Diffusing What Works in Urban Reproductive Health

Brainstorming at the Measuring Learning and Evaluation (MLE) Meetings

By Jessica Brinton, Program Coordinator, PEC Population Dynamics and Reproductive Health Representative 

There is fantastic Family Planning and Reproductive Health work being done throughout SSA, but the question always remains—how can we better diffuse program intervention ideas that work and how can the idea sharing happen on its own?

These two questions were the nucleus of one of the brainstorming sessions held at last week’s Urban Reproductive Health Initiative annual meeting in Nairobi, Kenya. For this particular exercise the tables in the room were divided up into two groups the Scale-Up discussions and the Diffusion discussions. I was at a “diffusion” table which was perfect considering my role in policy engagement and information sharing at APHRC. The discussion kicked off with a review of the information already being diffused to other groups not currently involved in the URHI Country Consortium project sites and the manner this diffusion was being done.

What is already happening?

Tupange, the program implementer in Kenya, shared experiences of how the SMS inventory tracking system being used in the Tupange sites in Kenya has generated lots of interest from other organizations. Tupange is now working with organizations like PEPFAR to share their approaches and experiences, particularly with the SMS commodities tracking—which is a way to monitor each clinic’s contraceptives stocks. In fact, some health centers outside of the Tupange sites have already begun using the SMS inventory tracking system and are now automatically sending their results to the Tupange program.

The program implementers in Nigeria shared how they have been diffusing the program’s information through capacity building efforts.  Since they don’t have the funding or staff to expand their program sites, they have been working with the Nigerian government to prepare budget plans for additional sites where the government wants to implement similar projects.

The group noted that URHI urgently needs to start documenting its diffusion efforts as well as to develop a network of additional partners to model URHI’s successful interventions. One important suggestion that came out of our group diffusion discussions was how the improved documentation of URHI and the telling of our stories would be a great way to get the URHI interventions replicated in a sustainable manner.

What about advocacy and information sharing?

The second part of the discussion focused on advocacy and information sharing efforts; and how important it is to have leadership buy-in particularly from the local leaders on up and the top leaders on down, and how doing one approach or the other would not be as successful as the two direction approach.  A good example is the way Tupange has informed and advocated their interventions to local Chiefs, and then encouraged those local Chiefs to become Family Planning advocates themselves. As a result, this effort was not only an investment in the Tupange specific site interventions but also in the future of FP in the area since after their term is complete the Chiefs move on to another post and will take their knowledge and enthusiasm about FP to a new area.

There were also some very creative ways mentioned to engage community members and key stakeholders. I was particularly impressed with Nigeria’s use of radio to create an on-air drama show that incorporates FP and RH messaging. Nigeria also had some creative ways to market their campaign slogans to communities, such as providing fruit cart owners with new colorful umbrellas with the organization FP logo on it. In exchange for the umbrella, the fruit cart owners would explain the slogan and provide information to customers and passers-by. In Kenya, Tupange’s creative interactive program with matatu’s (public transport minibuses) provide a free matatu ride to people willing to talk about family planning while they are passengers.

APHRC was present at the URHI meeting as the African evaluation arm of the 6 year Bill and Melinda Gates Foundation funded project which is working to address major challenges in Family Planning and Reproductive Health specifically facing urban informal settlements. The project is currently on its third year and APHRC is about to kick-off its midline evaluation survey in Kenya, Nigeria.  Senegal will follow later this year (the project is also being evaluated in India by the International Centre for Research on Women (ICRW)).

As the evaluator of the project, APHRC’s role is to study the programs being implemented to see if the work has had a significant impact on FP and RH indicators. Then after the results have been tallied APHRC will also help lead the information sharing process. It is critical that everyone involved in the project, including the program implementers, partners, and policymakers at all levels know what has been working and what still needs to be done within their constituency. APHRC’s team looks forward to sharing the evaluation findings with everyone from local communities to the President, ensuring everyone knows what URHI elements work and can best impact urban areas in Kenya, Senegal and Nigeria.

The midline survey team heads to the field in Kenya and Nigeria this month, and we expect preliminary results as soon as March of 2013.