Nala’s FP journey
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As a decision maker, you have the power to fund and support SBC interventions that help young women like Nala become and stay FP users.
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Doesn’t Marry
Marries
Hi, I'm Nala! I’m 17 years old. I hope to finish my education and I have big dreams for myself...
Hi, I'm Nala! I’m 20 years old. I hope to finish my education and I have big dreams for myself and my family...
Click on the options below to explore Nala's FP journey
Decision makers like you have the power to support SBC interventions to help Nala make informed, voluntary, and empowered decisions at every step of her FP journey.
Where can SBC help Nala along her FP journey?
Click on a step in Nala's journey below to explore the factors that influence her FP journey and to see how SBC can effectively address those factors.
Gets introduced to FP
Uses FP services
Continues using FP services
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2
3
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Unmarried Journey
Where can SBC help Nala along her family planning journey?
Continues using family planning services
Uses family planning services
Gets introduced to family planning
Click on a step in Nala's journey below to explore the factors that influence her family planning journey and to see how SBC can effectively address those factors.
Decision-makers like you have the power to support SBC interventions to help Nala make informed, voluntary and empowered decisions at every step of her family planning journey.
Married Journey
I am interested in learning about FP
Nala’s Journey - Gets intrOduced to FP services
I want to be introduced to my FP options and their benefits so I can make my own decisions. Norms, lack of skills and access to information, and power dynamics may prevent or delay me from learning about FP.
What affects my introduction to FP?
Click on the buttons below to explore the factors influencing my introduction to FP and to see how SBC can help me in my FP journey.
Barriers
Emotions
Needs
Influencers
Go back
Married Journey : Step 1
I want to be introduced to my family planning options and their benefits so I can make my own decisions. Norms, lack of skills and access to information, and power dynamics may prevent or delay me from learning about family planning.
I am interested in learning about family planning
Nala’s Journey - Gets introduced to family planning services
Click on the buttons below to explore the factors influencing my introduction to family planning and to see how SBC can help me in my family planning journey.
What affects my introduction to family planning?
I want to use FP services
Nala’s Journey - uses FP services
The decision to use contraceptives marks a key moment in my FP journey, but it's not always an easy decision to make. Dynamics with family members, gender, social norms, concerns about contraception, and provider attitudes may prevent or delay my use of FP.
What affects my decision to use FP?
Click on the buttons below to explore the factors influencing my decision to use family planning and to see how SBC can help me in my FP journey.
Married Journey : Step 2
The decision to use contraceptives marks a key moment in my family planning journey, but it's not always an easy decision to make. Dynamics with family members, gender, social norms, concerns about contraception, and provider attitudes may prevent or delay my use of family planning.
I want to use family planning services
Nala’s Journey - uses family planning services
Click on the buttons below to explore the factors influencing my decision to use family planning and to see how SBC can help me in my family planning journey.
What affects my decision to use family planning?
I want to continue using FP services
Nala’s Journey - Continues using FP services
I want to continue using FP to help me achieve my life goals and for the well-being of my family. Concerns about side effects, acceptability, partner approval, and social status may make it difficult for me to continue.
What affects my continued use of FP?
Click on the buttons below to explore the factors influencing my continued use of FP and to see how SBC can help me in my FP journey.
Married Journey : Step 3
I want to continue using family planning to help me achieve my life goals and for the well-being of my family. Concerns about side effects, acceptability, partner approval, and social status may make it difficult for me to continue.
I want to continue using family planning services
Nala’s Journey - Continues using family planning services
Click on the buttons below to explore the factors influencing my continued use of family planning and to see how SBC can help me in my family planning journey.
What affects my continued use of family planning?
I want to be introduced to my FP options and their benefits so I can make my own decisions. Norms around adolescent sexuality, lack of skills or access to information, and power dynamics may prevent or delay me from learning about FP.
Unmarried Journey : Step 1
I want to be introduced to my family planning options and their benefits so I can make my own decisions. Norms around adolescent sexuality, lack of skills or access to information, and power dynamics may prevent or delay me from learning about family planning.
Nala’s Journey - Gets intorduced to family planning services
The decision to use contraceptives marks a key moment in my FP journey, but it's a hard decision to make when I'm not married. Concerns about approval, privacy, power dynamics, access to contraception, provider attitudes, and social norms may prevent or delay my use of FP.
What affects my decision?
Unmarried Journey : Step 2
The decision to use contraceptives marks a key moment in my family planning journey, but it's a hard decision to make when I'm not married. Concerns about approval, privacy, power dynamics, access to contraception, provider attitudes, and social norms may prevent or delay my use of family planning.
I want to continue using FP to help me achieve my life goals. But concerns about side effects, acceptability, my own decision-making power, and social and gender norms may make it difficult for me to continue.
Unmarried Journey : Step 3
I want to continue using family planning to help me achieve my life goals. But concerns about side effects, acceptability, my own decision-making power, and social and gender norms may make it difficult for me to continue.
What are my needs?
For myself
I need to be able to make a decision about whether and when I want to have children.
I need access to full, accurate information about contraception, including side effects and switching methods.
From the health system
See how SBC has effectively addressed these needs
Spotlight: Ethiopia
Community and multimedia outreach positively influenced attitudes and FP among men and women
Overview
Community and multimedia outreach program aimed to increase awareness among women about their FP options Sessions with male community leaders encouraged paternal participation in FP Outreach conducted through mass media, interpersonal communication, and village unit–based small group sessions Village billboard and local radio used to disseminate maternal health information T-shirts and calendars with FP messages distributed to women and their families
Source
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Ethiopia
Northern Nigeria
Click on the circles to explore additional factors influencing Nala's FP journey and to review evidence-based SBC interventions that have successfully addressed those factors.
Click to explore more influencing factors and SBC interventions
Image Placeholder
Increased nurse confidence and satisfaction in FP.
The intervention group showed significant increases in knowledge about FP compared to the non-intervention group.
A 208-episode radio serial drama promoted positive social norms around:
Radio drama improved FP use and influenced positive reproductive behavior among community members
Spotlight: Northern Nigeria
Results
Of program listeners, 67.8% said that couples should share responsibility for making decisions about family size, compared to 16.4% in the reference group.
Improvement in odds of listeners stating they currently use some form of FP.
Improvement in odds of listeners that discussed FP with others.
Of program listeners, 55.1% said that women should be free to ask her husband to use a condom, compared to 34.6% in the reference group.
Contraceptive use increased from 31.3% to 61.8% in the intervention group.
Smaller family size Use of FP Effective birth spacing Delayed marriage Gender equity between couples
Radio was used to ensure maximum reach for men and women and provide accurate information about FP
Outreach conducted through mass media, interpersonal communication, and village unit–based small group sessions Village billboard and local radio used to disseminate maternal health information T-shirts and calendars with family planning messaged distributed to women and their families
Tap to explore more influencing factors and SBC interventions
What barriers do I face?
