building advocates for family planning among male leaders in senegal, adrienne allison - community...
TRANSCRIPT
New Messages Build Male Support and Boost Contraceptive Use in Senegal
April 2, 2014Adrienne Allison, MA, MPASenior Technical Advisor
FP/RH World Vision1
Objectives
To demonstrate the impact of:
• including outreach to boys and men in family planning (FP) programs in traditional societies
• building male support for FP by focusing on the health benefits of “Healthy Timing and Spacing of Pregnancies”
Background - Family Planning in Senegal
FP policies and programs introduced 50+ years ago were based on two rationales:• demographic - rapid population growth• economic – accelerating development.
They focused on increasing women’s access to FP services.
They largely ignored the structure of Senegal’s traditional society, where men control most decisions about desired family size and contraceptive use.
Results: Senegal’s contraceptive prevalence rate (CPR) is 11%, among the lowest in the world.
World Vision reached out to men with new FP messages focused on healthy fertility
World Vision recognized that men valued the health of children, mothers and communities.
Using Healthy Timing and Spacing of Pregnancies (HTSP) data, WV tailored HTSP messages for:• Civic officials, religious leaders,
community elders, fathers and boys• Ministry of Health (MOH) providers• Male village health workers
2.97
2.22
1.81
1.49
1.22 1.141.00 0.96 0.92
1.05
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
<6 6-11 12-17 18-23 24-29 30-35 36-47 ref. 48-59 60-95 96+
Adj.
Rel
ativ
e R
isk
Interval in months
Under Five Mortality by Birth to Conception Interval52 DHS Surveys
1,049,122 births
5
HTSP and under 5 Mortality
Rutstein, Measure DHS, 2008
Percent of Children Alive and Not Undernourished by Duration of Preceding Birth to Conception Interval
75%
71%
63%63%
59%
55%52%
48%
43%45%
40%
45%
50%
55%
60%
65%
70%
75%
80%
<6 6-11 12-17 18-23 24-29 30-35 36-47 ref. 48-59 60-95 96+
Interval in months
Perc
ent o
f chi
ldre
n
Alive and notundernourished
Shea Rutstein, Ph.D., Measure DHS 2008
352,447 births in 52 DHS surveys
6
Healthy Timing and Spacing of Pregnancy Messages
• Delay the first pregnancy until a girl is 18
• Wait until a child is at least 2 before trying to become
pregnant again
• Wait at least six months before trying to become pregnant again after a miscarriage or abortion
• Limit pregnancies to a mother’s healthiest years—ages 18 to 34
7
Mobilizing Male Support
World Vision provided information for:• Civic officials – data on spacing births
and saving lives• Religious leaders – discussions on the
Holy Koran’s support for timing and spacing pregnancies
• Community elders – messages for fathers and mothers
• Boys and men – banners and fliers at sporting events, community rallies and local competitions
All designed to build knowledge, increase understanding and provide a common language about HTSP and FP.
Campaign with Civic & Islamic Leaders
Challenges & Outcomes
• Lack of knowledge fed rumors about the side effects of using contraception
• Women perceived that men did not support FP and hid their contraceptive use
• Imams thought that FP programs were designed to limit births and control population growth
Outcomes - In 12 months the CPR rose from:• 2% to 9% at Health Huts• 12 % to 17 % at Health Posts
Outcomes, Lessons Learned, Results
Lessons Learned -• Men respond well to HTSP messages and help accelerate FP uptake• Educating men empowers them to make informed decisions to
support FP • FP programs benefit when they include men as partners• Demand generation and services must be simultaneous
Results -• The goal of the Ministry of Health (MOH), Department of
Reproductive Health is to build a healthy population• MOH calls for all births to be spaced in order to reduce infant
mortality.
Thank you!