Social norms on reproductive health and sexuality, and access to family planning services, are deeply influenced by a society’s history, culture and access to resources. But family planning is also intimate and deeply personal. Women and men make decisions about when to have children as they navigate  their social, emotional and relational lives, and pursue opportunities related to career, education, and community service. So, in order to support the government of Benin in developing country-level policy around reproductive health, Camber first wanted to take the time to deeply engage with youth, and better understand their hopes, plans for the futures, and challenges and joys in everyday life.

Working in partnership with the Laboratoire d’Etudes et de Recherche sur les Dynamiques Sociales et le Développement Local, Camber conducted a multi-faceted qualitative research with young men and women in rural and urban areas. The research combined a number of methodologies, and including focus groups, in-depth interviews and ethnographic observation. Through “photovoice” we asked participants to document their day-to-day lives with photography, generating rich visual data on their role models, ambitions, perspectives, and what matters to them.

This data generated a number of rich insights on youth’s experiences and needs around reproductive health. We learned, for instance, about young women’s aspirations and desire for family, interest in defying gender norms which limit women to the household, and frustration with a lack of work opportunities.  We heard about how women seek information on reproductive health, receiving a myriad of diverse messages (from friends, family, peers, media, health workers) while trying to discern the truth of what will work best for them in their lives. We heard about how young women’s outlooks differ from their mothers, and how they are navigating a landscape of rapidly shifting social norms.

These qualitative insights gave us perspective on how young women are experiencing numerous pressures, working towards multiple ambitions, and how their interest in and access to family planning sits at the intersection of social, cultural and economic factors in their lives. Based on these insights, we crafted a quantitative survey which allowed us to understand how these dynamics play out and impact family planning at a population level. We worked collaboratively with the government of Benin, and with local youth organizers, to develop a strategy for improving youth access to family planning, and a  communications plan to promote family planning in terms that resonate with young women and meet their needs. 

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The William & Flora Hewlett Foundation engaged Camber to provide a strategic analysis of the demand landscape in Niger, relying on in-depth qualitative research and a national survey, and complemented by a robust supply analysis.  The work’s objective was to provide a common fact base that Niger’s family planning community—including Government and international donors—could use to drive decision-making, as well as to highlight gaps between supply and demand.

A nuanced picture of family planning in Niger emerged from this work. While there have been notable strides in contraceptive supply, the demand picture remains challenging, and will likely take significantly more time and resources to resolve. We found that many women in Niger do not believe that they have control over their own fertility decisions (they believe that Allah or their husbands have control), or they believe they have control, but want many children nevertheless. 

Within this broad demand landscape, we found significant variation in women’s demand for family planning.  Using advanced statistical analyses, we derived five segments of women with discrete family planning needs, attitudes, and behaviors—representing the first segmentation of its kind (predictive of human behavior) to be developed in reproductive health services in Africa.  In Niger’s resource constrained environment, the segmentation allows Government, donors, and NGOs to focus on segments with the highest potential for contraceptive uptake, or to take different segments’ needs into account when defining policy and programming.

We are currently working with a range of partners, including the Ministry of Health, Animas-Sutura, Pathfinder, EngenderHealth, and Population Services International, to integrate this work’s findings into family planning programming and communications in Niger. We are also expanding our insights and strategy work into Burkina Faso, Côte D’Ivoire, Mauritania and Togo.

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