SOCIAL FRANCHISING IN CONTEXT OF MARKETING LONG-TERM AND REVERSIBLE CONTRACEPTIVES (LARCS) IN UGANDA: ANALYSIS OF PACE SOCIAL FRANCHISE MODEL

Background: Uganda is TFR is among the world’s highest at six children per woman, and contributes to the rising rate of poverty and maternal and infant mortality across the country. A social franchise model was adopted in Uganda to market and scale up contraceptive prevalence through the private sector. In 2008 PACE launched the Women’s Health Project, a core component of their reproductive health strategy to increase access to and demand for affordable, quality long‐term Family Planning (FP) services, through the setup of a network of private healthcare providers, branded as “ProFam” social franchise health facilities. The program expanded and included services aimed to offer and improve reproductive health services, limiting births through increased use of IUDs and implants as well change negative perceptions to FP. Until 2014, this network consisted of 189 private facilities spread out in 56 districts, following a business model of social franchising. Methods: The multifaceted effect of the social franchise intervention under PACE was then measured through a longitudinal cross sectional survey on perceptions towards Long-Term and Reversible Contraceptives (LARCs) use among the target population through a cross-sectional studies over two periods. The studies covered 53 districts hosting 194 privately owned health facilities branded Profam. Multi-stage cluster sampling approaches was used to draw a representative sample of women of reproductive age group. However, for Kampala (capital city), given its population size, the catchment area was restricted to a parish/Ward. Findings: There is an evident rise in current use of FP methods among WRA. Availability of LARCs particularly IUCDs significantly increased over the two time periods. Use of FP services among WRA is a socially sanctioned behavior/practice. There was reported increase in social support for FP services. There were high levels of correct knowledge about FP services and methods, particularly LARCs and outcome expectations from FP increased Conclusion: There is an opportunity for increasing uptake of LARCs especially IUDS and Implants through the private sector via a social franchising model. Further, positive changes have been registered in the campaign to mutate negative perceptions against LARCs suggesting positive effect of increasing service accessibility within the community of the target group in easily accessible outlets within the network

HIV-related risk perception among female sex workers in Nigeria

Augustine Ankomah1, Godpower Omoregie1, Zacch Akinyemi2, Jennifer Anyanti1, Olaronke Ladipo1, Samson Adebayo11Society for Family Health, Abuja, Nigeria; 2Population Services International, Kigali, RwandaBackground: Over one-third of sex workers in Nigeria are infected with human immunodeficiency virus (HIV), yet there is a lack of understanding of sex workers’ own perception of sexual risk-taking. Applying the theory of cognitive dissonance, this paper examined the personal HIV risk perception of brothel-based sex workers.Methods: The study is based on 24 focus group discussions held among brothel-based sex workers in four geographically and culturally dispersed cities in Nigeria.Results: It was found that sex workers underestimated their risk of infection and rationalized, defended, or justified their behaviors, a typical psychological response to worry, threat, and anxiety arising from the apparent discrepancies between beliefs and behaviors. To reduce dissonance, many sex workers had a strong belief in fatalism, predestination, and faith-based invulnerability to HIV infection. Many believed that one will not die of acquired immune deficiency syndrome if it is not ordained by God. The sex workers also had a high level of HIV-related stigma.Conclusion: From these findings, most sex workers considered risk reduction and in particular condom use as far beyond their control or even unnecessary, as a result of their strong beliefs in fatalism and predestination. Therefore, one critical area of intervention is the need to assist sex workers to develop accurate means of assessing their personal vulnerability and self-appraisal of HIV-related risk.Keywords: female sex workers, cognitive dissonance, risk perception, risky behavior, focus group discussions, Nigeri

Replication data for: Namibia (2006): Malaria TRaC Study Evaluating Ownership and Use of Insecticide Treated Nets in Two Northern Regions First Round

In April 2006 the Social Marketing Association (SMA), Population Services International (PSI) local affiliate in Namibia, conducted a household survey designed to investigate the important determinants of insecticide treated nets (ITN) use by households, focusing on those with pregnant women and children under five. The study also aimed to determine the current levels of a) household ITN ownership and use by under fives and pregnant women and b) opportunity, ability and motivation (OAM) related determinants of ITN use. The survey served as a baseline survey for future use. A multiple time cross-sectional study design was used to identify determinants of behavior, monitor progress and evaluate programmatic impact. This study served as a baseline and a follow up tracking survey will be done in 2008. Two hundred and forty (240) households with pregnant women and/or children under the age of five were randomly selected from two regions, Kavango and Oshana in Namibia. The heads of households were interviewed and a total of 480 households participated in the study. Results are presented in standard PSI Dashboard form. Only households with pregnant women and/or children under the age of five were included in the sample

Replication data for: Namibia (2009): Sexual Behaviour and HIV Risk Reduction Practices Among the Namibian Police

In November and December 2008, the Social Marketing Association (SMA), conducted a survey designed to investigate important determinants of Condom Use, Multiple Partners (MP) and Multiple Concurrent Partners (MCP), as well as Counselling and testing (CT) among Police members in 3 towns/cities in Namibia. The study also aimed to determine the current levels of Male Circumcision (MC) and self reported Sexually Transmitted Infections (STIs). The survey served as a baseline survey for future use. A cross-sectional study design was used to identify determinants of behaviour, monitor progress and evaluate programmatic impact. This study served as a baseline and with additional funding, a follow up tracking survey should be done in 2011