See how SBC has effectively addressed these barriers
Spotlight: Nicaragua
Mass media campaign sparked discussion about FP and reproductive health among adolescents
Campaign aimed to create awareness about and reduce stigma around FP and reproductive health issues for adolescents and youth between 13–24 years Activities included a national entertainment-education telenovela, call-in radio show, and community-based activities
Nicaragua
Mali & Benin
The campaign resulted in a 41% greater probability of interpersonal communication about FP and reproductive health.
The campaign resulted in a 32% greater probability that participants talked with their husband about condom use.
Initiative aimed to shift perceptions and cultural taboos about FP Informal and religious activities between select influencers, influential groups, men, and other community members Reflective dialogue sessions about FP were facilitated between community members and influencers in public and private spaces
Community and religious influencers shifted perceptions and taboos around FP among men and community members
Spotlight: Mali & Benin
I lack the skills to communicate about sex and contraception.
Longstanding cultural taboos in my community inhibit my family, religious leaders, and community members from talking about sexuality and reproduction.
From my community and family
“When the imam himself tells you that he is doing family planning, no one can say that religion is against family planning."
Religious leaders championing positive FP messages positively influenced men's outlook on FP.
— Husband from Mali
Campaign aimed to create awareness about and reduce stigma around family planning and reproductive health issues for adolescents and youth between 13–24 years
Initiative aimed to shift perceptions and cultural taboos about family planning Informal and religious activities between select influencers, influential groups, men, and other community members
Who influences whether I get introduced to FP?
My mother in-law and husband are uncomfortable talking to me about FP.
From my partner and family
My community and religious leaders discourage me from accessing or wanting to access information about FP products and services.
From my community and religious leaders
See how SBC has effectively engaged these influencers
Spotlight: Nigeria
Religious leader messaging encouraged and supported FP among young women
Activities aimed to facilitate the adoption of contraceptive methods to support family health among young women Religious leaders shared positive FP messages with young women through tailored FP messages based on scriptures
Nigeria
India
Approximately
Two Five
Source 1
Social mobilization approach aimed to shift attitudes of mothers-in-law and young married women around reproductive health, and improve communication and decision-making processes between mothers-in-law and daughters-in-law Initiative collaborated with existing youth and women's groups to serve as safe spaces for discussion, solution-building, and support Discussion groups involved husbands and mothers-in-law, who offered knowledge and support towards young women’s reproductive health-seeking behaviors
Social mobilization influenced attitudes and support for FP among mothers-in-law in rural settings
Spotlight: India
young women reported being exposed to FP messages from religious leaders in the year following the SBC Intervention.
in
There was a higher uptake of modern contraceptives among women with high exposure to the SBC Intervention (35.5%) compared with respondents in the low or medium exposure categories (14.5% and 24.5%, respectively).
Adolescent reproductive health outcomes improved more in the sites that addressed demand constraints through social mobilization than in sites that did not.
Results show that a social mobilization approach can change mother-in-law attitudes to support their daughter-in-law's reproductive health.
Young women were more likely to voice their reproductive needs to mothers-in-law who were, in turn, more likely to secure care for the younger women.
Mothers-in-law were more likely to be supportive of reproductive health than they were prior to the intervention.
Source 2
Activities aimed to facilitate the adoption of contraceptive methods to support family health among young women Religious leaders shared positive family planning messages with young women through tailored family planning messages based on scriptures
What emotions do I feel?
From my partner
I feel uncomfortable discussing sex and FP with my partner and family. For example, I would like to talk to my mother about sex, but I am embarrassed.
See how SBC has effectively addressed these emotions
Engaging men in FP counseling shifted gender norms and improved contraceptive uptake
Initiative aimed to promote a shift in perspectives about gender equity-related issues (e.g., preference for a male child) and to convey the importance of FP decision making Gender equity and FP counseling intervention delivered by male health care providers to married men, both alone and with their wives Sessions focused on discussing and practicing respectful marital communication and interactions
Burkina Faso
I am worried about side effects or the inconvenience of methods.
Series of counseling sessions to encourage mothers and fathers to decide to use contraception Participants had the option to immediately start some methods or get a prescription before being discharged Providers discussed information relevant to the weeks and months after birth, including accurate information about postpartum contraception, postnatal care, exclusive breastfeeding, and the need for FP
Postpartum FP counseling sessions empowered joint decision-making among couples and transitions from breastfeeding to other modern contraception
Spotlight: Burkina Faso
Exclusive breastfeeding, three-month postpartum visits, and effective modern contraception use at eight months postpartum were higher among the group that participated in the intervention than the control group.
More than 96% of program participants attended both 3- and 8-month follow-up counseling sessions.
Improved contraceptive use, improved marital contraceptive communication, and reduced intimate partner violence perpetration and acceptability.
Women were more likely to report contraceptive communication at 9-month follow-up and modern contraceptive use at 9 and 18 month follow-ups.
I am worried that my husband, mother-in-law, and provider do not approve of FP and would prevent me from learning about FP products or services.
I do not feel I need FP because I am breastfeeding.
Of intervention participants, 74% of couples or men attended at least two counseling sessions.
I do not feel I need family planning because I am breastfeeding.
Initiative aimed to promote a shift in perspectives about gender equity-related issues (e.g., preference for a male child) and to convey the importance of family planning decision making Gender equity and family planning counseling intervention delivered by male health care providers to married men, both alone and with their wives Sessions focused on discussing and practicing respectful marital communication and interactions
Series of counseling sessions to encourage mothers and fathers to decide to use contraception Participants had the option to immediately start some methods or get a prescription before being discharged Providers discussed information relevant to the weeks and months after birth, including accurate information about postpartum contraception, postnatal care, exclusive breastfeeding, and the need for family planning
Spotlight: Egypt
Multimedia strategy created awareness among newlyweds about their FP options
Multi-pronged communication strategy informed newlyweds about FP, pregnancy, safe delivery, and postpartum care Initiative used television, radio, information booklets, and group wedding celebrations to communicate FP messages and information
Egypt
Senegal
Project aimed to improve the quality and availability of contraceptive services Activities focused on demand generation for FP planning, including:
SBC increased awareness, support, and demand for FP among community members and leaders
Spotlight: Senegal
Women who were exposed to FP messages on television, who heard a religious leader speak favorably about FP, and who heard community-level religious talks on family planning, were significantly more likely to use a modern contraceptive method than those who were not exposed to these activities.
Women exposed to community-based activities were more likely to use modern contraception than those not exposed.
Modern contraceptive use increased from 16.9% to 22.1%, with a slightly larger increase among poor women.
Mass media campaigns on radio and television Community outreach activities Community drama productions Religious leader engagement
I need to be able to get my method at a location that is convenient and feels safe/private for me and my needs.
I need my husband to be aware of, involved in, and supportive of my FP needs and options so that we can make joint decisions.
I need access to full, accurate information about contraception, including side effects, what to do about them, and switching methods.
I need my community leaders and religious leaders to debunk rumors and stigma regarding FP services.
Exposure to project FP messages accounted for a 12% increase in modern contraceptive method use and an 11.5% increase in FP use after the birth of the first child.
