Smart Life Nepal Campaign

The goal of the recent Next Generation “Smart Life” Family Planning Campaign is to increase modern contraceptive use among young, low-parity couples (those with one or two children).

Dubbed “Smart Life,” the campaign takes a multi-channel approach, with high-quality television and radio spots airing across Nepal. The aim is to increase the use of modern contraceptives among young married couples, including both the newly married and young parents, or “1000-day” couples.

In describing the vision and positioning of the family planning campaign, Ron Hess, project director of HC3 in Nepal, says, “Family planning is a means to an end. We must start by asking, ‘Why family planning?’ People here give many reasons why they want to manage their number of children: to provide them better care and nurture, a better home and, very importantly, a better education. In short, parents in Nepal want a brighter future for their children, as parents do the world over. The current campaign respects these aspirations – placing the ‘why’ of family planning first, then offers family planning solutions as ‘smart’ means toward these ends.”

Timeline

Aug 2015

Launch of Campaign

Inquire

While gains in family planning (FP) and reducing unmet need have been made among certain segments of the population, young and newly married Nepali couples, those wishing to limit childbirth, or those in need of birth spacing, are lagging behind.

According to the Nepal Demographic and Health Survey (2011):

56 percent of women of reproductive age are below 30 years of age
Only 12 percent use FP to delay the birth of their first child
Less than 32 percent use FP to space their second child after the first birth
Fewer than 13 percent are using FP within two months after delivery

One of the Millenium Development Goals for Nepal was a contraceptive prevalence rate (CPR) of 67% by 2015. The CPR had stagnated at 44% between 2006 and 2011 and the total fertility rate declined from 3l1 in 2006 to 2.6 in 2011. There was found to be a high unmet need for FP among migrants, married adolescents, and socially excluded groups, and many missed opportunities for promoting FP.

The formative research consisted of sixty in-depth interviews on attitudes, norms, experiences, and processes that influence contraceptive use.

Participants included:

Unmarried women and men
Married women and men
Mothers-in-law
Migrants
Health workers and FCHVs
Influential community members

Major highlights from the formative research were:

Shared motivations: Fertility management is placed within the larger context of other parental care roles and practices
Cooperation: Fertility management is typically a cooperative decision
Family planning was related to shared goals for family and future
There were distinct stages when couples reported using family planning

Design the Strategy

The strategic objective of the Smart Couple campaign was to:

Increase modern contraceptive use among ‘1000-day Couples’, or young, low-parity women and men, specifically
- Increase age of first birth (AFB)
- Improve timing of FP use after delivery (PPFP)
- Increase optimal birth-spacing practices (HTSP)
- Increase long-term method use
- Reduce unmet need among Marginalized and Disadvantaged Groups (MDAGs)
- Improve contraceptive use dynamics among migrants (timing of initiation, discontinuation)

The strategy for the Smart Couple campaign was designed using the social-ecological model of behavior change.

The campaign approach was to:

Reposition Family Planning as the smart, healthy choice allowing couples to achieve success for themselves and their children
Be aspirational, encouraing a better life based on smarter life choices
Institute a brand to guide program and to tie all aspects together
Encourage couples to communicate with their partners, peers, elders, health providers, community health workers, etc.

The campaign approach is illustrated below

The strategy’s action plan was to encourage couples to:

Establish early family planning behaviors to delay first birth
Avoid unwanted postpartum pregnancy
Space births successfully
Encourage couples to know the facts about FP
Encourage action NOW

This would not only help to improve maternal and child health outcomes in the short term, but would establish family planning use as a behavioral norm and, thus, affect longer-term fertility trends. The campaign, through its community programs in the districts, also focuses on families of migrant workers and people from marginalized and disadvantaged communities.

Create and Test

Pretesting found the word “Smart” has entered the local vernacular in Nepal in association with “new technology.” Additionally, “Smart Couple” was associated to the concept of mutual understanding, along with a bright and intelligent future. Consequently, the “Smart Couple” campaign seeks to encourage modern contraceptive use earlier among young couples, as well as to increase space between the first and second child by using a family planning method postpartum.

Mobilize and Monitor

LAUNCH

The launch of the Smart Life campaign, on August 21, 2015, included speeches by the Health Minister, Ministry of Health, the Secretary of Health, the Director General of the Department of Health Sciences, and the USAID Mission Director, among others.

The event was MC’d by a celebrity couple, Malvika & Riaz (Ms. Nepal and her husband, dance instructor), and there were 175 attendees. The event was telecast live by Nepal TV, and there was national press coverage.

The campaign takes a fully integrated marketing approach. TVC placements cover all major national television channels in news and entertainment programs and have been pulsed over time. The media plan for radio commercials have followed a similar pattern, with placements in national radio stations, major national FM stations and all national FM networks to saturate coverage across the nation. The hoarding boards have been placed along major national highways and in high-traffic locations in focal JHU-HC3 Program districts. The reach of the campaign, with endorsement of the celebrities, was increased significantly through social media, mainly YouTube and Facebook.

DISTRICT CAMPAIGNS

The District Campaigns (13 focal districts) goals were:

Maximize contacts among eligible couples (newlyweds and 1000-day couples) through skilled referral agents (FCHVs and Peer Educators)
Increase referrals from community to “Hamro Swasthya Kendra” (Our Health Center)
Enhance Quality of Counseling (IPC-C) and FP Services provided by Health Workers at “Hamro Swasthya Kendra”

The district model:

District activities included:

Systematically contacting and referring “1000-Day” couples:
Improved IPC-Counseling at Hamro Swasthya Kendra (HFs)
Active FP service promotion
Regional, large-scale “Smart Couple” PR events
Local “Smart Couple” Celebration events
Street dramas, community school programs
Local FM airing of Smart Jeewan campaign spots, Radio Help Desk
Continuous coordination w DHO, DPAC, RHCC, HFOMCs, etc.

Regional events were also held – these were called Regional “Smart Jeewan” Melas and included leadership support; celebrity ‘infotainment,’ and a family-friendly atmosphere. Attendance was impressive, and all were broadcast live:

Western Region (Kaski): ~5000
Central Region (Chitwan): ~10,000
Midwestern (Nepalganj): ~20,000
Far Western (Kanchanpur): ~30,000