DFID REPRODUCTIVE HEALTH CASE STUDY
ESHE is a Family Planning program funded by UKaid, is implemented by a Palladium Group lead consortium of which Exp Social Marketing is the SBCC partner.
ESHE is a Family Planning program funded by UKAID that seeks to deliver increased family planning
across rural Kenya. ESHE targets women of reproductive age (WRA) and adolescent girls in 21 Counties.
As a partner in the program consortium, Exp was briefed to develop and execute an experiential social
and behaviour change program strategy, aimed at generating demand for FP methods among the
The Campaign Objectives
Neutralization of socio-cultural barriers to FP uptake was the overarching objective of the ESHE program's
social change component. This objective was borne out of insights gathered through a formative study
conducted by Exp which revealed that the target audience's socio-cultural environment was not
permissive to modern FP methods and practices, particularly in five underserved Counties namely:
Turkana, Samburu, West Pokot, Kajiado and Narok. Narok was selected as the pilot county.
Challenges that Exp had to overcome to ensure success
Deeply rooted socio-cultural beliefs and practices placed men high above women and made decision
making a rare privilege for women living in the underserved counties. Reproductive health decisions,
including the number of children and child spacing were therefore exclusively a man's role forcing
women to avoid or use modern FP methods in secret as efforts to receive partner consent were
always futile. Reaching and changing men's attitude towards modern FP was therefore a key
challenge for the program to overcome through Exp.
For wider acceptance of the program and its campaign messages, Exp linked FP to the audience's everyday
personal and communal activities and positioned it as a bridge to a better life. Exp deliberately changed the
program's secondary target audience (men) to primary in the social change component and were reached under
the 'Maisha Sambamba' Campaign, which translates to 'Good Life'.
Appreciation of, and respect for the cultures in each county formed a core consideration in the design of the
campaign concept which placed the target audience at its Centre. Exp designed the social change program to fit
into the larger ESHE program strategy, focusing on Opinion leaders, (political, religious and traditional) and using
the leadership to engage the key gatekeepers, “Men”, to build support for family planning and uptake of modern
contraceptives in the target communities. An Experiential discovery approach was used to up-weight negative
socio-cultural and economic effects of lack of family planning in Narok County. This was done through a County
stakeholders' workshop held ahead of the community social change activities.
County stakeholders included County government health officials, religious leaders, traditional council of elders'
officials, political leaders and other key opinion leaders in the county. Both male and female stakeholders
participated in the workshops for an inclusive FP support base. The workshops discussed factors that hindered
development in the communities, and FP was prominently mentioned by the participants. Solutions to the
mentioned factors were also discussed and leaders were asked to voluntarily make written pledges to make a
difference in their communities by taking action against the factors mentioned.
Family planning, as a thematic area, was listed by the leaders as an action point and was included in the
structured pledge forms which provided space for participants to indicate specific activities they were pledging
to undertake under each problem. The participants, who pledged to support FP, were followed up and invited
to FP campaign training and engaged by as men (peer) forum facilitators.
Small group forums were held across Narok County with men to discuss FP as a solution to problems such as Men's forum
intercommunity conflicts. Men accepted to attend and participate in the forums as they were run by their peers,
who adopted the Education Through Listening approach to allow for free sharing of experiences. Content of the
small group forums, with men, was developed with input from women drawn from different parts of Narok County
through a pre-exposure study conducted by Exp ahead of commencement of the social change campaign in
Narok. These included a women's wish list of how they wanted their men to support them with regards to FP. The
men would then be observed by the women who submitted a report on social change to Exp through community
scorecards designed alongside the forum content.
Campaign integration and community awareness was ensured through a radio soap opera and talk shows run on
a community radio during the same time as the men forums. The radio talk shows were highly interaction through
phone in sessions after the talk show.
A carefully designed community scorecard (CSC) initiative was included in the social change component of the
programme to give women a voice for holding their men to account and to measure progress with respect to
social change of attitudes around FP among men in the target Counties. The CSC design for Narok was based on
a pre-exposure study conducted with women to identify social cultural barriers to FP and to set indicators for
social change in Narok. Longitudinal CSC forums are now being conducted with the same women every six
months succeeding BCC activities.
The Results (Narok Only at this stage)
1. 114 opinion leaders successfully engaged through a workshop
2. Support pledge for FP received from 99% of the opinion leaders engaged at the workshop against a plan
3. More than 1202 men reached through men forums in three months of activation against a target of 900
4. At least 60% FP support pledge received from men who attended the forums against a target of 50%
5. 850,000 men and women reached with FP messages across Narok through the radio soap opera
6. Women's voice captured through round 1 of the community scorecard forums confirmed social
change is taking place