Multi-pronged communication strategy informed newlyweds about family planning, pregnancy, safe delivery, and postpartum care Initiative used television, radio, information booklets, and group wedding celebrations to communicate family planning messages and information
Spotlight: Sub-Saharan African countries
Community and mass media campaigns increased women's contraceptive choices and tackled misconceptions
14-country-wide intervention in sub-Saharan Africa aimed to address information gaps and contraception misperceptions during integrated FP counseling at service delivery sites Initiative engaged religious leaders, community health workers, and peer educators to build trusting relationships with community members who participated in the counseling sessions Combination of mass media education and awareness-raising activities offered accurate information about FP and countered myths Engagement encouraged through roadshows and involvement of satisfied clients
Sub-Saharan Africa
Rwanda
The uptake of IUDs increased by 429% and the uptake of implants increased by 1,567%.
Across the 14 country programs, long-acting reversible contraceptives increased 1,037% from 149,881 in 2008 to over 1.7 million in 2014.
Gender-transformative FP program focused on men and couples Activities promoted men's engagement in reproductive and maternal health, more equitable gender and power relations in the home, men’s support for FP, and joint decision making Group sessions for (expectant) fathers and their partners were held to share, discuss, and critically reflect on inequitable gender norms, attitudes, and behaviors in the home around pregnancy and FP
Engaging role models encouraged FP support and joint decision making
Spotlight: Rwanda
About half (46%) of long-acting reversible contraceptive users were adopters (women who had not used FP in the previous three months).
About half of long-acting reversible contraceptive users (46%) switched from a short-term method.
There are norms in my society around sexuality, family size, gender preferences (for children), contraception, and timing of children that encourage me to become pregnant early and often.
From the community
I do not have the decision-making power in my marriage to adopt FP.
My providers impose more eligibility criteria for contraception than are required by national guidelines, making it difficult for me to use FP.
I hear many myths, stigma, and rumors about contraception, including side effects that deter me from deciding to use contraceptives.
Increase in contraceptive use from 60.2% to 69.9% among female participants.
Increase in contraceptive use from 64.9% to 75.4% among male participants.
Overall, strengthened existing evidence showing that culturally-adapted, gender-transformative interventions with men and couples can be effective at changing deeply entrenched gender inequalities and a range of health-related behavioral outcomes.
Less dominance of men in decision making: A decrease of 22.3% and 24.8% in women and men, respectively, who said men had the final say on income and expenses, including FP expenses.
14-country-wide intervention in sub-Saharan Africa aimed to address information gaps and contraception misperceptions during integrated family planning counseling at service delivery sites Initiative engaged religious leaders, community health workers, and peer educators to build trusting relationships with community members who participated in the counseling sessions Combination of mass media education and awareness-raising activities offered accurate information about family planning and countered myths Engagement encouraged through roadshows and involvement of satisfied clients
Gender-transformative family planning program focused on men and couples Activities promoted men's engagement in reproductive and maternal health, more equitable gender and power relations in the home, men’s support for family planning, and joint decision making Group sessions for (expectant) fathers and their partners were held to share, discuss, and critically reflect on inequitable gender norms, attitudes, and behaviors in the home around pregnancy and family planning
Who influences my FP decision?
Providers in my community play a role in supporting my contraceptive choice and are not always willing to share information and promote contraceptive options with me.
My mother-in-law influences my FP decisions, particularly when I am recently married and am yet to prove my fertility or bear a son.
From my family
My religious and community leaders oppose contraception in general or certain methods that I considered and I do not want to make FP decisions that go against their views.
From the community and religious leaders
Spotlight: Pakistan
Multi-media tools encouraged religious and community leaders' support for FP
Robust campaign to share information with women about the availability, acceptability, and importance of FP and reproductive healthcare services Campaign developed alongside community members, policymakers, and religious leaders to ensure the messaging was appropriate Multi-media tools used to disseminate FP information, including: social media marketing, celebrity-led mass media public service announcements (PSAs), circulation of key messages through local digital networks of community health workers, community-based signposting, and community PSAs through mobile units
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Pakistan
Indonesia
Laws and policies in my country about FP determine what types of providers can deliver contraceptive methods, and where they are able to deliver these methods to me.
"Before this discussion, I considered family planning as meddling with a natural process... I knew that according to Sharia, every mother must breastfeed for two whole years. In the focus group discussion, the facilitator explained that actually exclusive breastfeeding is the natural method of avoiding pregnancy." —Imam
Initiative trained providers in client-centered counseling and communication Providers conducted weekly self-assessments Peer-review meetings were held to improve the quality of family planning services and providers' interpersonal communication and counseling skills Self-assessment and peer review aimed to maintain providers’ performance after training and to prompt continuous quality improvement
Improving providers' interpersonal communication and counseling skills encouraged the use of FP
Spotlight: Indonesia
"My fellow men paid heed to the messages [from the imams]. They discussed family planning with their wives. Some of them adopted family planning methods." —Man who received counseling from Imam
Involving religious leaders was key in shifting attitudes towards FP.
Adding peer review to self-assessment proved cost-effective. The cost of raising facilitative communication one percentage point in the control group was $500, compared to $12 for the self assessment group and $10 for the peer review group.
The number of clients' questions to providers about the information shared increased from 1.6 to 3.3.
The frequency of providers' facilitative communication, which fosters rapport and client participation, doubled from 15 to 30 instances per session.
In the month after training:
Robust campaign to share information with women about the availability, acceptability, and importance of family planning and reproductive healthcare services Campaign developed alongside community members, policymakers, and religious leaders to ensure the messaging was appropriate Multi-media tools used to disseminate family planning information, including: social media marketing, celebrity-led mass media public service announcements (PSAs), circulation of key messages through local digital networks of community health workers, community-based signposting and community PSAs through mobile units
Aligning contraceptive use with socially-accepted norms improved FP use among married women and men
Multi-pronged approach aimed to reach married girls and women aged 15–19 and their husbands Inititiave navigated northern Nigeria’s more conservative context by aligning contraceptive use with family health and stability Skills-building classes were used as entry points to engage in contraceptive counseling Health agents employed targeted one-to-one outreach
of girls voluntarily adopted a FP method.
Campaign promoted positive attitudes about FP among providers Activities combined public relations and mass media, provider sensitivity training, and professional health association advocacy Campaign promoted a community of "happy [FP] users" to further encourage positive perceptions among providers and the public Free FP counseling and ongoing training offered to providers about contraceptives and women's agency over family planning choices
A multifaceted campaign improved perceptions about FP among providers
I am concerned about my privacy, treatment and judgement by providers if I visit a health center to ask about FP.
I question the efficacy of contraceptives after seeing that my friends who use methods still get pregnant.
From my peers
I feel pressure to prove my fertility and to have a large family. I may be stigmatized or lose my social status if I delay pregnancy, do not have many children, or choose not to have children.
84%
of girls voluntarily used a long-acting FP method after participating in the program.
28%
As a result of the multifaceted approach, health care providers’ concerns and barriers were addressed, and the campaign achieved significant behavior and attitude changes in women.
