Family Planning – Demand Generation I-Kit for Underutilized, Life Saving Commodities https://sbccimplementationkits.org/demandrmnch Mon, 13 Apr 2015 18:56:58 +0000 en-US hourly 1 https://wordpress.org/?v=6.4.5 Overview: Family Planning https://sbccimplementationkits.org/demandrmnch/fp-overview/ https://sbccimplementationkits.org/demandrmnch/fp-overview/#respond Wed, 12 Mar 2014 20:00:39 +0000 http://www.sbccimplementationkits.org/demandrmnch//?p=963

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This section of the I-Kit provides guidance on completing the six steps of a communication strategy for three family planning commodities: contraceptive implants, female condoms, and emergency contraceptive pills.

Illustrative, adaptable content is provided for each step at the bottom of the page. By clicking on the links, you can view these examples by step either as a preview (which does not require download) or download in MS Word or PDF. A full version of each commodity strategy is also available under “core resources” in the right sidebar. The full strategy includes both guidance and illustrative content for the entire strategy.

The six steps are:

Step 1:  Analyze the situation

Step 2:  Define a vision

Step 3:  Choose the target audiences

Step 4:  Select key messages

Step 5:  Determine activities and interventions

Step 6:  Plan for monitoring and evaluation

In each step, further guidance and resources can be found in the right side bar. "Core resources" include suggested cross-cutting tools developed specifically to support demand generation programs for the life-saving RMNCH commodities. "Additional resources" include further tools and materials specific to that step. Examples of project materials from around the world can also be found under "Step 5: Determine activities and interventions".

Every country and context is different, and the content of your demand generation plan should be based on research and data from your local context. The adaptable content is offered as examples, and is not designed as a “one-size-fits-all” model.

By working through the six steps, using the illustrative examples as a foundation, users will develop commodity-specific messaging and activities, tailored to the country context, which can be integrated into existing communication strategies and interventions for RMNCH.

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Step 1: Analyze the Situation https://sbccimplementationkits.org/demandrmnch/fp-step1/ https://sbccimplementationkits.org/demandrmnch/fp-step1/#respond Thu, 30 Jan 2014 19:31:53 +0000 http://www.sbccimplementationkits.org/demandrmnch//?p=1191 illustrative examples. These are representative of the global situation, and should be adapted based on data and research from the local context.]]>

Every demand generation strategy should begin with a thorough analysis of relevant information to assess the social and behavioral determinants driving demand for the commodities in the local context. A strong situation analysis provides a comprehensive understanding of the operating environment, foundational information on the commodity and guides the identification of strategic priorities for the demand generation strategy.

What is already known about the social and behavioral drivers of demand generation for contraceptive implants, emergency contraception, and female condoms?

A global review of the evidence on the social and behavioral drivers of demand for the reproductive health commodities was conducted and synthesized into summary tables for the reproductive health commodities. This research was analyzed and described in a full report and spotlight brief. Background information and technical documents, such as technical briefs and links to key resources, are available for contraceptive implants , emergency contraception, and female condoms.

Why conduct a situation analysis?

The situation analysis focuses on gaining a deeper understanding of the challenges and barriers to address within a specific context that influence the current demand and utilization of a priority RMNCH commodity, including individual knowledge, attitudes and behaviors of providers, end-users and other influencing audiences; social and cultural norms; potential constraints on and facilitators for individual and collective change; and media access and use by the intended audiences. It also examines the status of each commodity, including relevant policies, regulations, manufacturing, prices, supply-chains, and availability. In short, the situation analysis answers the question, “Where are we now?”

The situation analysis should also examine the attitudes, values, interests, aspirations, and lifestyle of the intended audiences. This information, called psychographics, allows for a better understanding of what motivates and what hinders the intended audiences’ decisions and actions. Psychographics provide character sketches of the intended audiences that go beyond demographic information (sex, age, education, parity, etc.) and help to build a fuller picture of the audiences as individuals and how they may be nested within and influenced by their community.

A comprehensive situation analysis is essential as it provides a detailed picture of the current state of the commodity, needs, and barriers which will direct the design and implementation decisions of the strategy and ultimately affect the level of success in generating demand and use. 

How should I conduct a situation analysis in my country?

Conducting a situation analysis typically involves collating available data and resources and then convening a group of stakeholders to review and identify key information.

