Transform/PHARE

Introduction

Transform/PHARE was a five-year cooperative agreement funded by the United States Agency for International Development (USAID) that applied novel techniques from marketing, advertising, human-centered design, and behavioral economics to enhance health-related behavior change programming and family planning outcomes. The consortium was led by Population Services International in partnership with Camber Collective, IDEO, and YLabs.

Transform/PHARE developed innovative social and behavior change programs to address barriers to modern contraceptive use, transform attitudes about reproductive health and promote family planning in West Africa. These new approaches were employed across four countries—Benin, Burkina Faso, Côte d’Ivoire, and Niger—and four thematic areas— audience segmentation, male engagement, provider behavior change, and cross-sectoral social and behavior change.

This Spotlight details the approaches used by Transform/PHARE. The resources provided include Innovation Briefs, which describe the innovations developed and considerations for adapting them in future family planning and reproductive health social and behavior change programs, as well as materials from specific interventions developed in the focus countries.

Adapting Innovative Approaches from Other Fields

Innovation is not necessarily an invention that is entirely new; it may be building on an approach from a different field or combining two or more existing approaches. Transform/PHARE adapted techniques pioneered outside the global health sector to better understand behavior related to family planning and design solutions with communities.

For example, human-centered design is an approach to problem-solving that places the people being served at the center of the design and implementation process, ensuring that their needs inform program decisions and testing potential solutions to ensure they are desirable and effective for the community. This increases the likelihood of social and behavior change strategies being well-received and leads to sustainable solutions. Other approaches leveraged by Transform/PHARE included the Total Market Approach, a process that maps a comprehensive picture of the family planning market in order to inform improvements in family planning resources and delivery points to meet consumers’ needs, and technology solutions such as interactive voice response.

Audience Segmentation

Transform/PHARE used non-traditional and innovative approaches to audience segmentation drawn from private sector marketing and advertising. These audience segmentation techniques aimed to identify segments or groups of people who are likely to adopt a behavior, change an opinion, or use a product or service according to specific desires. This analysis of attitudes and behaviors was then used to target efforts to increase the demand for family planning products and services in francophone West Africa.

For example, this approach to audience segmentation was employed in a national demand analysis of family planning in Côte d’Ivoire and an analysis of family planning attitudes and behaviors among men and women in Niger, which informed interventions developed in these countries.

Engaging Men and Community Influencers

Men and boys play a key role as users of family planning methods, partners, service providers, social influencers and decision-makers. Transform/PHARE launched a number of interventions that promoted dialogue among couples and religious leaders, stimulated conversations about the negative impacts of rigid gender roles, and actively addressed gender inequalities during project design and implementation.

Some Transform/PHARE interventions also involved non-traditional actors, such as entrepreneurs, musicians, and comedians, to bring fresh perspectives on how to create programs that resonate with the public.

When engaging men and other community influencers, projects must account for power and gender dynamics between influencers and target audiences, which can often impact intervention outcomes.

Provider Behavior Change

Just as patients may act in ways that do not align with their health preferences, providers may also act in ways that might not align with their intentions. The complexity of providing health care services in low-resource settings amplifies many of these challenges, and the stakes in these settings are particularly high. Healthcare providers’ misconceptions and biases may influence the quality of the reproductive care they provide, including family planning, contraceptive counseling, and services to women or couples. Helping providers overcome their own biases and offer client-focused services can significantly improve clients’ experience and outcomes.

“Model providers” are health workers who consistently deliver high-quality services, such as voluntary family planning, despite societal and systemic obstacles. The insights and examples of model providers can be used to support and improve provider performance across the workforce, ultimately increasing access to voluntary family planning.

Cross-sectoral Social Behavior Change

Cross-sectoral social and behavior change approaches aim to provide information and encourage dialogue about family planning in settings outside the traditional health context, such as in agricultural settings, trade schools, or businesses. Transform/PHARE applied this cross-sectoral approach in Benin, Niger, and Côte d’Ivoire to determine whether men and women who do not usually express interest in learning about family planning and contraception from health providers would be more inclined to do so in non-health related environments.

For example, in Benin, Transform/PHARE developed a prototype craft academy, Académie de l’Artisanat, to reach young, out-of-school women with information and referrals for modern contraceptive methods while teaching them income-generating skills. Transform/PHARE also used other tool such as social network analysis and interactive voice response to reach women outside of traditional health settings.