Family planning during the COVID-19 pandemic: The use of digital technology to support self-care interventions

Self-Care Month this July offers an opportunity to double down to make quality self-care interventions available, affordable, acceptable, and accessible to those who need them the most. For R4S partner PSI, digital solutions offer a strong entry point to put power and care into consumers’ hands — during COVID-19 and well beyond.

Betty Abrera, Product Portfolio & Marketing Manager, Social Enterprise
Andrea Novella, Latin America Regional Social Media Manager, Social Enterprise
Vidhi Kalra, Assistant Manager of Digital Marketing, India, Social Enterprise
Peter Buyungo, Head of Strategic Information & Learning, Uganda, Social Enterprise & DISC
Kenneth Kiiza Mulogo, Sales & Marketing Analyst, Uganda, Social Enterprise
Rebecca Rwakabukoza, Marketing & Communications Coordinator, Uganda, Social Enterprise & DISC
Lillian Sekakembe, Director of Programs, Uganda, DISC
James Brown, Senior Technical Advisor, A360

Njideka Ofoleta, Stanback Fellow, R4S, FHI 360
Aubrey Weber, Technical Officer, Research Utilization, FHI 360
Eden Demise, Research Coordinator, FP/RH, PSI

Research for Scalable Solutions (R4S) is a new, USAID-funded implementation science project that aims to increase the production and use of evidence to improve voluntary family planning (FP) programs around the world. Specifically, R4S focuses on generating evidence related to self-care and client-driven approaches for FP, increasing information about the cost and cost-effectiveness of implementing high-impact practices, and addressing equity within programs. Led by FHI 360 in partnership with Evidence for Sustainable Human Development Systems in AfricaMakerere University School of Public Health (Makerere SPH) in Uganda, Population Services International (PSI), and Save the Children, R4S works with a range of country-based stakeholders to strengthen research and research utilization capacity and support countries in their journey to self-reliance. For R4S’s second blog post, we spoke with PSI about the use of digital technology to support self-care — the ability of individuals to maintain and promote health with limited or no support of a health provider — to ease the burden on health systems as they respond to COVID-19.

Self-Care Month this July offers an opportunity to double down to make quality self-care interventions available, affordable, acceptable, and accessible to those who need them the most. For R4S partner PSI, digital solutions offer a strong entry point to put power and care into consumers’ hands — during COVID-19 and well beyond.

Using digital platforms to promote self-care amidst COVID-19, PSI’s pandemic adaptations and self-care solutions enable increased access to reproductive health (RH) information, allow self-counseling for different methods, encourage telemedicine, and facilitate product ordering and delivery to consumers.

Here are some ways PSI has used digital platforms:

In India and Uganda, PSI’s Social Enterprise Business Unit employed a Digital Acceleration Strategy to increase access to FP products and care. By pivoting its existing business models and leveraging popular digital platforms, PSI Social Enterprise has accelerated gains in digitally enabled self-care, all while fostering continuity of FP health care information, products, and services, and directly supporting consumers in making, and owning, their RH choices during COVID-19 and beyond. The Digital Acceleration Strategy aims to deliver a fully digitalized consumer health journey, with individuals engaged through online communities, information provided via digital touchpoints such as social media, care delivered digitally whenever possible, and products delivered to consumers’ front doors. For example, through targeted messaging on social media, women in India can access Between Us, a consumer-driven lifestyle brand, to begin a personalized journey based on their needs. They might engage in a self-counseling process through artificial intelligence, receive a referral to an online consult with a network provider via a third-party service, or be signposted to an e-commerce platform that delivers RH products directly to their home. This digital strategy leapfrogs off of existing platforms and technologies and leverages the private sector to quickly address COVID-19-specific barriers to health care, such as national guidelines restricting movement, de-prioritization of nonemergency medical services, and decreased face-to-face engagement with health care providers.

In Nigeria, PSI’s flagship youth-powered FP/RH program, Adolescents 360 (A360), co-funded by the Children Investment Foundation Fund (CIFF) and the Bill & Melinda Gates Foundation (BMGF), has adapted by integrating digital platforms such as WhatsApp, Facebook, and bulk SMS into mobilization and service delivery activities. When the program’s “Life, Love and Health” classes — A360 Nigeria’s aspirational programming component aimed at prompting participants to consider their life dreams and to improve their understanding of how their bodies work  — were unable to proceed in person due to social distancing restrictions, A360 used WhatsApp to continue interactive text-based classes run by health providers. In addition, SMS has been used to reach clients with RH information and referrals for certain services. The SMS text messages have proven particularly relevant for reaching participants who do not have a smartphone or Internet access. In addition to the digital adaptations, A360 has adapted by training new community health workers to integrate COVID-19 prevention and awareness messaging into FP/RH outreach. These adaptations ensure continued care during and after the evolving pandemic.

In Uganda, through a separate CIFF-funded effort called Delivering Innovation in Self-Care (DISC), PSI,  the Ministry of Health, and the Uganda Family Planning Consortium have focused on social and behavior change through social media platforms and mainstream media to reach women ages 15–24 and 25–34 with RH information, products, and services. So far, DISC has sent three rounds of text messages (two in English, one in Luganda) to more than 75,000 contacts and audio messages to 12,000 Ugandans reminding them to seek FP care and instructing them to dial 161 for more information. PSI has used the on-demand 161 platform (through Viamo and Airtel) since 2017 to communicate information on contraception and cervical cancer from the Ministry of Health. As part of this updated campaign, PSI will link the COVID-19 menu on the platform to the contraception menu and include a message on the safety of the various FP methods during the pandemic.

Through R4S, we are committed to documenting the learnings — what is and is not working — as we collectively pivot in response to the current pandemic. To date, we have seen the efficacy of harnessing digital technologies to encourage self-care and increase the accessibility and availability of RH information and services for consumers who need them the most.  

This is a journey. And we are in it, together.

Photo: Jessica Scranton/FHI 360

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