Hesperian’s Family Planning Choices App: Increasing Access to Family Planning Counseling and Services

Access to family planning and contraceptive services is a key indicator of sustainability and development, supporting healthy families and also enabling a way out of poverty – this is why the United Nations Sustainable Development goals include working towards universal access to sexual and reproductive health (SRH) information and services (FIGO, 2018). Despite impressive increases in contraceptive use worldwide (particularly in Kenya and Mozambique), there are currently 214 million women of reproductive age in the developing world who have an unmet need for contraception (Guttmacher, 2016), and they account for 84% of all unintended pregnancies, often resulting in unwanted pregnancies and unsafe abortions. Francophone countries in West Africa have among the highest rates of maternal and child mortality in the world, and their rates of modern contraceptive use are among the lowest.
According to FIGO, “if contraceptive services placed more emphasis on improving information and counselling related to reproductive health, then unmet need could decline substantially (2018).
In addition, Hesperian Health Guide’s formative research for the FPC app identified two main barriers hindering frontline health workers (FHWs) and peer promoters from providing quality counseling and delivery of contraceptive services – overall, FHWs felt:
(1) Discomfort and a lack of confidence in discussing birth control preferences, since this requires conversation about sex and sexuality – this was exacerbated when talking with adolescents or unmarried women.
(2) Intimidated by the detailed technical aspects of various contraception methods, and therefore unable to offer sound advice or discuss the pros and cons of each method.

Hesperian’s Family Planning Choices (FPC) app acts as a portable counseling tool to support the delivery of quality contraception services by enabling frontline health workers (FHWs) and peer promoters to share unbiased information and to counsel clients about family planning and birth control options.
The FPC app content fits broadly into 3 interrelated segments :

an interactive “method choosing tool” to help a woman determine the best method for her based on preferences, health history, and circumstances;
a comprehensive description of birth control methods, the benefits and disadvantages of each method, and who should avoid using each particular method;
an informative and entertaining set of conversations, strategies and advice to discuss sexuality and sexual health, talking with male partners, and other sensitive topics.

Designed to address the barriers detailed above, Hesperian’s Family Planning Choices (FPC) app will act as a portable, discreet, and accessible tool for FHWs and peer promoters to utilize when counseling women/ adolescents about family planning services, increasing their capacity and reducing barriers to discuss sex, sexuality, and family planning. As promoters and other community health workers are peers and often operate outside of the formal health systems, they can provide appropriate, sustainable and effective counseling that will help connect underserved and hard-to-reach adolescents and women to family planning services.
One critical and unique feature, is that the FPC app can be accessed without the use of a data plan, making it accessible to those who face economic and/or location limitations – easily downloaded onto a phone or tablet, it can be taken with a FHW or peer promoter to counsel women and adolescents, particularly in underserved and marginalized communities. It can also be shared onto women’s own devices (with smartphones more prevalent than ever in the Global South), for immediate access to accurate, discreet and unbiased family planning information.
In addition, the multi-lingual app, currently available in English, French, Spanish and Swahili (the user can choose which language they want to set the app in), can be used in different regions (Latin America, Francophone Africa, etc.) with documented needs for increased contraceptive use. The FPC app can be easily adapted to local context, will be able to be translated rapidly into even more languages (based on our deep experience with translating resources), and will easily scale globally for greater reach and impact.