproductive health clinics called the Diva Centres, which are now serving over 5,000 girls in Lusaka, Zambia.

Thanks to the Diva Centres, we are seeing decreases in rates of unplanned pregnancy, which means that girls who might have otherwise gotten pregnant before they were ready are staying in school longer and ultimately have a chance at fulfilling their dreams.

Now for shit.

A few years back, we worked with Water and Sanitation for the Urban Poor and Unilever in Kumasi, Ghana. There, we took on the issue of open defecation, which is pretty much what it sounds like.

When people lack access to clean, safe, and effective toilets in Kumasi, they do what any of us might, they either go to the bathroom outdoors or they’ll collect their waste in a bucket or bag and ditch it outside their homes. All of which means that before long, the landscape is literally littered with human waste. So, here we are looking to understand the deep human experience of open defecation and pretty much across the board people denied that they’d ever done it. Taboo subject, no one wants to talk, and yet the evidence is sitting in fetid baggies all around town.

And you can’t really blame people, right? I have a toilet in my house, but if you just march straight up to me and ask me about my bathroom habits, I’d tell you to get lost. So we can’t exactly expect to get the straight story, especially when we’re talking about the public disposal of our bodies’ most private functions. Finally a woman opened up and told us how, in the middle of the night, she has the occasional emergency. In cases like those, she would pull a bucket out from under her bed, use the bucket to go to the bathroom, and then the next morning throw that waste in a bag in the gutter outside of her home.

Reframe the Question

OK, great, someone finally told us a story about open defecation. But what was really powerful about talking with this woman was that when we asked people to talk about a regular behavior that they considered shameful, like open defecation, they were unwilling to acknowledge it. But if we took a different tack and instead asked them about those emergency situations—an irregular behavior that only happens when you’re really desperate, and gosh, haven’t we all be there at some point in time—they were willing to talk. Human nature, right? And in perhaps an even stronger showing of human nature, when we asked people to talk about their neighbors and open defecation, they were very willing to tell us what they knew.

Reframing the conversation around a pretty taboo subject ultimately led us to design a social enterprise called Clean Team. Clean Team provides access to affordable toilets that sit just outside of people’s homes and are emptied a few times a week by a service operator. Today 4,500 people in Kumasi have access to clean, dignified sanitation and are no longer tossing little bags of shit into empty fields and gutters.

And finally, the taboo topic that we talk about—and around—maybe most of all, money. We’ve got a pretty robust portfolio of financial inclusion projects at IDEO.org, and for the past few months, we’ve been working with a leading U.S. financial institution to design digital tools to improve the financial health of low-income Americans.

The research we’ve done has shown something that’s not really groundbreaking at all:

The trick, we soon learned, wasn’t to approach people about the parts of money management that stymie so many of us, like long-term saving and planning for the future. Instead, the best route to getting people to open up is to explore the places where they were succeeding—the tips, tricks, and hacks that they were using in order to make smart financial decisions in the near term.

Build on What Works

The first prototype in this journey to design digital tools to improve the financial health of low-income Americans is called Money Stories. We’re doing precisely what worked so well in talking to people in person: we’re collecting tips, tricks, and successes from people across the country as a way to understand what kind of digital financial tools can really improve lives. Check it out, and add your story.

So what if your work suddenly hinges on getting people to have really candid conversations about taboo subjects? Here’s a summary of what’s worked for us.

First off, consider the context. What’s the nail salon equivalent that you could set up that would put people at ease and make them feel more comfortable talking about the hard stuff?

Next, reframe the question. How might we get people to talk about those emergencies situations or their neighbor’s behavior instead of asking them to talk about their regular behaviors to get them to open up about shame-inducing topics?

Finally, build on what works. Instead of starting off with the really challenging stuff that makes people feel uncomfortable, start by asking them about the successes. Start from a place that feels really good, then move into tougher territory.

Adapted from the Big Idea speech IDEO.org Co-Lead and Executive Director Jocelyn Wyatt gave at the 2016 Emerge: Consumer Financial Health Forum in New Orleans.