Using "conversations" to convert family planning knowledge into practice

Background:In the Philippines there is a significant gap between the knowledge of and the use of family planning. The challenge for health partners is not the provision of information, but converting knowledge into practice. This paper describes a behavior change approach focusing on reducing this gap.

Method: The approach, known as Usapan, or “conversation,” was developed by the USAID/PRISM2 project. Focusing on private midwives, a key family planning provider in the Philippines, Usapan is a structured process of facilitated group discussion followed by one-on-one counseling and immediate service provision. Usapanuses adult learning exercises to encourage reflection. The linkage between knowledge acquisition, behavior change decision-making, and immediate, on-site, service provision, maximizes the chances of converting positive attitude changes into behavior changes and family planning uptake.

Results: Close to 19,000 women and men were reached with family planning counseling through Usapan. Seventy percent of those reached indicated interest in specific family planning methods, and close to 50 percent received their desired method immediately. These figures point to the ability of the approach to generate high demand for contraceptive methods and to transform demand into contraceptive uptake. When implemented properly, Usapan has proven to be an important tool that private midwives can use to market their services.

Discussion: Results indicate that the Usapan approach motivates and facilitates contraceptive uptake among people who might otherwise hesitate to obtain services. Adapting this approach for use in other geographic and service settings has the potential to significantly contribute to reducing unmet need for family planning.