The use of oral contraceptives increased significantly from 4% to 11% and corresponding sales increased 46%.
Inititiave navigated northern Nigeria’s more conservative context by aligning contraceptive use with family health and stability
Skills-building classes were used as entry points to engage in contraceptive counseling
Health agents employed targeted one-to-one outreach
young women reported being exposed to family planning messages from religious leaders in the year following the intervention.
of girls voluntarily adopted a family planning method.
Activities combined public relations and mass media, provider sensitivity training, and professional health association advocacy
Campaign promoted a community of "happy [family planning] users" to further encourage positive perceptions among providers and the public
Free family planning counseling and ongoing training offered to providers about contraceptives and women's agency over family planning choices
The program successfully delayed marriage and pregnancy age among young women by approximately 1.5 years.
Contraceptive use and consistent condom use was more likely to be reported by both young men and young women in intervention than control sites.
Spotlight: Bangladesh
FP counseling targeting husbands improved contraceptive continuation
Activities aimed to improve contraceptive acceptability and continuation by targeting husbands Providers held FP counseling sessions with husbands at four health clinics to encourage husbands to play supportive role in decison making Husbands received an informational brochure about contraceptive methods, their duration of effectiveness, advantages and disadvantages, availability, and follow-up requirements
Bangladesh
Training program for Proprietary Patent Medicine Vendors Two-page job aid provided critical FP information Job aid included key counseling messages and guidance on contraceptive use and side effects management
Training Proprietary Patent Medicine Vendors on side effects increased contraceptive continuation
Significantly increased reinjection rates for late-returning injectable clients.
Proprietary Patent Medicine Vendors who reported using at least two FP job aids were approximately 2.5 times more likely to have DMPA-IM and DMPA-SC contraceptive and side effects knowledge nine months after the training, compared to those who used one or no job aids.
I need to be able to continue making my own decision about whether and when I want to have a child or more children.
I need to be continuously able to get my method at a location that is convenient and feels safe/private for me and my needs.
I need to know what to do when I encounter negative side effects or pressure to discontinue.
The discontinuation rate at 36 months was 32 per 100 women (± 2.4) for the acceptors in the husband counseled group versus 42 per 100 women (± 3.8) for the acceptors in the husband not counseled group.
At 36 months, the discontinuation rates were lower for implant acceptors in the husband counseled group than for acceptors in the husband not counseled group.
Implant acceptors whose husbands were counseled were less likely to discontinue than acceptors whose husbands were not counseled.
Kenya
Mozambique & Tanzania
Providers held family planning counseling sessions with husbands at four health clinics to encourage husbands to play supportive role in decison making
Husbands received an informational brochure about contraceptive methods, their duration of effectiveness, advantages and disadvantages, availability, and follow-up requirements
Training program for Proprietary Patent Medicine Vendors Two-page job aid provided critical family planning information Job aid included key counseling messages and guidance on contraceptive use and side effects management
See how SBC effectively addressed these barriers
Spotlight: Kenya
Dialogue encouraged normalization of FP and joint decision making among couples and community members
Initiative aimed to challenge and shift key community norms about gender dynamics and FP Activities focused on creating a social environment that is more supportive of equitable gender relations and the continued use of FP Ongoing community dialogues about gender and FP, specifically acceptability of FP, gender norms, and continued use of FP Myths and misconceptions were addressed and spousal communication and decision making around FP were encouraged
West Africa
Exposure to FP dialogues was associated with 1.78 times higher odds of using a modern FP method for women.
Evaluation results showed that an intervention that catalyzes open dialogue about gender and FP among couples can shift social norms, enable more equitable couple communication and decision making, and, ultimately, increase use of FP.
Series of television programs and community activities aimed to:
TV programs boosted ongoing contraceptive use, debunked myths, and helped manage side effects among women of reproductive age
Spotlight: West Africa
Women participants described partner support as a key enabler of [ongoing] FP use.
Even though I have used contraception in the past, I consider stopping because of method-related issues.
I have used a specific type of contraception but since it is not available, I risk losing interest.
I face similar barriers to continuation as I did when I started as a FP user, including social and gender norms that encourage pregnancy and large families, and myths and rumors about contraceptives and their side effects.
From my community
The number of women who discussed FP with their partner increased from 41.9% to 52.8%.
Increased discussion about FP with peers and spouses/partners that led to a more positive attitude toward FP.
(Cameroon, Burkina Faso, Togo, and Côte d'Ivoire)
Encourage ongoing contraceptive use and partner communication Debunk myths and rumors about FP methods Provide information on managing side effects Empower women of reproductive age and the community to expect and demand specific standards of quality from providers Promote Gold Circle health clinic sites
I face similar barriers to continuation as I did when I started as a family planning user, including social and gender norms that encourage pregnancy and large families, and myths and rumors about contraceptives and their side effects.
Tanzania
Initiative aimed to challenge and shift key community norms about gender dynamics and family planning Activities focused on creating a social environment that is more supportive of equitable gender relations and the continued use of family planning Ongoing community dialogues about gender and family planning, specifically acceptability of family planning, gender norms, and continued use of family planning Myths and misconceptions were addressed and spousal communication and decision making around family planning were encouraged
Who influences my family planning continuation?
My providers do not follow up with me about how I am doing or check in on my FP goals and method choices.
My husband or family does not approve of me continuing to use family planning.
From my family and partner
My religious leaders encourage me to accept what God gives and to not limit or space my pregnancies.
From my religious leaders
Spotlight: Uganda
Interactive game for providers promoted continued joint decision making among men
Intervention for health care providers and community leaders to engage men in conversations about ongoing FP and reproductive health Games aimed to equip men with the knowledge, confidence, and resources to continue to make informed decisions about FP with their wives Formats such as interactive games and role-plays used Activities leveraged existing moments where men come together to engage them around FP
Uganda
Cambodia
My mother-in-law influences my decision to continue using FP, particularly when I am recently married and am yet to prove my fertility or bear a son.
Initiative aimed to encourage continued contraceptive use by reminding women of the importance of contraceptive use and the opportunity to receive non-judgmental FP counseling Activities included six interactive automated voice messages with counselor phone support Voice messages sent to participants’ mobile phones at preferred times during the three months following an abortion
Mobile phone messages fostered continued FP use among women
Spotlight: Cambodia
My husband is worried about the side effects I am experiencing from my FP method.
“[We] discussed and agreed not to have another child when this one is still young.”
“We discussed the number of children we want and to have them after five years.”
“Together with my wife, [we] decided to choose a five-year implant.”
Increasing men's confidence and providing resources improved communication with their wives and joint decision making about FP.
“We chose a three-month contraceptive after the games; however, we plan for a longer child spacing method of three years and above.”
Significantly more women in the intervention group reported using a long-acting contraceptive method at 12 months.
Significantly more women in the intervention than the control group reported effective contraception use at four months (64% versus 46%, respectively).
From my family & partner
My husband is worried about the side effects I am experiencing from my family planning method.
