Family Planning for All: Leveraging a Modestly-Funded Donor-Funded Communication Strategy to Achieve Nationwide Results

Background:  Ukraine has one of the world’s lowest fertility rates and one of the highest abortion rates. Low desired fertility coupled with the nonuse, ineffective use, and inappropriate use of modern contraception drive the high abortion rate. Myths and misinformation are major barriers to modern contraception use. Only 3.7% of Ukrainian women of reproductive age use contraceptive pills and 12.1% use IUDs. The number of abortions per 1,000 live births in Ukraine in 2008 was 400 compared to 238 for European countries.

Program background:  JSI’s USAID-funded Healthy Women of Ukraine Program (HWUP) developed Ukraine’s first national, multi-stakeholder family planning (FP) communication strategy to increase positive attitudes and expand the use of modern contraceptives as an alternative to unintended pregnancy and associated abortion. Previous efforts by government and NGOs to change FP attitudes and behaviors among women of reproductive age and their partners lacked coordination and a national approach. JSI developed the communication strategy as a joint national action plan for government (national and regional), donors, NGOs, and other stakeholders to reach audiences with key FP messages. Achieving buy-in was essential and the government’s endorsement of the strategy was key. Using jointly developed messages and one logo, all strategy partners agreed to use and promote the same national communication channels (e.g. website, hotline, social media, TV/radio, outdoor advertising, IEC materials, peer training modules, media training). Oblast governments developed complementary regional-level strategies, which increased reach among target audiences and bolstered local ownership and sustainability.

Evaluation Methods and Results:  JSI conducted an evaluation of the communication strategy to determine its effectiveness among target audiences. Data was collected via focus groups with HWUP regional partners in six regions of Ukraine. Focus groups assessed the strategy’s impact on target audiences in the following areas: 1) increase in knowledge of FP advantages, 2) improvement in attitudes to modern methods of contraception and dispelling myths, and 3) increase in usage of modern methods of contraception. Results show that the national FP communication strategy positively impacted knowledge and attitudes of target audiences in all areas surveyed.

Conclusions:  Ukraine’s national FP communication strategy was effective because government and many different organizations came together to support it. Though it originated with the USAID-funded Healthy Women in Ukraine Program, JSI was able to bring together many partners who contributed their resources and time. This greatly extended the reach of the campaign’s messages beyond what would have been possible using only donor-provided program funds.

Implications for research and/or practice:  A multi-stakeholder, multi-level (national and regional) communication strategy can be an effective approach to address a culturally complex topic, such as FP in Ukraine. The format of Ukraine’s national FP strategy has already been replicated with success in other areas (e.g., increasing women’s political participation, preventing domestic violence). Creating preconditions for sustainability should be built into the strategy from the beginning, for example, building the capacity of national and regional partners to continue the work when donor funding ends.