Conducting a National Assessment on Demand Generation for Underutilized, Life-Saving Commodities: Guidance and Tools” provides guidance to country-based partners to carry out collection of relevant data. Sources of country-specific secondary data may include Demographic and Health Surveys (DHS) or Multiple Indicator Cluster Surveys (MICS), quantitative and qualitative research conducted by NGOs, or private sector market research, where available, such as Nielsen. RMNCH policies and guidelines may also assist in analyzing the situation.

The tool also provides semi-structured interview guides to collect information from key stakeholders, including RMNCH program staff within the Ministry of Health, procurement agencies, donors and other experts such as private sector wholesalers, manufacturers and academic institutions.

Lastly, the tool provides guidance in holding a stakeholder workshop to review the findings and reach consensus on implications and next steps for country activities.

If existing data, particularly on social and behavioral drivers and psychographics, is not sufficient, is outdated, or does not provide enough insight into priority audiences, it may be necessary to conduct additional primary formative research through quantitative surveys or qualitative research methods such as focus group discussions, key informant interviews, and observation checklists. It may be especially important to conduct formative research around provider attitudes and other drivers to provider behavior, as this information is typically less available. Similarly, it may be important to conduct formative research with all audiences (providers and end users) to develop realistic psychographics. If primary formative research is required, the findings should be analyzed prior to the start of strategy development. Guidance and tools to conduct formative research are provided in the additional resources listed.

What are the key questions to ask?

The situation analysis has two main sections:

Health and Commodity Context:

An important part of the situation analysis is information on the health situation and the commodity context. This section examines the rates of unintended pregnancy, and issues around contraceptive implants, emergency contraception, and female condoms commodity registration, prices, manufacturing, supply-chains, and point-of-access for end-users.

Audience and Communication Analysis:

The audience and communication analysis examines the social and behavioral drivers that facilitate or act as barriers to uptake of the commodity. Completing this section enables program managers to

  • Determine potential audiences and their characteristics, those who influence them, and the drivers and barriers to behavior change.
  • Identify potential communication resources, including communication channels, ongoing activities, and organizational and professional resources.
  • Assess the environment to determine availability of products and services being promoted, accessibility, affordability and acceptability.
  • Assess the social, economic and political conditions influencing behavior.

Illustrative questions are provided to guide a situation analysis for contraceptive implants, emergency contraception, and female condoms.

Integrating Gender into the Situation Analysis

Gender norms, cultural expectations, and roles of males and females within a community may be key barriers to increasing demand for contraceptive implants, emergency contraception, and female condoms. Therefore, it is important to identify gender-related determinants of health behavior during the situation analysis in order to achieve successful program design and implementation.

Addressing the Role of Gender in the Demand for RMNCH Commodities: A Programming Guide provides information and practical tools to help program managers determine how gender norms and roles for both men and women affect the demand for the commodities, and how to address these norms and roles to ultimately increase the demand for and utilization of these commodities. The Guide includes guidance and a checklist on integrating gender into the situation analysis.

Using the Situation Analysis to Identify Strategic Priorities

After developing a strong situation analysis, program managers should be able to identify the key implications or challenges from the data. What are the reasons that contraceptive implants, emergency contraception, and female condoms are not being utilized? Are the commodities available? Are they affordable? Are they part of the national essential medicines list or standard delivery protocols?  What do potential users – end-user, health care providers, and health educators – believe about the commodity? What is the potential market for commodities? Finally, select only a few key factors that the demand generation strategy will address. While it is tempting to address all factors, successful communication programs focus on the factors that will have the biggest impact given available resources.

Population Services International Global Social Marketing Department offers the following series of questions to guide the the selection of strategic priorities:


What?

Data Collection: Using all the relevant sources you can identify, collect and report the type of facts that will help you make demand generation strategy decisions.

So What?

Data Analysis: Identify possible implications that the facts may have on the demand generation strategies.

Now What?

Identify Strategic Priorities: Choose which implications to address in the demand generation strategy. Limit to 3-5 strategic priorities in order to focus the plan.

Examples:

In Benin...
Male partner support dramatically influences usage of family planning.
In 2007, PSI data showed that only 34% of non-users of a family planning method discussed family planning with their male partner compared to 68% of current users.

 

Examples:

    To date, family planning interventions essentially targeted women and considered male partners as a secondary audience, yet the contraceptive prevalence rate remained very low, between 6%~7%. A shift of focus is required.

 

Examples:

    Therefore, addressing men as a primary target group rather than just a secondary audience becomes a Strategic Priority.


