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New Messages Build Male Support and Boost Contraceptive Use in Senegal

April 2, 2014 Adrienne Allison, MA, MPA Senior Technical Advisor FP/RH World Vision
1

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 womens access to FP services.


They largely ignored the structure of Senegals traditional society, where men control most decisions about desired family size and contraceptive use. Results: Senegals 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

HTSP and under 5 Mortality


Under Five Mortality by Birth to Conception Interval 52 DHS Surveys
3.5

2.97
3.0

1,049,122 births
2.22

2.5
Adj. Relative Risk

2.0

1.81

1.49
1.5

1.22
1.0

1.14 1.00 0.96


0.92

1.05

0.5

0.0 <6 6-11 12-17 18-23 24-29 30-35 36-47 ref. 48-59 60-95 96+ Interval in months

Rutstein, Measure DHS 2008

Percent of Children Alive and Not Undernourished by Duration of Preceding Birth to Conception Interval
80% 75% 75% 71% 70%

352,447 births in 52 DHS surveys


63% 63% 59%

Percent of children

65%

60% 55% 55% 48% 45% 43% 45% 52%

50%

Alive and not undernourished

40% <6 6-11 12-17 18-23 24-29 30-35 36-47 ref. 48-59 60-95 96+

Interval in months

Shea Rutstein, Ph.D., Measure DHS 2008

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 mothers healthiest yearsages 18 to 34

Mobilizing Male Support


World Vision provided information for: Civic officials data on spacing births and saving lives Religious leaders discussions on the Holy Korans 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!