My mother-in-law influences my decision to continue using family planning, particularly when I am recently married and am yet to prove my fertility or bear a son.
My providers do not follow up with me about how I am doing or check in on my family planning goals and method choices.
Intervention for health care providers and community leaders to engage men in conversations about ongoing family planning and reproductive health Games aimed to equip men with the knowledge, confidence, and resources to continue to make informed decisions about family planning with their wives Formats such as interactive games and role-plays used Activities leveraged existing moments where men come together to engage them around family planning
Initiative aimed to encourage continued contraceptive use by reminding women of the importance of contraceptive use and the opportunity to receive non-judgmental family planning counseling Activities included six interactive automated voice messages with counselor phone support Voice messages sent to participants’ mobile phones at preferred times during the three months following an abortion
Spotlight: Malawi
Client-centered counseling tools helped clients make choices about which method is right for them
Tools aimed to create a measurable impact on client satisfaction with their counseling experience, the continuation of their chosen method, and perceptions of side effects and bleeding changes Activities encouraged collaborative dialogue between provider and client, rooted in informed choice Tool emphasized active listening and improved information-sharing about method benefits, side effects, limitations, and client preferences
Malawi
Program aimed to engage the whole community to shift norms and behaviors around early marriage and childbearing Adolescents trained in communication and negotiation skills, and strategies to resist societal pressures Activities included street theatre, home visits with parents and mothers-in law, community meetings, welcome ceremonies, visits from change agents, wall paintings, and puppet shows
SBC program positively changed norms and perceptions around contraception and pregnancy among married women
I believe that pregnancy is the best chance I have to increase my social standing and status, which makes it hard for me to choose to continue using contraceptives.
Current use of contraception among young married couples increased from 4% at baseline to 21% at endline.
The use of contraception by young women to delay the first birth increased from 3% to 16% The use of contraception to space the second child increased from 6% to 25%.
I am worried about the side effects I am experiencing from my FP method, which makes me hesitant to continue.
I have my own life goals that I want to achieve after I get married, and continuing to use FP helps me reach those goals.
"Counseling for Choice allows me to provide clients with the information that is essential for them. The approach saves me—and them—time. ” — FP provider, Mali
"Counseling for Choice makes providers’ jobs easier. It helps them to support clients to know their chosen method well. And clients say that they have more quality experiences with providers trained in Counseling for Choice.” — FP provider, Mali
Clients counseled through Counseling for Choice were found to be more satisfied with their counseling experience and likely to continue their voluntary FP method for as long as they need it.
I have my own life goals that I want to achieve after I get married, and continuing to use family planning helps me reach those goals.
I am worried about the side effects I am experiencing from my family planning method, which makes me hesitant to continue.
Spotlight: Zambia
Nail salons offered safe spaces for adolescent girls to discuss FP and plan their futures
Nail salons used to facilitate informal conversations and counseling among adolescent girls in a safe and judgment-free environment Peers trained to meet girls where they are to create awareness about contraception and to promote informed FP decisions Adolescent girls encouraged to make a connection between contraceptive use and attaining their future aspirations Trainers offered a variety of short- and long-term contraceptive methods
Zambia
Guatemala
Young female mentors (between 15 and 19 years old) led youth clubs for approximately 40 girl leaders per cycle Workshops conducted with girls and their mothers included sessions on self-esteem, life skills, developing aspirations, planning for the future, sexual and reproductive health, and HIV and AIDS prevention Community leader engagement and relationship building between adult leaders and youth leaders helped shift social and gender norms Knowledge-sharing sessions equipped girls with the information they need to make decisions about FP and reproductive health
Young female mentors empowered 'girl leaders' to make their own decisions about FP
Spotlight: Guatemala
During the program cycle, 97% of girl leaders remained childless, compared with the 78.2% national average for girls in their age range (15–19).
There was a higher uptake of modern contraceptives among women with high exposure to the intervention (35.5%) compared with respondents in the low or medium exposure categories (14.5% and 24.5%, respectively)
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Among adolescent girls who visited one of the three Diva Centres, 82% got contraceptive services and 36% returned for another visit.
Nail salons used to facilitate informal conversations and counseling among adolescent girls in a safe and judgment-free environment Peers trained to meet girls where they are to create awareness about contraception and to promote informed family planning decisions Adolescent girls encouraged to make a connection between contraceptive use and attaining their future aspirations Trainers offered a variety of short- and long-term contraceptive methods
Young female mentors (between 15 and 19 years old) led youth clubs for approximately 40 girl leaders per cycle Workshops conducted with girls and their mothers included sessions on self-esteem, life skills, developing aspirations, planning for the future, sexual and reproductive health, and HIV and AIDS prevention Community leader engagement and relationship building between adult leaders and youth leaders helped shift social and gender norms Knowledge-sharing sessions equipped girls with the information they need to make decisions about family planning and reproductive health
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Spotlight: Nepal
Peer education fostered partner and peer support for adolescent girls' FP choices
Activities aimed to shape attitudes and behaviors among unmarried adolescents, their peers, and their partners Peer education stimulated new, more accepting social norms to increase FP use and support Adolescent girls shared knowledge with each other about the appropriate marriage age for a girl and ways to avoid pregnancy Activities encouraged partner support and involvement in FP discussions and decisions
Nepal
Increase in respondents who believe family size should be determined by both partners – from 73% at baseline to 80% at mid-term.
Significant increase in communication about FP among adolescents girls—from 30% at baseline to 77% at mid-term.
Youth-led multimedia campaign in francophone West Africa sought to improve reproductive health and FP outcomes Approaches included radio, television, social media, and community events Series of youth-driven videos encouraged both youth and adults to find new ways to talk about FP and break taboos by talking to each other about reproductive health and FP Activities encouraged health providers to avoid stigmatizing youth who want to adopt FP
Youth-led multimedia campaign helped youth challenge norms around FP
Longstanding cultural taboos in my community inhibit my parents, teachers, religious leaders, and other community members from talking about sexuality and reproduction. I wonder if this is driven by an inaccurate belief that providing this information will make me promiscuous.
Significant increase in adolescent girls' knowledge about appropriate marriage age (20 years) for a girl—from 70% at baseline to 81% at mid-term.
Increase in knowledge of ways to get pregnant or to avoid pregnancy among participating adolescent girls—from 32% at baseline to 64% at mid-term.
“Let’s break the taboos. There is no shame in preparing your children for their future.”
Exposure to the campaign has shifted attitudes and norms around FP by encouraging open discussion
— Young man from the Democratic Republic of the Congo
From my community & family
Activities aimed to shape attitudes and behaviors among unmarried adolescents, their peers, and their partners Peer education stimulated new, more accepting social norms to increase family planning use and support Adolescent girls shared knowledge with each other about the appropriate marriage age for a girl and ways to avoid pregnancy Activities encouraged partner support and involvement in family planning discussions and decisions
Youth-led multimedia campaign in francophone West Africa sought to improve reproductive health and family planning outcomes Approaches included radio, television, social media, and community events Series of youth-driven videos encouraged both youth and adults to find new ways to talk about family planning and break taboos by talking to each other about reproductive health and family planning Activities encouraged health providers to avoid stigmatizing youth who want to adopt family planning
My teachers and elders feel uncomfortable teaching us about sexual and reproductive health and FP.