Source: Population Services International. The DELTA Companion: Marketing Planning Made Easy.


Illustrative Examples of Situation Analyses in Family Planning

Global situation analyses for each of the commodities are provided below as illustrative examples. These are representative of the global situation, and should be adapted based on data and research from the local context.

By clicking on the links above, you can view these examples by step either as a preview (which does not require download) or download in MS Word or PDF. A full version of each commodity strategy is also available under “Adaptable Strategies” in the right sidebar in MS Word or PDF formats. The full strategy includes both guidance and illustrative content for the entire strategy.

About the Life-Saving Commodities in Family Planning

Female Condom Emergency Contraception Contraceptive Implants

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Step 2: Define a Vision https://sbccimplementationkits.org/demandrmnch/fp-step2/ https://sbccimplementationkits.org/demandrmnch/fp-step2/#respond Thu, 30 Jan 2014 19:31:24 +0000 http://www.sbccimplementationkits.org/demandrmnch//?p=1189 illustrative examples. These examples should be adapted based on data and research from the local context.]]>

The vision anchors a communication strategy by stating what the program hopes to achieve. A vision statement sets forth the direction the strategy should follow and defines clearly and succinctly how the demand generation activities will affect the broader commodity and health environment.  The vision should paint a mental picture of a desired scenario in the future.

The vision should be agreed upon by the stakeholders involved in the strategy design process and will thus be “shared” by all. This shared vision is a short statement that articulates what is important; illustrates what is desired in the future for the commodity once the demand generation strategy is successfully implemented; and clarifies the goal of the demand generation strategy. The shared vision ensures that all stakeholders are working toward the same goal and guides the strategy design and development process.

In addition, a true vision should be realistic, concrete, and be attainable given the resources available. The vision should also communicate enthusiasm, be inspirational, and foster commitment and dedication from stakeholders towards the shared goal.

Some organizations call the vision the “Goal” or the “Primary Objective.”

Illustrative Examples of Visions for Family Planning Commodities

By clicking on the links above, you can view these examples by step either as a preview (which does not require download) or download in MS Word or PDF. A full version of each commodity strategy is also available under “Adaptable Strategies” in the right sidebar in MS Word or PDF formats. The full strategy includes both guidance and illustrative content for the entire strategy.

About the Life-Saving Commodities in Family Planning

Female Condom Emergency Contraception Contraceptive Implants

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Step 3: Choose the Target Audiences https://sbccimplementationkits.org/demandrmnch/fp-step3/ https://sbccimplementationkits.org/demandrmnch/fp-step3/#respond Thu, 30 Jan 2014 19:30:50 +0000 http://www.sbccimplementationkits.org/demandrmnch//?p=1187 illustrative examples. These examples should be adapted based on data and research from the local context.]]>

group learningSegmenting the audience

Segmentation is the process of identifying unique groups of people, within larger populations, which share similar interests and needs relative to contraceptive implants, female condoms, and emergency contraception. If the group shares common attributes, then the members are more likely to respond similarly to a given demand generation strategy. Segmenting allows for targeted use of limited resources to those populations that would most affect increased demand. It ensures that the activities developed and implemented are the most effective and appropriate for specific audiences and are focused on customized messages and materials.

While using the key findings collected from the situation analysis, the first step in audience segmentation answers the question, “Whose behavior must change in order to increase demand and appropriate use of the commodity?”

Primary audiences are the key people to reach with messages. These may be the people who are directly affected and who would directly benefit from the use of the commodity. Or they may be the people who can make decisions on behalf of those who would benefit from the commodity. Primary audiences may be further segmented into sub-audiences. For example, identifying specific segments of women of reproductive age who may share common attributes– such as young unmarried women, married women or high-parity women.

Influencing audiences are people who can impact or guide knowledge and behaviors of the primary audience, either directly or indirectly. Influencing audiences can include family members and people in the community, such as community leaders, but can also include people who shape social norms, influence policies, or affect how people think about the commodity. Prioritizing key influencing audiences by an estimated power of influence related to increasing demand and uptake of the commodity is crucial. For example, male partners are a likely key influencing audience, but the level of influence (low, moderate, strong) may depend on country context and/or commodity and should be discussed among stakeholders.

