Promoting Health-Adjusting The Reproductive Environment (Transform/PHARE)
To promote male engagement (ME) in FP, the United States Agency for International Development (USAID)-funded Promoting Health-Adjusting the Reproductive Environment (Transform/PHARE) Transform/PHARE project has been working to develop and pilot innovative approaches, including a Human Centered Design (HCD) project in Côte d'Ivoire focusing on men in the informal employment sector and an innovation lab in Burkina Faso aimed at increasing ME in FP.
These activities were designed to explore and address men and boys as users of contraceptive methods, supportive partners of FP use, decision makers, social influencers, and agents of change. The project piloted ME in FP approaches in order to increase modern contraceptive use, promote shared decision making between couples, stimulate conversations about the negative impacts of rigid gender roles, and actively address gender inequalities.
Transform/PHARE is a five-year (2015-2020) initiative led by Population Services International (PSI). The project is designed to infuse innovative practices from a range of disciplines into Social and Behavior Change (SBC). It emphasizes creative thinking, exceptional design, and high-quality production and implementation. Interventions and approaches are tested and iterated and the results of those showing potential impact on behavioral outcomes are disseminated to be adopted, adapted, and possibly scaled up by other implementing agencies.
The two projects described below use Human Centered Design (HCD) to identify both problems and solutions. HCD is a specific set of processes that place the intended audience and other key stakeholders at the center of the research, design, and implementation process. It is an innovative approach to SBC because it applies a set of core design principles to areas which are not traditionally defined as needing "design". These principles emphasize a human-centered point of view, experimentation, iteration and redesign, and tangibility. Applied to SBC, the process helps to ensure that audience needs and expectations inform design decisions, leading to a higher likelihood of reaching desired behavioral outcomes.
- Secondary Research: Existing research that is summarized, collated, and synthesized.
- Sacrificial Concepts: Simple abstract ideas, designs, concepts, or scenarios that are intended to elicit a reaction or serve as conversation starters for eliciting insights from an end user.
- Inspiration Research: A collection of tasks and activities focused on learning about and understanding the audience's needs from immersive experiences and direct interaction with the audience.
- Ideation: Identify opportunities for design, brainstorming, and prototyping possible solutions.
- Prototyping: The process of quickly making ideas tangible.
THE DESIGN OPPORTUNITY
How might we use dating advice to encourage young men in supporting behaviors related to contraceptive use?
It was clear from the insights and archetypes that young men are oblivious to issues around gender equality and have few positive role models who can show them alternative ways of behaving. They are excited about women and relationships, but not really interested in sexual health or contraception. These realities present both a challenge, and an opportunity.
The insights, archetypes, and co-creation workshop informed the design of a prototype of an interactive story delivered through SMS messaging, a live show, and Facebook, intended to motivate discussions on sexuality, condom use, unplanned pregnancy, and contraception.
A tantalizing piece of the story is delivered in 160 characters every day via WhatsApp or SMS. The messages create suspense and draw in readers. The story progresses as the audience votes on what happens next at crucial moments. Polling engages the audience and allows monitoring of changes in their attitudes toward relationships, gender equality, and FP/RH choices. The platform is also used to engage the audience on Facebook and in upcoming "Dude Zone" events nearby (see below).
Young men can meet Didier's characters and chat with positive role models about sex and relationships during live shows. The live shows consist of "Dude Zones", Didier interactive skits, and networking.
- Dude Zones: The live show starts with informal chats between young men and a positive role model (e.g., Big Brother).
- The Show: Didier characters then perform interactive skits.
- Networking: At the end of the live show, young men can chat with male and female Didier characters, ask questions, and are invited to stay in touch through the Facebook page.
Young men can follow the latest story episode, interact with Didier characters, participate in polls about relationships, sexual health, and gender equality, and be connected with health services. It serves as a fun space to chat, ask questions, and learn from positive role models through Didier-themed content.
Three ideas were selected for the prototyping phase:
- L'académie de 14 février (The February 14 Academy): Plans social activities for young couples and educates them on how to effectively discuss FP issues (Pathfinder/Alliance Technique d'Assistance au Développement)
- L'homme Faiseur (The man-maker): Creates male ambassadors to talk about FP and its benefits to other men (Organisation Catholique pour le Développement et la Solidarité/Resilience and Economic Growth in the Sahel)
- Père Burkinbila (Burkinbila Fathers): Teaches fathers to support the FP needs of their teenage children (Save the Children/IPC/Association Zood Nooma pour le Développement)
The jury selected Père Burkinbila to pilot for three months. The intervention responds to the need to strengthen the capacity of fathers to initiate and engage in parent-child communication on FP/RH. The intervention aimed to reduce the rate of unwanted pregnancies among girls and young women and make men more active agents of change. The pilot organized motivated fathers into three Father's Clubs composed of 12 members in each of the three villages. Parents and community members expressed appreciation for the activity and all men participating in the clubs received a certificate nominating them as "Pères Burkinbila". Activities consisted of:
- Educational sessions for Père Burkinbila;
- Discussions between fathers and sons using visual aids; and
- Home visits to support fathers.
Pilot Results and Lessons Learned
- Frequency of communication about sexuality and FP between fathers and teens in households increased. Prior to the intervention, only two of the 36 fathers reported that they had discussions with their sons about pregnancy. Following the intervention, that number increased to 36 out of 36.
- The overwhelming majority of fathers reported that they had discussions for the first time with their sons on responsible sexual behaviors and unwanted pregnancy. Sons disclosed surprising revelations to their fathers about their early sexual lives and discussions opened the debate on other topics such as education of girls and demand for contraception.
- Strong community engagement was achieved through involvement of the administrative and customary authorities, commitment of village leaders, contributions from community radio, and community acceptance and appreciation for the intervention.
The pilot encountered a number of challenges that can inform any future scale up or adaptation:
- Facilitators found it difficult to supervise fathers during the discussions given the presence of the adolescent boys.
- Educational guides and data collection support were not appropriate to the fathers' level of education.
- The intervention is likely to create demand for FP/RH services, but services have not been established.
For more information on Transform/PHARE's Male Engagement work, please contact Luis Fernandez Martinez, Social and Behavior Change Communication Senior Technical Advisor, Transform/PHARE, firstname.lastname@example.org
For more information on Breakthrough ACTION, please visit https://breakthroughactionandresearch.org
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