From my friends and partner
My community and religious leaders discourage me from accessing or wanting to access information about FP methods and services.
Religious leaders championed positive FP messages
Handbooks and discussion guides for religious leaders used scriptural references that support FP Religious leaders shared positive messages about FP to young women in order to address religious barriers to contraceptive use
Southern and Eastern Africa
Two FIVE
Activities aimed to increase consistent condom use by focusing on key mediators of behavior change, such as self-efficacy, social norms, attitudes, and action planning
In-school and after-school sessions promoted sexual and reproductive health among adolescents
Spotlight: Southern and Eastern Africa
young women reported being exposed to FP messages from religious leaders in the year following the intervention.
The intervention had a positive effect on condom use among male adolescents who participated (p = 0.004).
The rate of sexual initiation at 12 months following the PREPARE intervention was almost two times lower in schools that participated in the intervention than those schools that did not.
There was a higher uptake of modern contraceptives among women with high exposure to the intervention (35.5%) compared with respondents in the low or medium exposure categories (14.5% and 24.5%, respectively).
Who influences whether I get introduced to family planning?
My community and religious leaders discourage me from accessing or wanting to access information about family planning methods and services.
My teachers and elders feel uncomfortable teaching us about sexual and reproductive health and family planning.
From my friends & partner
Initiative mobilized schools, parents, peer educators, health providers, and communities to promote FP among adolescents
Interactive sessions held after-school to allow for and encourage more adolescents to attend
Teacher-led lessons integrated into primary school science curricula
Spotlight: Southern & Eastern Africa
Handbooks and discussion guides for religious leaders used scriptural references that support family planning
Religious leaders shared positive messages about family planning to young women in order to address religious barriers to contraceptive use
Religious leaders championed positive family planning messages
2 5
Southern & Eastern Africa
Spotlight: Democratic Republic of the Congo
Multilevel SBC package built knowledge, confidence, and positive attitudes around FP among very young adolescents
Package aimed to foster an environment that values and supports very young adolescents (VYAs) in their FP and reproductive health journeys and decisions Project worked with key adults to build VYAs' knowledge about health, gender-positive attitudes and skills, and self-efficacy so they felt equipped, empowered, and supported to make their own decisions around reproductive health and FP Approaches included group learning sessions, family discussion groups and videos, teacher orientations, exchange visits between providers and VYAs, and community dialogues
Democratic Rep. of Congo
South Sudan
Health care workers and parents facilitated dialogues with adolescents about sex and FP Community member support groups built parents' capacity and comfort level to discuss FP topics with their children Series of sessions with adults and adolescents on health, safety, and myths and misconceptions improved awareness and support for FP
Provider-led dialogues addressed FP myths and taboos with adolescents and adults
Spotlight: South Sudan
Participation in the dialogues built parent capacity and support for discussing FP with their children.
“Since I am part of the dialogue team, I feel less tension advising my daughter on issues of sexually transmitted infections and unwanted pregnancy and freely discussing any family planning side effects.” —Participating Mother
Out-of-school VYAs in Growing Up GREAT! showed increased communication about topics like puberty, reproductive health, and FP with key people (e.g., peers or supportive adults), including their partners within romantic relationships.
Out-of-school VYAs were about 1.6 times more likely to discuss pregnancy with a parent or adult compared to VYAs who were not part of the program.
I am worried my partner, parents, and provider do not approve of FP and would prevent me from learning about FP products or services.
I do not feel I need FP because I do not have sex often.
Package aimed to foster an environment that values and supports very young adolescents (VYAs) in their family planning and reproductive health journeys and decisions Project worked with key adults to build VYAs' knowledge about health, gender-positive attitudes and skills, and self-efficacy so they felt equipped, empowered, and supported to make their own decisions around reproductive health and family planning Approaches included group learning sessions, family discussion groups and videos, teacher orientations, exchange visits between providers and VYAs, and community dialogues
Series of sessions with adults and adolescents on health, safety, and myths and misconceptions improved awareness and support for family planning
Community member support groups built parents' capacity and comfort level to discuss family planning topics with their children
I need my sexual partner(s) to be aware of, involved in, and supportive of my FP needs and options so we can make joint decisions.
I need my community leaders, religious leaders and school leaders to debunk rumors and stigma regarding FP services.
Sharing contraception information via SMS increased knowledge about contraception
Automated, on-demand SMS system provided basic messages about nine contraceptive methods ranging from short-acting to permanent SMS system promoted via radio campaigns and through health clinics Young people who texted the sponsored numbers received clear and concise information about contraceptives, free of charge Text messages addressed misconceptions about contraceptives System provided information and location of nearest clinics when requested
Mozambique and Tanzania
more women said they felt informed about other methods of contraception.
25%
more women reported being told about side effects and what to do if they experience side effects.
50%
Approach aimed to encourage dialogue and create an enabling environment for young women to choose whether and when to bear children Activities focused on community interventions around FP, co-management committees, digital job aids for providers, and facility makeovers, including extending health facility opening hours to ensure young people can access private and confidential services Activities sought to build mutual accountability and shared responsibility for FP decisions Citizen Report Cards enabled participants to provide feedback on their experiences with FP counseling and services
Multifaceted approach strengthened and mainstreamed youth-friendly FP services
Spotlight: Mozambique and Tanzania
A total of 89% (Tanzania) and 71% (Mozambique) of clients aged 10–24 referred by community health workers received the method for which they were referred.
Significant youth uptake in FP, method mixing, and reproductive health services—particularly for long-acting, reversible contraceptives.
Within the first year, there were 93,691 new contraceptive users in Tanzania; of these, 31.7% were between ages 10 and 24.
Almost all youth respondents to the Citizen Report Cards were satisfied with the FP services provided and almost all respondents reported being treated with respect.
I need to be able to get my method at a location that is convenient and feels safe or private for me and my needs.
Automated, on-demand SMS system provided basic messages about nine contraceptive methods ranging from short-acting to permanent
SMS system promoted via radio campaigns and through health clinics
Young people who texted the sponsored numbers received clear and concise information about contraceptives, free of charge
Text messages addressed misconceptions about contraceptives
System provided information and location of nearest clinics when requested
Approach aimed to encourage dialogue and create an enabling environment for young women to choose whether and when to bear children
Activities focused on community interventions around family planning, co-management committees, digital job aids for providers, and facility makeovers, including extending health facility opening hours to ensure young people can access private and confidential services
Activities sought to build mutual accountability and shared responsibility for family planning decisions
Citizen Report Cards enabled participants to provide feedback on their experiences with family planning counseling and services
Spotlight: Tanzania
Contraceptive counseling sessions empowered girls to make their own FP decisions
Activities focused on entrepreneurial skills-building and contraceptive counseling sessions tailored to and branded for the unique needs Sessions supported girls aged 15-19 to explore the role contraception plays in helping them make empowered decisions about if, when, and how they want to use FP Segmented outreach delivered information that resonated with girls emotionally and cognitively
girls voluntarily took up a long-acting method.