Primary or influencing audiences for demand generation may include national, sub-national or community-level decision-makers, such as legislators and religious leaders, as they can be instrumental in removing or creating access barriers or spreading misguided beliefs about the product. Involving decision makers and influencers from the political and media realm and carefully considering the legal and policy environment are important to ensure demand generation efforts are not hindered by political or social barriers. Scaling Up Lifesaving Commodities for Women, Children, and Newborns: An Advocacy Toolkit provides advocacy resources to raise awareness and engage stakeholders in addressing commodity-related gaps in policy. Therefore, advocacy audiences are not included in the illustrative communication strategies provided here.

How to Segment Audiences

Initial segmentation is often based on demographics, such as: age, sex, marital status, education level, socio-economic status, employment, and residence (urban/rural). Audiences can be further segmented by psychographics, which refer to people’s personalities, values, attitudes, interests, and lifestyles.

Developing an Audience Profile

Audience profiles are the cornerstone of a communication strategy. Audience profiles first help bring to life and personify each audience segment, which subsequently guide communication messaging and activity planning. The profile should embody the characteristics of the specific audience, with a focus on telling the story of an imagined individual within the group who can neutrally represent the intended audience. Basing decisions on a representative, personalized example from a specific audience segment rather than a collection of statistics or a mass of anonymous people allows for more intimate knowledge of that audience segment and better defined and focused communication strategies. Therefore, the profile is important to ensure the messages are tailored to members of this selected group, resonate with them, and motivate them to take action.

Audience profiles for each audience segment are developed using the information collected in the situation analysis. The profile consists of a paragraph that should include details on current behaviors, motivation, emotions, values, and attitudes as well as socio-demographic information such as age, income level, religion, sex, and place of residence. The profile should exemplify the primary barriers to the desired behavior relative to the audience segment. The profile may include the name of this individual or a photo that represents this person to help visualize who this person is and tell his or her story. If the information gathered in the situation analysis lacks detail on a particular audience segment, additional research may need to be conducted to address the identified gaps. For example, for all provider audiences, it may be especially important to conduct formative research around provider attitudes and other drivers to provider behavior that could be used to better inform the audience profile and strategic design.

Characteristics of a good audience profile

  • No two profiles will follow the same outline because the same data will not always be available for every group in every country.
  • The best profiles include qualitative research as a source. Qualitative research will generate a wealth of in-depth audience insight.
  • The profile should be a “living document”, meaning it is regularly updated when new information becomes available.

Source: PSI.org

How to Use an Audience Profile?

As one of the cornerstones of the communication process, the audience profile helps guide our demand generation planning. For example, when making decisions about communication pieces or commodity distribution strategies, we should continually refer to the audience profile. The profile can aide in answering questions like:

  • Where will our target audience learn about contraceptive implants, female condoms, and emergency contraception?
  • Would our target audience read this brochure/poster? Where would they encounter it? Where would they read it?
  • Where would our target audience want to access reproductive health commodities?
  • How would our target audience react to the message in this radio spot or TV advertisement?
  • Which of the determinants of behavior can we most effectively address?

Basing decisions on a representative example, the audience profile, from our target audience allows us to better define and focus demand generation strategies.

Source: PSI.org


Illustrative Audience Segments and Profiles for Family Planning Commodities

Illustrative examples of audience segments and profiles are available below for contraceptive implants, female condoms, and emergency contraception. These should be adapted to the country context. For more information on audience segments and profiles, refer to the additional resources provided.

By clicking on the links above, you can view these examples by step either as a preview (which does not require download) or download in MS Word or PDF. A full version of each commodity strategy is also available under “Adaptable Strategies” in the right sidebar in MS Word or PDF formats. The full strategy includes both guidance and illustrative content for the entire strategy.

About the Life-Saving Commodities in Family Planning

Female Condom Emergency Contraception Contraceptive Implants

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Step 4: Select Key Messages https://sbccimplementationkits.org/demandrmnch/fp-step4/ https://sbccimplementationkits.org/demandrmnch/fp-step4/#respond Thu, 30 Jan 2014 19:30:12 +0000 http://www.sbccimplementationkits.org/demandrmnch//?p=1185 illustrative examples. These examples should be adapted based on data and research from the local context.]]>

clinic counselingThe message strategy is one of the most important elements of a communication strategy. It drives the rest of the program and ensures synergy, consistency and coordination for the purposes of shared objectives and clear, harmonized messaging among all stakeholders and partners. A message strategy is designed for each primary and influencing audience and includes (a) communication objectives, (b) positioning, and (c) key messages. As previously mentioned, audience profiles are used to determine whether or not the objectives, positioning and key messages are appropriate for that individual.

