Promoting Male Engagement and Partners' Dialogue

Transform/PHARE: Côte d’Ivoire

In Year Three, using a human centered design (HCD) approach, Transform/PHARE explored innovative ways for designing and reaching young men outside of traditional health communications settings, which resulted in an SBC intervention prototype that is being tested at small scale in Abidjan. Entitled “Didier”, the activity promotes male engagement and partners’ dialogue regarding contraception among young urban males ages 15-24 working in the informal sector. The objective was to see whether combining interpersonal communications along with a Facebook story could be an effective way to engage these men as users of contraception, as partners, and as agents of change with regard to family planning. 

Results from initial testing of this strategy showed good promise in terms of audience engagement, reach and its ability to spark discussions, though with some important challenges and lessons learned. Analysis and observations based on user involvement and data collected on the Facebook interaction process have provided valuable insights, such as:  

  • There is large interest in the story mostly from young men and most of them are from Abidjan.  
  • It seems that many of the followers are boys in school or in higher education.  
  • It is not possible to find out how young men from the informal sector have been involved and whether the story is having any influence on the target audience.  
  • Although baseline and follow-up data were gathered and analyzed, Facebook followers participating in the polls are not representative of actual Didier story followers, and certainly not representative of the target audience. 

Building off the lessons learned in Year 3 and drawing from the experience of other projects using social media, Transform/PHARE will use core funding to launch a second phase of the Didier storyline on Facebook, while simultaneously integrating interpersonal communications in selected communes of Abidjan, targeting young men 15-24 from the informal sector. The objective is to determine whether combining the Didier Facebook story with interpersonal communications can provide improved opportunities to engage these men as users of contraception, as partners, and as agents of change with regard to family planning.  

A second chapter of the Didier story will be published in Facebook in a series of 10 episodes. In order to evaluate the current story amongst the target group and also gain insights into the contents of a continued story, focus group discussions (FGD) will be held with men from the informal sector who are also followers of Didier on Facebook. The second series of Didier will be guided from the insights gained in such FGDs. 

National Demand Analysis, Côte d’Ivoire

A literature review and qualitative investigation with men and women age 15-49 was  conducted. This served to characterize the forces shaping FP use and non-use, in addition to understanding what it takes to close the intent to use gap and identify groups most likely to increase their use of FP.  A nationally representative survey of 1,000 women age 15-49 was also conducted.  The customized survey data was analysed to identify overall trends and context, sub-groups of women with acute FP demand and/or risks, and to develop a statistical segmentation of women based on their needs, attitudes and behaviours. Recommendations for priority groups as well as promising near-term strategies to help CDI meet its 2020 FP target were developed. 

Healthcare Provider Barriers to Family Planning Service Delivery in Côte d’Ivoire 

The project first started with a literature review related to the supply of FP services in West Africa and was followed by 15 focus groups with 107 providers in 6 regions in Côte d’Ivoire. The discussions led to the pre-selection of 30 proposed positive deviantproviders.  Such providers were visited by 30 mystery clients to validate the selection. At the end, 15 in-depth individual interviews were held with 15 providers identified as positive deviants. 

Three major categories of barriers in the supply of FP services were identified: a) organizational barriers such as lack of appropriate materials or appropriate structures, b) community barriers such as the influence of cultural or religious values, and c) personal barriers based on client characteristics such as age, marital status or parity. 

It was concluded that positive deviant providers are characterized from the point of view of the client by the quality of their service, confidentiality, the effective communication and finally by their availability to prescribe and accurately provide information about the methods. The elements that enable positive deviant providers to overcome barriers lies on their motivation (the love of the trade), continuous capacity building, exceptional work experiences and innovative communication strategies. 

The technique of identifying positive deviants was also used to identify best practices. At the end of the analysis, it can be retained that positive deviants offer the full range of FP services to clients demonstrating empathy and good listening skills that enhance the client’s likelihood to adopt and continue using a modern method of contraception. 

Social Behavior Change Communication landscaping using TMA in Côte d’Ivoire 

The SBCC landscaping in Cote d’Ivoire, using the total market approach, allowed the project to identify existing FP products and linked communication. This analysis painted a full picture of the FP market in Cote d’Ivoire which in turn can inform programming at every level to support positive behavior change. Through this analysis it was found that the FP market includes 32 million condoms (79% of which are socially marketed), 2.5 million contraceptive pills, and injectables, which are primarily sold through the private sector. Unmet FP need in the country is estimated at 27.2%. It was also found that recurring inventory shortages often affected the providers’ ability to conduct quality services. In addition, due to high communication costs in the country, FP communication was often left out, which created an environment of negative perceptions surrounding FP products from consumers and even suppliers. The research indicates that in order for CDI to move ahead in reaching its FP goal, the Ministry of Health needs to encourage increased mass and social media communication activities on modern contraceptives and eliminate media taxes to motivate the different actors in promoting FP. 


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