This piece is a part of A360’s replication series on the UK Aid-funded Vale-a-Pena project. With and for young people, Vale-a-Pena is proving the power in applying A360’s youth-powered approach to determine what it takes to enact effective, resonant and ultimately lasting adolescent and youth sexual and reproductive health (AYSRH) behavior change in Mozambique – and beyond.
By Fuva Muiambo, Communications Officer, PSI/Mozambique
In no uncertain terms: family planning remains a taboo topic among Mozambican families.
The lack of communication between parents and children and the lack of consent to access contraception are some of the main barriers young people face when deciding whether to use contraceptive methods.
Through Vale a Pena, we’re designing new ways to reverse that reality.
Our insights during Vale a Pena’s inception phase revealed that parents struggle to bring up the subject and are sometimes unable to find the right approach. This is both due to their lack of knowledge about sexual and reproductive health (SRH) issues and because it’s not usual in the family for parents to talk about that with their children.
As a solution to this, we thought that parents talked openly with their children about SRH, more adolescents would be able to access family planning and unwanted pregnancy rates amongst teenage girls could be reduced. We prototyped in urban and peri-urban contexts to see what this could look like.
Reaching and Engaging Parents – The Peer Coaching Sessions
To kick-start the prototype, we held a one-day Ideation Workshop with “family influencers” of adolescent girls. This included fathers, mothers and grandmothers who were engaged in an ideation process. The main learnings from this and the basis for the prototype were:
- Peer influence among parents is strong and is a powerful way to share information;
- Parents are more likely to listen to their peers (i.e. other parents) on how to address taboo topics such as sexuality and family planning;
- Having testimonials from parents who have been successful in talking with their children will deliver a powerful message to other parents and motivate them to replicate the behavior;
- The sessions will enable parents to give written consent and refer adolescents to SRH services after understanding the importance of the topic.
This helped us to identify the main components of the ‘Peer Coaching Session’ prototype which was then tested in Maputo. It focused on using storytelling to start a conversation about family planning and sexuality between parents and their children. The goal was for parents to understand the importance of talking to their children, that they discuss their own challenges and coach others on how to approach difficult topics and finally gain their approval to allow and consent to their children to access family planning services.
In order to understand if the prototype were successful, we measured the prototypes’ efficacy using 3 variables:
- Coupons: to measure the efficacy of the session, the moderator distributed different coupons that were invitations for an event with SRH services.
- WhatsApp Group: we wanted to understand if parents use WhatsApp groups to communicate and clarify questions, so the moderator would announce and distribute flyers for them to contact the group if they had any questions after the meeting.
- Consents Signed: to measure written individual consent; after each session, the moderator would ask the parents to sign a consent form allowing adolescents to access SRH services.
Our intention was to understand, through these indicators, how the prototype could translate into action and, ultimately, to behavior change.
What we’ve learned
Storytelling based on parents’ own personal experiences served a successful tool throughout the sessions. In fact, mothers mentioned that they learned the most through the example of their peers. Storytelling therefoore, allowed them to learn from their peers and hear first-hand that they aren’t alone when it comes to facing the same problems with the adolescents.
What didn’t work
The WhatsApp groups were not successful among parental sessions. Even after explaining several times in detail by the moderator, no one engaged through WhatsApp in any of the sprints.
We also realized that, despite the success of the storytelling component, stories shared were not directly linked with contraception, but rather with other themes such as menstruation, relationships and early pregnancy.
What have we achieved? Our results
In total 36 parents attended the sessions we held. 50% of them referred their children to the events, and 95% signed the consents, allowing their children to access counseling, health services, and contraceptive services.
Peer Sessions will continue to be a part of Vale a Pena’s implementation phase. We will recruit parents through school counsels (a meeting that joins parents, students representatives, teachers representatives, school board and community leaders), to make sure we have more parents in the sessions. At the same time, we’ll establish structure with specific days to meet within community. And to ensure the stories shared on the groups are directly linked to contraception and to also have parents in the group encouraging their children to use contraceptive methods, we will continue using Health Promoters to model the types of stories we seek to have shared. They will also serve to moderate the dialogue that ensues.
Onward we go.
Learn more about how Mozambique’s Vale-a-Pena intervention is applying the A360 Blueprint for AYSRH Change to reimagine how young Mozambicans access modern contraception, today.