Communication Objectives

Communication objectives are measurable statements that clearly and concisely state what the target audience should know (think), what they should believe (feel), and what they should do (behave) as well as the timeframe required for the change. “SMART” objectives are Specific; Measurable; Attainable; Relevant; and Time-bound. Communication objectives should be derived from available evidence on the factors that drive or inhibit adoption by target users, as well as influencing audiences.

Positioning

Positioning is the heart of the demand generation strategy and identifies the most compelling and unique benefit that the product offers the target audience. Positioning is often the emotional "hook" upon which the demand generation strategy hinges. Effective positioning moves beyond the functional benefits of the commodity and appeals to the target audience with emotional benefits.

Positioning presents the desired behavior in a way that is both persuasive and appealing to the target audience. It provides direction for developing a memorable identity, shapes the development of messages, and helps determine the communication channels to be used. Positioning ensures that messages have a consistent voice and that all planned activities reinforce each other for a cumulative effect.

As part of the positioning, a key promise is identified that highlights the main benefit associated with the proposed change. Changes in behavior, policies, and social norms are made only because there is a perceived benefit to those changes. The benefit must outweigh the personal cost of the change.

An accompanying support statement, also called a “reason to believe” in marketing, describes why the audience should believe the promise. This could be based on data, peer testimonials, a statement from a reliable source, or a demonstration. The key promise and support statement should include a balance of emotion and reason.

Key Messages

Key Messages outline the core information that will be conveyed to audiences in all materials and activities. Messages cut across all channels, and must reinforce each other across these channels. When all approaches communicate iterative and harmonized key messages, effectiveness increases. Well-designed messages are specific to the audience of interest, and clearly reflect both a specific behavioral determinant and positioning. They also clearly describe the desired behavior, which must be “doable” for the audience. Key messages are not the text that appears in print materials (taglines), or the words that are used to define a campaign (slogans). Creative professionals are often hired to translate key messages into a creative brief, which is a document for creative agencies or internal teams that guides the development of communication materials or media products, including taglines and slogans.

It is important that key messages are always:

  • Developed on the basis of country-specific formative research;
  • Derived from context-specific, strategic choices regarding segmentation, targeting, and positioning;
  • Addressed to known drivers of and barriers to behavior change in the country context; and
  • Pre-tested with the target audience and refined based on audience engagement.

 

Illustrative Examples of Objectives, Positioning and Key Messages, by target audience:

By clicking on the links above, you can view these examples by step either as a preview (which does not require download) or download in MS Word or PDF. A full version of each commodity strategy is also available under “Adaptable Strategies” in the right sidebar in MS Word or PDF formats. The full strategy includes both guidance and illustrative content for the entire strategy.

About the Life-Saving Commodities in Family Planning

Female Condom Emergency Contraception Contraceptive Implants

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Step 5: Determine Activities and Interventions https://sbccimplementationkits.org/demandrmnch/fp-step5/ https://sbccimplementationkits.org/demandrmnch/fp-step5/#respond Thu, 30 Jan 2014 19:29:50 +0000 http://www.sbccimplementationkits.org/demandrmnch//?p=1183 illustrative examples. These should be adapted to the country context.]]>

Activities and interventions allow for communication of key messages through a variety of communication approaches and channels. Well-designed demand generation programs include activities across a range of different intervention areas and communication channels, to reinforce messages and reach the audience when they are most receptive to the message. An overview of the types of strategic approaches that can be used is available here.

Activities and channels should be carefully selected based upon type of messaging, ability to reach the intended audience through a variety of media/channels, timeline, cost, and available resources. It is helpful to refer to findings from the situation analysis to guide selection of activities and interventions. Some channels and activities may be better suited to addressing particular behaviors or behavioral determinants than others.

Theories are often used to guide the design of messaging content aimed at increasing demand for health services and commodities. However, it is less common that theories are used to guide the selection of the media through which those messages are conveyed. In fact, given that different media have different capacities and abilities to effectively transmit information, the medium and the message cannot be considered separately—one needs to select media and develop content in concert and in a way that optimizes both. A new “Theory-Based Framework for Media Selection in Demand Generation Programs”  is a tool to assist program managers carrying out demand generation activities in identifying and selecting the appropriate media channels, including ICT and new media channels. More tools on choosing communication channels are provided in the additional resources.