51%
voluntarily adopted a method after engaging with the intervention.
71%
Program employed a socio-ecological approach to address norms and perceptions around contraception, marriage age, and pregnancy Activities for unmarried adolescents, community members, and other influencers included:
SBC tools positively changed norms and perceptions around contraceptives, marriage age, and pregnancy among adolescent girls
A three-day training program Community meetings Street theater performances Wall paintings Puppet shows Small group meetings SBC materials to encourage discussion and normative shifts
I do not have the decision-making power to adopt FP.
My providers may refuse FP services or only offer certain contraceptive methods to me because I am unmarried.
Of participating adolescent girls ,
A total of
More program participants than those in control sites said that someone had discussed the importance of delaying the first pregnancy with them.
Activities focused on entrepreneurial skills-building and contraceptive counseling sessions tailored to and branded for the unique needs Sessions supported girls aged 15-19 to explore the role contraception plays in helping them make empowered decisions about if, when, and how they want to use family planning Segmented outreach delivered information that resonated with girls emotionally and cognitively
Program employed a socio-ecological approach to address norms and perceptions around contraception, marriage age, and pregnancy
Activities for unmarried adolescents, community members and other influencers included:
Laws and policies in my country about FP determine what types of providers can deliver contraceptive methods and where they are able to deliver these methods to me.
In line with social and cultural norms in my community, my friends, partner, and parents influence my FP decisions when I am not married.
My religious and community leaders oppose contraception in general or certain methods that I considered, and I do not want to make FP decisions that go against their views.
Spotlight: Botswana, Ghana, Uganda, and Tanzania
Initiative created a youth community to encourage healthy sexual behaviors
Initiative aimed to engage youth (aged 10–24) in reproductive health matters and to provide them with the necessary information, skills, and support to protect themselves Activities included youth-friendly clinical services, policy and advocacy efforts around youth-friendly FP, institutional capacity building, and establishment of coordination mechanisms between agencies and teams that implement programs for young people
Botswana, Ghana, Uganda and Tanzania
Providers in my community play a role in supporting my contraceptive choice but are not always willing to share information or promote FP options to me.
Compared with girls who were not exposed to the African Youth Alliance (AYA) program in Uganda, AYA-exposed girls were at least:
13%
Initiative aimed to promote gender-equitable norms to encourage respect and joint decision making and to prevent gender-based violence in relationships Activities focused on engaging cricket coaches, peer mentors, and the community Program leveraged teachable moments with male players during cricket games to discuss and challenge norms that may influence their perspective and support for FP
Engaging community leaders in teachable moments promoted FP and gender equality among young men
more likely to report having used a condom.
more likely to report that they had consistently used condoms with their current partner.
10%
more likely to have used contraceptives.
“The program helped me think how, as men and women, we are all equal. Earlier, I used to think that men are always powerful and they can do anything that they want. But now I think in a different way.” — Male Coach
The program reported shifts in the norms that restrict the agency and self-efficacy of adolescent girls, constrain their access to information and education, and reinforce gender inequality within relationships.
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Initiative aimed to engage youth (aged 10–24) in reproductive health matters and to provide them with the necessary information, skills, and support to protect themselves
Activities included youth-friendly clinical services, policy and advocacy efforts around youth-friendly family planning, institutional capacity building and establishment of coordination mechanisms between agencies and teams that implement programs for young people
Initiative aimed to promote gender-equitable norms to encourage respect and joint decision making and to prevent gender-based violence in relationships
Activities focused on engaging cricket coaches, peer mentors, and the community
Program leveraged teachable moments with male players during cricket games to discuss and challenge norms that may influence their perspective and support for family planning
I am concerned about my privacy, treatment, and provider judgement if I visit a health center to ask about FP.
I question the efficacy of contraceptives after seeing my friends who use FP methods still get pregnant.
From my peers and friends
I feel pressure to prove my fertility and to have a large family. I may face stigma or lose my social status if I delay pregnancy, do not have many children, or choose not to have children.
Engaging grandmothers and community influencers built support and confidence in FP decisions
Program aimed to change engrained social norms related to FP methods and choices Activities engaged adolescents, adults, elders, religious leaders, and health workers Dialogue and consensus-building activities worked to relieve pressure on adolescent girls to become pregnant early and often Intergenerational forums and workshops with grandmothers, girls, mothers, and teachers Grandmother leadership training provided spaces for adolescent girls to feel safe and supported by key influencers in their lives
Initiative aimed to remove physical and psychological barriers young women face in accessing FP services Activities encouraged uptake of FP and tackled provider bias, a key factor in creating safe and welcoming spaces for young women A 72-hour clinic makeover included:
Tackling provider bias created comfortable and confidential FP service experiences
Expanded equitable access to FP services through new and existing service delivery channels.
Among women of childbearing age, there was an 11.5% increase in modern contraceptive use over five years of implementation.
As a result, over 350,000 more families began using modern FP methods in implementation states.
“Often, when parents plan to marry a young daughter the grandmother is against it. The father listens to the grandmother's’ advice because she is his mother. He cannot refuse her advice.” —Program participant
28% of adolescent girls who participated in the program sought advice on pregnancy from grandmothers, compared to 5% who did not participate.
Significantly shifted deep-rooted social norms and practices related to girls’ education, child marriage, and teen pregnancy.
Source 3
Creating a welcoming and confidential in-clinic environment Training providers to counsel and provide contraceptives Developing and disseminating tools to enhance the quality of FP service delivery
Program aimed to change engrained social norms related to family planning methods and choices
Activities engaged adolescents, adults, elders, religious leaders, and health workers
Dialogue and consensus-building activities worked to relieve pressure on adolescent girls to become pregnant early and often
Intergenerational forums and workshops with grandmothers, girls, mothers, and teachers
Grandmother leadership training provided spaces for adolescent girls to feel safe and supported by key influencers in their lives
Initiative aimed to remove physical and psychological barriers young women face in accessing family planning services
Activities encouraged uptake of family planning and tackled provider bias, a key factor in creating safe and welcoming spaces for young women
A 72-hour clinic makeover included:
Creating a welcoming and confidential in-clinic environment
Training providers to counsel and provide contraceptives
Developing and disseminating tools to enhance the quality of family planning service delivery
I need to be able to continue making my own decision about whether and when I want to have any or more children.
Spotlight: Southern Nigeria
Prompting service providers to deconstruct biases improved FP counseling outcomes with adolescents girls
Activities aimed to enable providers to support unmarried girls aged 15–19 with the knowledge and confidence their lives are their own as they continue their FP journeys “Method Choice Book” tackled biases around FP and encouraged ongoing provider behavior change Activities facilitated greater understanding among providers about what matters to girls regarding their continued FP options, the most effective contraceptive methods, the possibility of side effects, and key communication strategies about long-term FP Providers received tools and communication strategies to support girls in their FP journeys
Southern Nigeria
Iran
of girls voluntarily took up a long-acting method.
