Rig Trucks: Meeting women with family planning ‘where they are’

By Stephen Alege, Head, Social Behaviour Change, PSI Uganda; Gracie Nakazzi, Area Program Officer, PSI Uganda

It’s a rainy afternoon. The dark clouds have just unleashed a ferocity of rain punctuated with scattered thunderstorms in Namuwongo, six kilometres from the heart of Uganda’s capital of Kampala. The weather has ground all business to a standstill as the drains fill up with gushing water.

With visibility drastically dropping, a bright pink branded Discover Your Power rig truck squeaks to a stop in front of a corner shop. The occupants scramble to cover the mounted PA system with plastic sheeting.  The accompanying branded Discover Your Power ambassadors jump down and scatter in different directions to take shelter from the downpour.  

Minutes later, as the rains diminish, business starts to resume. A young woman decides to approach one of the Discover Your Power brand ambassadors still perched against the wall at the corner shop.

She inquires, “Before the rains, I heard through the speakers that there is a family planning meeting in Katoogo village.” With a heart-warming smile, the ambassador confirms and pulls a family planning guide from under her sweater.

This ambassador is one of many community members in Uganda and Nigeria who aim to meet women where they are – emotionally, economically and physically – with family planning options that fit their needs and lifestyles, in a way that is convenient and accessible, proven to be effective, and part of a larger family planning movement.

THE DISCOVER YOUR POWER CAMPAIGN

Discover Your Power is a multichannel promotion campaign led by the Delivering Innovation in Self-Care (DISC) Project, aiming to give women an opportunity to understand, use and continue self-injection as a family planning option within the context of other available contraceptives.

The campaign promotes contraceptives with community engagements and by using digital channels like Facebook and the WhatsApp automated digital companion chatbot (Tina); FM radio magazines; talk shows; spot adverts; and social media influencers on Twitter, TikTok and Instagram. The branded rig truck, that sparked the young woman’s interest above, is another tool of the campaign that has the community taking notice.

The rig, while on the move throughout the community, plays scripted messages like, “Discover your power with self-inject contraceptive” and “Protect yourself against unintended pregnancy for 3 months in the comfort of your own home”. We know these messages spark interest in family planning (FP) because brand ambassadors near the vehicle are approached by interested community members. Promoting FP using experiential techniques and face-to-face communication tactics disrupts the status quo and reaches consumers in an approachable way. Interactions like those with brand ambassadors are unique, dynamic, memorable, and emotional experiences for clients, and increase FP awareness and uptake within communities.

A rig truck and activation crew drive along a road in Kampala, Uganda while brand ambassadors prepare to mobilize clients for services

DISC data show that rig trucks are the most effective channel within our community activations, when measured in terms of the number of users reached. The pie chart below shows the number of users reached via various community mobilization channels from April 2021 through May 2022.

By May 2022, 88 rig truck FP community drives and engagements were held in nine districts, reaching over 13,446 birth spacing mothers and urban youths. Of those reached, 56% took up self-inject.

How Rig Truck Drives Support Demand for FP

To maximize its effect, the Discover Your Power truck is strategically deployed a day prior to all scheduled community FP events, as well as during events. Its presence sparks interest within communities and attracts potential clients to the area. From there, ambassadors are available to answer questions, offer resources, and direct clients to service points.

At the service points, which include private and public clinics, clients are given information about all contraceptive methods with emphasis on the method of their choice. Clients that have chosen a FP method suitable to their needs are directed to a health provider tent where they are registered in the service book and receive specialized information about that method.  

A healthcare provider from Kiganda Maternity, Kampala district emphasizes how rig trucks are reaching members of the community. “Rig trucks cover a wide area during mobilization unlike the Village Health Teams (VHTs). This leads to good client turn up and improves service uptake since the clients come for the events with some information about family planning which they have heard from the ambassadors on the rig truck in an exciting way.”

SUCCESSES AND LESSONS LEARNED

Based on the successes of this approach with increased uptake of FP, PSI Uganda has deployed rig trucks to address COVID-19 vaccine hesitancy in the two districts – with promising results. Here is what we’ve learned:

  • To maximize impact, we should prioritize the most bustling, high-volume activation sites, with the greatest numbers of women of reproductive age (WRA). This includes workplaces such as markets. Reaching women at their workplaces can be especially meaningful considering that female shopkeepers and vendors don’t necessarily have the luxury of taking time off to visit health centres, so direct outreach affords a rare opportunity for them to discuss FP matters with trained professionals without disrupting their daily routine.
A brand ambassador shares information about FP with an interested market vendor. Markets are an ideal setting for community activation.
  • It’s most helpful when activation teams are sufficiently equipped with SI doses, so that women who have been trained to self-inject can take units home with them for future use, rather than needing to subsequently collect doses at events or clinics. Maximizing client satisfaction is important, not least because ‘word of mouth’ has the potential to attract new users who learn about self-inject from existing satisfied users.  Currently the ‘satisfied users’ channel represents only 1% but it has the potential to grow considerably if we can ensure a seamless experience for the client.
A brand ambassador introduces a client to DMPA-SC and explains how to use it.
  • There’s room to be creative and make in-person activations as entertaining and as meaningful as possible. Establish a positive emotional connection with the client through provocative slogans, dramatic skits and interactive quizzes. For example, activation teams may shout out a localized version of the word ‘economy’ to grab attention, and pair it with a catchy slogan to emphasize the economic advantages of having fewer children.
  • To optimize the effectiveness of communication, it’s essential to use the local vernacular. DISC has translated a short instructional video on self-inject into various local languages. This video is displayed on rig trucks to clearly demonstrate the technique.
  • Activation teams can leverage a prime opportunity to be more gender-transformative by getting men in the community on board with women’s contraceptive self-care. When male engagement is done tactfully, it can send a strong message to men that supporting their partner’s FP choices not only promotes the health of their family and community but also poses no threat to their masculinity. DISC’s activation teams make a point to reach out to groups of men including boda boda drivers, pool and Ludo players, mechanics, and others.

Learn more about how DISC’s #DiscoverYourPower campaign meets women with FP options where they are here.

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