Recommended communications channels, or intervention areas, for reproductive health demand generation strategies include:

Mass Media

Mass media includes radio, television, print (newspapers and magazines), and outdoor signage (billboards, advertising on buses and taxis, etc.). Mass media is an excellent option to reach a wide audience, although it can be expensive and cost of production and purchase of airtime must be factored into budgeting. Television allows for storytelling, demonstrations of the desired behavior and, when well done, a TV spot can be highly memorable.  In some countries television reaches all socio-economic sectors, while in other countries TV is a luxury. Radio can also reach a wide audience, allow for storytelling and be memorable, especially when messages are linked with songs or jingles. In some countries, radio stations are targeted to specific audiences, which may be helpful when selecting the best ways to reach audience segments. Radio is typically less expensive than TV.

The effectiveness of print media varies widely by country and literacy rates must be considered. Print can be effective for advocacy efforts, especially when selecting newspapers read by decision-makers. Outdoor advertising reaches audiences based on geography and not based on demographics. The audience reached will likely see the message repeatedly if they pass by the outdoor media regularly.

Given the wide reach of mass media, with the potential to reach thousands of people, a small to moderate effect size will have a greater impact on public health than would an approach that has a large effect size but only reaches a small number of people. Thus mass media can have a major public health impact given its wide reach, when done well. However, not all messages are appropriate for all media, and may for example, be better suited to interpersonal communication or other channels.

Illustrative activities in the mass media domain are provided in the illustrative examples. Materials from mass media campaigns and other tools are also available in the additional resources.

ICT and New Media

Information and Communication Technologies (ICTs) are electronic, digital technologies that enable the creation and exchange of information. ICTs provide the platform for new media, such as web-based applications and social media sites, which, in comparison to traditional media like radio or television, can be interactive and empowering. Given the global proliferation of mobile and wireless technologies, ICTs and new media have the potential to transform health communication and service delivery. ICTs and new media offer methods for connecting and mobilizing consumers and providers – even those living in hard-to-reach areas – and reaching them with up-to-date health information.

Examples of demand generation programs utilizing ICT and new media are presented in “Utilizing ICT in Demand Generation for Reproductive, Maternal, Newborn and Child Health: Three Case Studies and Recommendations for Future Programming” which presents key program design elements, evaluation data and lessons learned. Other tools and examples on the use of ICT and new media are also available in the additional resources.

Clinics, Pharmacies and Drug Shops

Demand generation activities focused on clinics, pharmacies and drug shops can be targeted both to providers and to clients. Effective activities targeting providers include medical detailing, provider training, and supportive supervision. For clients, the most common demand generation activity is high quality counseling. Additional activities targeted to clients include clinic-based small group education sessions and availability of print materials such as brochures and posters.

Counseling is a critical demand generation activity in clinics because the environment is ideal for communicating key messages. Counseling sessions are often one-to-one communication opportunities, which allow clients to ask questions and providers to tailor the information and key messages. Second, health care providers are typically trusted and influential sources of information, which lends credibility to the key messages. Counseling tools or job aids can be part of a demand generation plan, and are used to help clients and counselors improve their interactions. Service providers should be trained to use the tools and aids.

Illustrative activities in clinics, pharmacies and drug shops are provided in the illustrative examples. Materials from such activities and other tools are also available in the additional resources.

Community-based services and outreach

Community-based services and outreach are an excellent option for increasing demand for contraceptive implants, female condoms, and emergency contraception among hard to reach audiences. At the outset, it is important to note the differences between community-based services and community-based communication efforts, even though both approaches share many similarities.

Community-based outreach is generally face-to-face interaction with a target audience that aims to generate demand for commodities or services, or to change behavior. Community-based outreach can be conducted through interpersonal communication (IPC) in one-to-one or one-to-group counseling. Job aids such as flip charts and brochures are helpful communication tools for IPC workers, when they are culturally appropriate and designed to accommodate literacy levels, and their development or adaptation should be included in demand generation plans that contain IPC activities. Another community-based outreach approach is community mobilization, which is the process of bringing people together to share a vision, promote dialogue, build their capacity and take collective actions to address problems affecting the entire community. It makes people feel that they are a part of a solution even if they are not directly affected by the issue.

Community-based services are the provision of health care services in communities, outside of clinics. Most community-based service programs include an IPC strategy to generate demand for the services. In Ethiopia, for example, community-based health workers were successful in delivering contraceptive implant counseling and insertion services to women with the highest level of unmet need in four rural areas of the country.

