Programming for Key Populations

© 2007 Virginia Lamprecht, Courtesy of Photoshare

The needs of family planning clients vary depending on their age; health status; sex; geographical location; social, cultural, and physical environment; and many other factors. CBFP programs need to be mindful that CHWs, drug shop operators and mobile outreach services are going to be encountering different populations groups that should be taken into consideration when designing their program and trainings for these CBFP staff.   While many family planning programs are focused on women, some additional groups that should be considered in CBFP programs include:

Engaging Men

Traditional FP programs focused almost exclusively on women, failing to recognize that men play a significant role in reproductive health decision-making. Research has shown that men ARE willing to change their attitudes, beliefs, and behaviors relating to reproductive health when they are given the information and support to do so.  Involving men in FP can happen in their roles as clients, as supportive partners, or as agents of change around community norms. The appropriate information and education on the benefits of FP can encourage a man to support his partner in achieving FP success and allow him to be an active participant in planning the number and spacing of his children.

Men’s roles as clients themselves can contribute to FP by encouraging the use of male methods, such as vasectomy and condoms. While vasectomy is currently poorly accepted due largely to misconceptions, it is the simplest, safest, and least expensive of the permanent methods.

Engaging Youth

More than 1 billion young people are entering their reproductive years, with another 2 billion to follow, yet many young people lack basic information about and access to services for reproductive and sexual health.

The majority of adolescent pregnancies actually occur within marriage. Girls under 18 who become pregnant are twice as likely to die of pregnancy-related complications than young women aged 20–24, and girls under age 15 may be five times as likely to die. Age is not a contraindication for any method of contraception, although methods such as sterilization are in most cases inappropriate. However, adolescents often have high rates of discontinuation of FP methods, in part due to concerns about side effects or lack of understanding of how to use the method correctly. Judgmental attitudes, locations of health centers, and inconvenient hours of services often make it difficult for youth to get the health services they need.

“Youth-friendly” FP as well as the prevention and management of STIs/HIV are central components of health services for youth. These services should also include age-appropriate education and counseling on responsible sexual behavior, FP, STI/HIV prevention, and pregnancy care, as well as counseling on and referral for gender-based violence and sexual abuse, for both young men and women. The active involvement of youth as partners in the planning and implementation programs can help ensure that the program is relevant to their needs, increases ownership, and takes advantage of young people’s expertise and energy in developing strategies and messages for effectively reaching their peers.

Engaging Faith Leaders

The role of faith in FP is critical in achieving successful outcomes related to maternal and child health. Faith communities, organizations, and leaders can be important facilitators to educate communities, create demand for FP services, act as agents of change, and create synergies with organizations and institutions that provide the elements needed to carry out robust programs.

Religious leaders are often important gatekeepers in disseminating reproductive health messages and influencing positive behavior change within communities. Research has shown that not only is FP accepted by many religious leaders and faith communities around the world, they are already engaged in FP activities within their communities. Religious leaders have the potential to actively influence shifts in gender norms and attitudes about FP and optimal child-spacing. An important entry-point into these discussions can be HTSP and fertility awareness-based FP methods because they are directly linked to fertility concepts, which are strong cultural forces in many societies.