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Empathways: Improving the Relationship Between Healthcare Providers and Young People

Breakthrough ACTION’s New Tool Asks Critical Questions

A major barrier to young people’s access and use of family planning is mistrust. The new Empathways tool leads providers and young potential clients through a process that addresses this barrier by fostering empathy, creating opportunities to improve youth family planning service delivery.

Where did you grow up?

Who in your life inspires you?

Name two things you would like to achieve in the next two years – what, if anything, would stop you from achieving them?

While these questions may not feel like the cornerstones to a family planning consultation, they just might encourage providers to see their young clients in a new light: as real people, living real lives, with real struggles and potential—just like any other client who walks through their doors.

Time and again, research has shown that around the world, there is mistrust between young clients and family planning providers. Providers may deliver incomplete family planning services or refuse young clients altogether. This could be due to various professional constraints, or to the provider’s own biases tied to a client’s age, whether or not they have had children, or their relationship status. Young clients may fear judgement or a lack of confidentiality from providers, and avoid seeking the information and services they desire.

Two people sit together at a table, using Empathways materials to guide their conversation
©Breakthrough ACTION, 2021, Pre-testing in Côte d’Ivoire

How can we bridge the gap?

A new tool, Empathways, developed under the USAID-funded Breakthrough ACTION project, posits that empathy holds the key. Breakthrough ACTION designed this tool following a desk review, key-informant interviews, and multiple validation and design sessions with stakeholders (including donors, family planning program implementers, and young people). Empathways is a card activity designed to take family planning service providers and young, would-be clients on an engaging journey—from awareness, to empathy, to action. The objective is to forge greater understanding of young clients among providers through a series of dynamic discussions, and then for providers to apply this empathy to improve youth family planning service delivery.

Empathways has three rounds:

  1. “Open Up,” which consists of icebreaker questions like those at the beginning of this post, and more focused questions about gender roles and transitional life events, such as marriage and having a first child;
  2. “Discover,” which focuses more on factors that influence personal family planning attitudes, autonomy, and tenets of quality youth family planning services;
  3. “Connect,” which presents a series of youth family planning scenarios—written, in large part, by young people themselves—followed by discussion questions. These questions invite providers to distill their thoughts from Rounds 1 and 2, and use these insights to improve the way they deliver family planning services to their young clients.
Two people sit together at a table, using Empathways materials to guide their conversation
©Breakthrough ACTION, 2021, Pre-testing in Côte d’Ivoire

Does it work?

In March 2021, the West Africa Breakthrough ACTION (WABA) team tested a reduced, tailored version of the card deck with 15 young people and 15 providers. This smaller deck allowed the team to use Empathways in two- to three-hour standalone discussions (linked to the youth-centered reproductive health and family planning Merci Mon Héros campaign), rather than as a half- or full-day exercise integrated into a larger provider training as originally designed.

Overall, the results were extremely encouraging. Nearly all participants noted the themes addressed in the deck were relevant to improving youth FP service quality, and said the tool increasingly generated empathy for young people with each successive round. All participants said the tool was unique, and that they would use the tool again. Multiple providers asked for a copy of the deck to take back to their own health centers. The tool is a useful resource that can increase understanding among providers of the unique needs of adolescents and young people, and can improve provider training on adolescent responsive services.

Now what?

Based on the Côte d’Ivoire pre-tests, Breakthrough ACTION updated Empathways with simpler language and a new scenario focused on responding to young men’s family planning needs. Breakthrough ACTION also added guidance to the facilitator’s manual to ensure effective, fruitful sessions and to encourage collaborating with youth or community organizations when using the tool. WABA plans to continue using Empathways with providers, and has further adapted the tool for use with community members, highlighting the role that parents, teachers, religious leaders, and other opinion leaders play in increasing youth access to family planning information and services.

A web-based version of Empathways, complete with downloadable decks for in-country printing, is available on Breakthrough ACTION’s website and will soon be translated into French. The project also plans to pilot the tool in two countries in the coming months.

For more information on the Empathways tool, or to discuss piloting the tool in your own work, please contact Erin Portillo, Senior Program Officer on Breakthrough ACTION, at erin.portillo@jhu.edu.

Erin Portillo

Senior Program Officer, Family Planning, Johns Hopkins Center for Communication Programs

Erin Portillo is a Senior Program Officer at the Johns Hopkins Center for Communication Programs, where she supports family planning, youth, and reproductive health social and behavior change programs. Erin has a public health background and over a decade of international experience, mostly in francophone West Africa.