Niger has the highest rates of adolescent marriage and fertility in the world, fueling the country’s 2012-2020 Action Plan for Family Planning which aims to increase contraceptive prevalence from 16% in 2010 to 50% in 2020. The action plan sets out a number of initiatives, including mobilizing religious and traditional leaders as family planning advocates.

YLabs joined forces with PSI Niger to use a human-centered design (HCD) methodology to explore how religion, social norms, peers, family, aspirations, and financial constraints affect community attitudes surrounding reproductive health.

“Through our research, we found family planning is not an individual decision,” said Senior Designer Sarah Fathallah. “Even though a religious leader may not directly influence a young couple’s choice to have more children, they do play an important role in setting community norms and values, which may guide decisions about family size.” 

After ideation, prototyping, and rapid iteration, YLabs worked with community leaders to develop the three complementary components of Sarari that would increase community support for using modern contraception for birth spacing.

Leaders Engagés:

The first component of Sarari is Leaders Engagés, or ‘committed leaders.’  “We worked with religious and community leaders to develop religious justifications that Imams could use within sermons along with audio and visual supplementary materials that advocated for birth spacing and wellness and condemned spousal abandonment,” said Fathallah.

Leaders Engagés are now structured collectives of religious leaders who act as agents of change. They are trained by their peers to speak on the importance of birth spacing for maternal and infant health and overall family well-being during religious services, at Koranic schools, or during private consultations.

Séminaire des Leaders

Séminaire des Leaders, or ‘Leader Seminars,’ are a series of debates that take place between religious and youth leaders to dispel myths and misconceptions about family planning and birth spacing.

In this forum, these two influential groups are given the space to engage in candid discourse about family planning and birth spacing. “Since these meetings take place out in the open, they generate awareness with the larger community and set a precedent that these conversations were welcome and accepted,” said YLabs Technical Lead Nicole Ippoliti. 

All materials needed to be created for low literacy populations, which presented a unique design challenge. “All of our research material and resources needed to be 100% visual, making the good, intuitive design a critical component of the project,” said Ippoliti.

Dede Ruwa Dede Tsaki

“While the initial focus of the program was religious leaders, through design research we discovered that there was an enormous need to focus on young men who had a more direct influence on the reproductive decisions of their wives,” said Ippoliti. 

The team found that husbands, as the heads of house, make decisions about money, the number and timing of children, and whether or not their wives use contraception. “However, through interviews with young men in the community, we realized that they weren’t considering the financial implications of having multiple children,” said Ippoliti. 

Dede Ruwa Dede Tsaki is a Hausa proverb that translates to ‘just the right amount of water for the flour’ and expresses the need for balance. This component of the Sarari program takes place in fadas, existing structures in communities where men usually meet, and combines a financial planning and budgeting exercise with visual messaging drawn from the Koran and the commentary of the Prophet (Hadith) that supports birth spacing, informed decision making, and a balanced quality of life. 

“Through testing different approaches, we found that understanding the expenses incurred with having children, combined with exposure to messaging on their religious and moral obligations to provide for their children, helped young men understand and visualize how they can work towards achieving a better quality of life for their families,” said Fathallah.

Impact

To date, 555 men and 14 women have participated in the pilot, and midterm findings indicate that Sarari has the potential and to continue to create a supportive environment for reproductive health that is accepted and cherished by religious leaders, community members, and young couples.

“We’re especially excited about the potential of Dede Ruwa Dede Tsaki,” said Ippoliti. “To date, 79% of participants have reported a 50% reduction in the number of children they desire following the financial planning exercise.”

YLabs will continue to update the Sarari website as more pilot data is collected. To find out more about the project and explore our tool kits, visit www.sarari-niger.org. All resources are available in both English and French.