Decades of programming in West Africa to promote greater access to family planning (FP) have not closed the gap between unmet and met need; and social barriers are an important reason for this gap. In Mali, for example, communication between couples about spacing or limiting the number of births is not accepted, and decisions around couples’ fertility are heavily influenced by family members. Lack of social support is also a barrier to use: women and men who use FP methods are often stigmatized by their peers because of beliefs that use is immoral or leads to immorality, and not condoned by religion. Terikunda Jékulu (TJ) guides communities to shift social norms surrounding FP and leads to attitudes and behaviors that support use. A low-cost package of activities that relies on existing social networks to diffuse new ideas in support of FP, TJ was designed to be a scalable intervention; it works with communities’ own resources and is easily added to existing development projects and portfolios. TJ was designed, tested, and rigorously researched in Benin where it resulted in increases in public and couple communication and use of modern contraception.
Over 18 months, the Institute for Reproductive Health in Mali, with support from the Ministry of Health, seeks to test the scalability of the intervention package with 10 NGOs working in six different regions of the country. We hypothesize that social network approaches which work with community-identified influencers such as religious leaders, and important social groups can unlock a new way to mobilize communities to address unmet need for FP.