Demand generation activities and modern contraceptive use in urban areas of four countries: a longitudinal evaluation

Agra

Aligarh

Allahabad

Gorakhpur

Moradabad

Varanasi

Interpersonal communication: home visits by peer educators to provide women and men information, counseling, and referral; focus on LAPMs for pregnant women

Mid-media: street plays, road shows, magic shows (low exposure)

Mass media: radio and television with targeted messages

Postpartum service integration: targeted FP information, counseling, and promotion during pregnancy and postpartum; ensure supplies and provider competencies to offer LAPMs

Postabortion service integration: provide FP counseling and services during postabortion care

Expand service delivery and quality

• Expand method choice

• Improve technical and client-provider interaction skills of providers

Public-private partnerships

• Partnerships with Janani and other high-volume private facilities

• Strengthen routine and fixed day services for poor from slum communities

Social marketing of condoms and pills

Focus on policy, advocacy, scale

Nairobi

Kisumu

Mombasa

Kakamega

Machakos

Generate demand by addressing social norms and barriers that inhibit FP use

• Community mobilization

• Wide distribution of print project materials

Local and mass media, including radio and television shows targeted to urban poor and young audiences

Improve quality and accessibility of FP services through integration of services. Focus on facilities: close to slum/informal settlements; with high-volume attendance; and with high usage from slum/informal settlements

Ensure contraceptive security throughout the life of the project and beyond by addressing poor forecasting and developing electronic stock-out reporting system

Engage formal and informal private sector: work with selected private nurses and clinical officers to offer high-quality and low-cost comprehensive FP services

Advocacy for improved policy environment

Capacity building and sustainability: build capacity of local implementing partners, policy makers, private and public-sector providers to respond to FP/RH goals and needs

Dakar

Guédiawaye

Pikine

Mbao

Mbour

Kaolack (outside the region of Dakar)

Outreach workers identifying FP needs

Theater to promote discussion on a topic

Small group discussions led by midwives with users to discuss FP-related topics

Engagement of religious and community leaders to participate in and lead FP discussions

Radio and television using public, private, and community-level stations

Integration of FP into MCH services including postpartum and postabortion care

• Train providers to use cost-effective and evidence-based service delivery systematic screening tool to identify unmet FP needs

Expand availability and quality of long-acting FP services in health facilities

• Train providers; ensure stock reliably available

• Integrate trained midwives into facilities to increase access to and availability of FP on a regular basis

• Outreach through mobile clinics targeting poor areas

Social franchise strategies to increase access through the private sector

• Use Blue Star to increase access to FP in existing private-sector services

Advocacy to create a favorable policy environment

Abuja

Ibadan

Ilorin

Kaduna

Benin City

Zaria

Social mobilization: interpersonal communication activities to encourage discussion and reduce barriers of miscommunication and social stigma to normalize FP, undertaken in various settings including markets, special events; spread of branded items in numerous community settings

Media: radio and television at the state and local levels; use local-language slogans for specific city radio programs; radio magazine entertainment-education program

Improve quality and integrate high-volume facilities: train providers, ensure stock, improve facility environment including quality standards

Test novel public-private partnerships: Family Planning Providers Network trains, markets, and supplies providers with what they need to provide appropriate FP services and networks the providers together

• Clinical services: performance improvement to ensure that clinical providers offer full menu of methods with quality counseling and integrated services

• Patent Medicine Store/pharmacist: provide information, basic counseling, and non-clinical FP methods as first-line providers

Advocacy to promote FP discussions in public forum and to encourage acceptance at all levels