Access and demand are crucial levers in voluntary family planning programming. However, “understanding how these two are linked and when each should be prioritized is difficult,” note Michelle Weinberger, Emily Sonneveldt, and John Stover. This challenge is illustrated by the relatively weak attention to social and behavior change (SBC) approaches in voluntary family planning programs. SBC is an evidence-based, theory-driven process that uses communication to identify and address behavioral determinants, and positively influence individual and collective behaviors to improve health outcomes. Available evidence shows that SBC approaches can increase the use of modern contraceptives by addressing the attitudes and social norms that influence demand. Despite proven results, SBC interventions often do not get as much attention, in part because many practitioners are not effectively measuring SBC efforts.
Breakthrough ACTION interviewed voluntary family planning stakeholders in the Ouagadougou Partnership countries and identified a lack of awareness that SBC is needed to improve outcomes, and a belief that it does not generate the same return as investments in service delivery and procurement.
These responses reflect a broader trend across francophone West Africa, where investments through initiatives like the Ouagadougou Partnership have focused more heavily on access-driven programming. Yet Weinberger, Sonneveldt, and Stover note that without greater investments in strategies to increase demand, efforts to expand voluntary family planning use in countries with a high desired ideal number of children may achieve limited success. Investing in SBC measurement enables programs to engage in continuous learning and improvement, enables them to demonstrate how SBC interventions improve desired outcomes, and provides evidence of SBC’s effectiveness that can be used to mobilize further investment.