FP2020 IN COUNTRIES

CULTIVATING SOCIAL AND BEHAVIOR CHANGE

Cultural attitudes are one of the most important factors in determining whether women and girls can exercise their right to use family planning. In some countries there is a lack of good information about contraception, and often an abundance of harmful misinformation. Many cultures place a premium on large families and frequent childbearing. Restrictions on women’s rights, and notions that it is somehow wrong for women to plan their families, are serious barriers—as are beliefs that adolescents and young people should not have access to sexual and reproductive information and services.

This is why social and behavior change (SBC) is an essential element of a successful family planning program. SBC investments help to publicly open the dialogue about family planning, improve public knowledge about methods and access points, and bring family planning discussion into everyday life.

CASE STUDY: CAMEROON

Youth Health International (YHI) in Cameroon used a grant from FP2020’s Rapid Response Mechanism to successfully advocate for comprehensive reproductive health education in schools. Over the course of eight months from 2016 to 2017, YHI trained 650 peer educators, 395 teachers, and 140 school nurses and school-linked clinic nurses on youth-friendly family planning services. This new cadre of educators ultimately reached more than 109,500 adolescents through 9,300 school-based reproductive health training sessions. As a result, school-linked clinics have reported an increase in the number of adolescent students visiting health centers, particularly for emergency contraceptives, voluntary counselling, and HIV testing. Regional and national advocates have built upon YHI’s successes to generate a declaration signed by government, school, local, and parent stakeholders prioritizing school-based reproductive health programs.

SOCIAL AND BEHAVIOR
CHANGE IN BURKINA FASO

Burkina Faso’s new costed implementation plan for 2017–2020 includes an ambitious SBC strategy, developed after a detailed analysis of the factors that prevent women and girls from using contraceptives. These include misperceptions about contraceptive side effects, opposition from male partners, women’s limited decision-making power, and the opinion of many husbands and parents that contraception encourages promiscuity.

Working with Track20’s FP Goals program, refer here the government explored the potential impact of greater investments in SBC. The new costed implementation plan aims to achieve a MCPR for married women of 32% by 2020 (up from 23.3% in 2016), and allocates almost one-fourth of the total budget to SBC activities. The planned SBC activities were chosen because of their demonstrated effectiveness in Burkina Faso and the West African region:

  • National Family Planning Weeks
  • Mass media campaigns targeted at specific audiences
  • Promotions linked with major national events, such as National Farmers Day, the Tour du Faso, and International Women’s Day
  • Information campaigns for women that are segmented according to age, place of residence, and socio-professional category
  • Comprehensive sex education in school, including information on family planning
  • Tailored messages for adolescents and youth that are delivered through appropriate channels
  • “Schools for Husbands” to inform men about contraception and enlist them as supporters
  • Mobilization of religious and traditional leaders to advocate within communities for family planning

An appropriate SBC strategy:

  • Includes a focus on reaching new, underserved, or marginalized populations while continuing to meet the needs of existing users.
  • Addresses the barriers that impede access for key populations (women, adolescents, young people, the poor, those living in rural and remote areas, and displaced persons).
  • Employs interventions that are appropriate and effective for specific audiences.
  • Promotes supportive community norms.

A country’s SBC strategy should also be informed by a careful understanding of the values and factors affecting contraceptive use, along with a realistic assessment of the potential impact of SBC investments. Track20 has developed a Maximum Contraceptive Prevalence “Demand Curve” to help countries examine the possibilities and identify the amount of resources to invest (See Figure 9).

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