Incorporating community-based strategies into a demand generation plan can be an effective if community-based services are permitted in the context where you work. If community-based services are not permitted, you may consider adding advocacy for this strategy to the demand generation plan.

Illustrative activities in community-based services and outreach are provided in the illustrative examples. Materials from such activities and other tools are also available in the additional resources.

Structural Approaches

Structural approaches for demand generation include development and/or dissemination of policy and guidelines, advocacy with decision-makers, and pre-service training for providers. Scaling Up Lifesaving Commodities for Women, Children, and Newborns: An Advocacy Toolkit provides advocacy resources for utilizing the Commission platform to raise awareness and engage stakeholders in addressing commodity-related gaps in policy.

Illustrative activities for structural interventions are provided in the illustrative examples. Materials from such activities and other tools are also available in the additional resources.

Linkages with non-communication programs

Communication campaigns will be most successful when they link with programs that have an impact on demand. For reproductive health communication campaigns two important program linkages are efforts to train health care providers to offer contraceptive implants, female condoms, and emergency contraceptive pills, and supply and distribution initiatives to ensure the availability of the commodities. The following are examples of additional programs to which demand generation programs should develop linkages:

  • Other reproductive health programs that do not currently include contraceptive implants, female condoms, and emergency contraception
  • Quality of care improvement initiatives for service providers/clinics
  • Pre-service education and existing continuing education or in-service refresher training initiatives for clinical and non-clinical providers
  • Supply chain management and market shaping
  • Social marketing programs
  • Cross-sectoral programs (e.g. water and sanitation, education, economic empowerment, transport)

Public-Private Partnerships

Public Private Partnerships (PPPs) are sometimes an appropriate and effective way to increase resources, expand revenue streams, increase visibility and expand credibility for demand generation programs. Successful partnerships are engaging and mutually beneficial for both parties and consider the other partner’s relative comparative strengths. Each partner brings expertise to the table, but also each has constraints and competing demands, as well as opportunities to be explored.

"The P for Partnership": Addressing the Role of Public Private Partnerships to Increase the Demand for RMNCH Commodities” provides information and practical tools to help program managers determine how to develop PPPs to ultimately increase the demand for and utilization of these commodities. This tool provides a typology of PPP models along with step-by-step guidelines on how to select private sector companies and how to create effective partnerships for demand generation programs. By utilizing this tool, managers will be better equipped to engage the private sector and understand various types of partnerships for demand generation.

Other tools and examples on PPPs are also available in the additional resources.

Illustrative Activities and Interventions

Illustrative examples of an activity strategy are available for contraceptive implants, female condoms, and emergency contraception. These should be adapted to the country context.

By clicking on the links above, you can view these examples by step either as a preview (which does not require download) or download in MS Word or PDF. A full version of each commodity strategy is also available under “Adaptable Strategies” in the right sidebar in MS Word or PDF formats. The full strategy includes both guidance and illustrative content for the entire strategy.

About the Life-Saving Commodities in Family Planning
Female Condom Emergency Contraception Contraceptive Implants

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Step 6: Plan for Monitoring and Evaluation https://sbccimplementationkits.org/demandrmnch/fp-step6/ https://sbccimplementationkits.org/demandrmnch/fp-step6/#respond Mon, 27 Jan 2014 14:56:06 +0000 http://www.sbccimplementationkits.org/demandrmnch//?p=996 illustrative examples. These examples should be adapted to the country context.]]>

Monitoring and evaluation (M&E) is a critical piece of any program activity because it provides data on the program’s progress towards achieving set goals and objectives.

Although planning for M&E should be included in the communication strategy, avoid developing a complete monitoring plan at the time of strategy development (indicators, sample, tools, who will monitor, frequency of data collection, etc.). At the time of strategy development, focus on the indicators that should be incorporated into the program's plan. M&E indicators should be developed based on formative research and should indicate whether the key messages and strategies are having the desired effect on the intended audience.

A full M&E plan should then be developed as a separate program document. Developing an M&E plan should outline what M&E indicators to track, how and when data will be collected, and what will happen to the data once it has been analyzed. A variety of data sources can be used to collect M&E data. It is important to assess the scope and context of the program to choose the most applicable methodology, as M&E activities vary in cost, staff, and technology requirements. While some lower-cost M&E options will allow for identification of trends in demand for services, they may not be able to provide additional insight into the causal effects of activities and the way in which the program worked. To measure cause and effect, larger program-specific data collection activities geared towards evaluation are needed. See below for examples of low and high cost options.