34%
of girls voluntarily adopted a method.
74%
Initiative trained health providers in the World Health Organization's Decision-Making Tool for Family Planning to create awareness of FP options Decision-Making Tool helped clients make informed and empowered decisions about FP services and methods
Provider-facilitated decision-making tool encouraged informed and empowered FP decisions
Spotlight: Iran
The Decision-Making Tool improved verbal and non-verbal communication between clients and providers and impacted positively on the client's choice of contraceptive method, providers' technical competence, and the quality of information provided to clients.
Clients were more satisfied with FP services and participated more actively in selecting their contraceptive method.
Use of the Decision-Making Tool increased client satisfaction with FP services from
I need to be able to continuously get my method at a location that is convenient and feels safe and private for me and my needs.
Increased the uptake of long-acting reversible contraceptives and injectables from 15% to 20%.
After engaging with the program,
72% to 99%
Activities aimed to enable providers to support unmarried girls aged 15–19 with the knowledge and confidence their lives are their own as they continue their family planning journeys
“Method Choice Book” tackled biases around family planning and encouraged ongoing provider behavior change
Activities facilitated greater understanding among providers about what matters to girls regarding their continued family planning options, the most effective contraceptive methods, the possibility of side effects, and key communication strategies about long-term family planning
Providers received tools and communication strategies to support girls in their family planning journeys
Initiative trained health providers in the World Health Organization's Decision-Making Tool for Family Planning to create awareness of family planning options
Decision-Making Tool helped clients make informed and empowered decisions about family planning services and methods
Mexico
In Burkina Faso, high campaign exposure was associated with an adjusted increase of 21.8% in the proportion of women currently using modern contraceptive methods compared to women with no exposure.
Initiative provided detailed, structured pretreatment counseling about the hormonal effects of injectable contraception to young women Tools helped providers counsel on menstrual changes to expect with contraception use Contraception continuation rates encouraged by equipping women with accurate information and clear expectations about side effects
Counseling on expected side effects improved continuation of contraceptive use among young women
Spotlight: Mexico
Contraceptives use termination rates were significantly lower among women who received the pre-treatment counseling compared those who did not.
Discontinuation rates were 17% among women who participated in the intervention, compared to 43.4% for women who did not.
I have used a specific type of contraception, but since it is not available, I risk losing interest.
In Cameroon, contraceptive prevalence for all women increased by 20% between baseline and follow-up.
Encourage ongoing contraceptive use and inter-partner communication Debunk myths and rumors about FP methods Provide information on managing side effects Empower women of reproductive age and the community to expect and demand specific standards of quality from providers Promote Gold Circle health clinic sites
Encourage ongoing contraceptive use and inter-partner communication
Debunk myths and rumors about family planning methods
Provide information on managing side effects
Empower women of reproductive age and the community to expect and demand specific standards of quality from providers
Promote Gold Circle health clinic sites
Initiative provided detailed, structured pretreatment counseling about the hormonal effects of injectable contraception to young women
Tools helped providers counsel on menstrual changes to expect with contraception use
Contraception continuation rates encouraged by equipping women with accurate information and clear expectations about side effects
Who influences my FP continuation?
My partner or parents do not approve of me continuing to use FP.
In line with social and cultural norms in my community, my friends, partner, and parents influence my continued FP decisions when I am not married.
Music videos and social media sparked conversations about FP among youth
Initiative sought to normalize condom use and conversations about contraception with people close to them, such as parents or partners Activities focused on addressing misconceptions and stigma associated with buying condoms Music videos and social media campaigns directed at youth conveyed key FP messages
My religious leaders encourage me to accept what God gives and not limit my pregnancies or space births.
From religious leaders
The campaign made conversations around condoms more acceptable in social spaces and amongst peers. Use of music and a less overt approach to messaging encouraged the audience to engage with the content.
Integrated multimedia approach included a free comic distributed at the national level (705,000 copies a month) and an online platform Weekly syndicated radio show and digital media (Facebook, SMS, Twitter, WhatsApp) showcased stories of fictional characters and real youth representatives from different parts of the country as they encountered and resolved challenging life and health issues Platform for young people to form a community where they could discuss FP questions and concerns and receive information and practical tools about sexual and reproductive health
Multimedia platform improved the lives of youth by normalizing and stimulating FP behaviors
The campaign reached people, at one point becoming India’s #1 trending topic (beating COVID-19).
Digital media exposure was associated with an 18.1 percentage point increase in using condoms and a 13.8 percentage point increase in the use of modern contraceptive methods.
My partner is worried about the side effects I am experiencing from my FP method.
33
million
Initiative sought to normalize condom use and conversations about contraception with people close to them, such as parents or partners
Activities focused on addressing misconceptions and stigma associated with buying condoms
Music videos and social media campaigns directed at youth conveyed key family planning messages
Integrated multimedia approach included a free comic distributed at the national level (705,000 copies a month) and an online platform
Weekly syndicated radio show and digital media (Facebook, SMS, Twitter, WhatsApp) showcased stories of fictional characters and real youth representatives from different parts of the country as they encountered and resolved challenging life and health issues
Platform for young people to form a community where they could discuss family planning questions and concerns and receive information and practical tools about sexual and reproductive health
I want to achieve my dreams and continuing to use FP helps me reach my goals.
I believe that pregnancy is the best chance I have to increase my social standing and status so I decide not to continue to use contraception.
Aspirational program boosted girls' confidence and broke stigma and taboos around reproductive health
Initiative aimed to increase girls' confidence about the decisions they make through adolescent health programs that provided accurate, contextualized information about reproductive health Magazines and education through girls' clubs covered topics like pregnancy, sexually transmitted diseases, and contraceptives Provided reliable and constant access to menstrual hygiene products for girls at school to help normalize this stage in girls' reproductive journeys
Brazil
girls across 140 schools in Kenya.
Aimed to equip young women with the tools and confidence to make their own decisions about FP Meetings for pregnant adolescent girls focused on FP, self-esteem, pregnancy prevention, motivation to continue education and/or work, and the postpartum mother-child relationship
Forums improved self-esteem and decision making around FP for adolescent girls
Spotlight: Brazil
Improved reproductive health attitudes, gender norms, and self-efficacy among girls who had access to pads and educational health programs.
During the 23.4-month follow-up period, only 3.52% of participating women had repeat pregnancies during adolescence, with an average time between the two deliveries of 22 months.
3,500
Reached
Magazines and education through girls' clubs covered topics like pregnancy, sexually transmitted diseases, and contraceptives
Initiative aimed to increase girls' confidence about the decisions they make through adolescent health programs that provided accurate, contextualized information about reproductive health
Provided reliable and constant access to menstrual hygiene products for girls at school to help normalize this stage in girls' reproductive journeys
Aimed to equip young women with the tools and confidence to make their own decisions about family planning
Meetings for pregnant adolescent girls focused on family planning, self-esteem, pregnancy prevention, motivation to continue education and/or work, and the postpartum mother-child relationship
