January 25, 2016

“Not about me alone”: Social networks as powerful resources for reducing unmet need

Written by Sarah Burgess, Research Officer | Institute for Reproductive Health, Georgetown University

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“If my husband sleeps with me, the next day, I feel ill-at-ease. That’s why I prepare tea, which allows me to clean out my stomach…to avoid an unintended pregnancy.”

Idaya spoke about her marital relationship, which was tense because she did not want to become pregnant. Discussing child spacing with her husband was stressful. So instead, she used a traditional method to prevent pregnancy in secret.

Idaya shared her stories in a series of interviews that began before and continued through the Tékponon Jikuagou Project (http://irh.org/projects/tekponon_jikuagou/). Tékponon Jikuagou’s five-component intervention package is designed to spark conversations about family planning (FP) use, encourage individuals to act on their reproductive intentions, and reduce unmet need for FP among women and men alike. As the project progressed, Idaya described new conversations about FP, with a discussion facilitator, and with her friends.

Two years later, after Tékponon Jikuagou ended, Idaya described major life changes. She had switched from using a traditional method to a modern one–birth control pills– and the gender dynamics of her marital relationship had shifted. She had become more assertive with her husband. When he questioned her use of pills, she replied: “I told him that it’s not because I’m sleeping around…if I had wanted to do that, I would have been doing it for a while….That [using FP] was advice given to us all, and not just to me alone. It’s in this moment that he accepted.”

As part of research efforts to understand how social networks impact FP behavior, Tékponon Jikuagou followed 50 participants, each with stories as rich as Idaya’s, over two years. Idaya’s changes are as much about her community as they are about her. In her second interview, she described starting a conversation with her husband after attending Tékponon Jikuagou discussion groups. Later, her ability to convince her husband to support FP use was successful when she evoked her community, asserting that her desire to use FP was not just “about me alone” but about bigger changes in their network.

The metrics that the global health world uses to measure FP often center on individual use. Yet, qualitative and quantitative results from Tékponon Jikuagou show that FP use is intensely social. Participants like Idaya speak about FP with peers before speaking about it with their partners, and before taking action to use it themselves. The Tékponon Jikuagou household survey shows that women who break communication taboos like talking with someone in their network about FP are more than five times as likely to talk with their partner about obtaining a method as those who do not. Men who believe their network approves of FP are 3.5 times more likely to visit the health center to obtain FP. Results also show that a supportive environment is significantly associated with modern FP use, and that Tékponon Jikuagou was successful at fostering those environments, and reducing unmet need.

Dynamic and supportive social networks, like Idaya’s, exist not only in Benin, but throughout West Africa. These networks are powerful resources which can be used to encourage FP discussion, and reduce unmet need. Tékponon Jikuagou began scale-up in early 2015; we aim to continue building evidence on social network approaches to addressing unmet need for FP.

Learn more about Tékponon Jikuagou:

Brief: Overcoming social barriers to family planning use: Harnessing community networks to address unmet need (http://irh.org/resource-library/overcoming-social-barriers-to-family-planning-use-harnessing-community-networks-to-address-unmet-need/)Brief: Social networks & social change: New program approaches to reducing unmet need for family planning (http://irh.org/resource-library/tekponon-jikuagou-brief-social-networks-social-change-new-program-approaches-reducing-unmet-need-family-planning/)