While the collection of M&E data tends to receive the most attention, it is also critical to have a process for analysis and review of the collected data. M&E data should be used to inform program changes and new program development. It is best to build these M&E review processes into existing program management activities to allow for regular dissemination of M&E indicators.

Data Sources/System

Low cost option

The low cost option will make use of existing data sources and opportunities to gain insight into the program and its associations with changes in demand or uptake of contraceptive implants, female condoms, and emergency contraceptive pills. However, it will only allow for the identification of trends and will not allow for the attribution of change to a given program or to program activities. Illustrative data sources for a low cost option include:

  • Formative research for key messages, positioning, development of materials and media choice (focus groups with intended audiences and in-depth interviews with members of primary and influencing audiences)
  • Evaluation of communication campaigns (focus groups with intended audiences; in-depth interviews with primary and influencing audience members; adding questions to omnibus surveys on campaigns, messages and activities)
  • Service statistics (Information from clinics and providers such as referral cards and attendance sheets)
  • Communication channel statistics (Information from television or radio stations on listenership of mass media activities)
  • Omnibus surveys (Addition of questions related to program exposure and impact to omnibus surveys)
  • Provider self reported data (Small scale surveys among providers about services rendered and prescription practices; small-scale retail audits among pharmacies and rural drug shops on medicines requested and offered)
  • Demographic and Health surveys (Trends in family planning and fertility approximately every five years)

High cost option

The high cost option will make use of representative program-specific surveys and other data collection methods to gain considerable insight into the effects of the program and the way in which it worked. Illustrative data sources for a high cost option include:

  • Formative research for key messages, positioning, development of materials and media choice (focus groups; in-depth interviews; photo narrative or observation with families or inside clinics, pharmacies, or with CHWs to observe and record)
  • Service statistics (Information from clinics and providers such as referral cards and attendance sheets)
  • Communication channel statistics (Information from television or radio stations on listenership of mass media activities)
  • Provider self-reported data (about services rendered, product and sales audits among wholesalers and government procurement agencies; retail audits at pharmacies and drug shops to check medicines requested and rendered)
  • Large, nationally representative program-specific surveys (focus on issues related to knowledge, perceptions, acceptability and use) – may include baseline survey, follow-up and endline to measure changes and outcomes
  • Client exit interviews (to assess whether client counseling took place, whether clients were offered a range of contraceptive methods, and user satisfaction with services delivered including their perceptions, experience and intentions)

M&E indicators

M&E indicators should include process, output, outcome and impact indicators:

Process indicators: Measure the extent to which demand creation activities were implemented as planned.

Program Output Indicators: Measure (a) changes in audiences’ opportunity, ability and motivation to use the commodity, and (b) the extent to which these changes correlate with program exposure

Behavioral Outcome Indicators: Measure (a) changes in audiences’ behavior, and (b) the extent to which these changes correlate with program exposure

Health Impact Indicators: Measure changes in health outcomes

To increase the utility of M&E data, indicators should be disaggregated to facilitate more in-depth analysis of program performance.  It is recommended that indicators are disaggregated by, for example, gender, geographic location, type of provider etc.

Common biases that programmers should be aware of when designing, implementing and interpreting M&E include:

  • Self-selection bias – for example, a current family planning user may be more interested and willing to answer a survey about family planning compared to someone who does not approve of it or who has never tried family planning before.
  • Social desirability bias – following exposure to health promotion initiatives, intended audiences may feel pressured to give ‘right answers’ to survey questions, e.g. to report positive attitudes towards a commodity even though they do not really feel that way.  As demand generation interventions are successful at shaping positive social norms, social desirability bias may become more of a challenge in M&E.

Illustrative Examples of M&E indicators for Family Planning Commodities

Illustrative examples of M&E indicators are available below for contraceptive implants, female condoms, and emergency contraception. These should be adapted to the country context. For more information on audience segments and profiles, refer to the additional resources provided.

By clicking on the links above, you can view these examples by step either as a preview (which does not require download) or download in MS Word or PDF. A full version of each commodity strategy is also available under “Adaptable Strategies” in the right sidebar in MS Word or PDF formats. The full strategy includes both guidance and illustrative content for the entire strategy.

About the Life-Saving Commodities in Family Planning

Female Condom Emergency Contraception Contraceptive Implants

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