Reaching people living in poverty has become a key objective for many global health programmes and the Leave No One Behind agenda. The Women's Integrated Sexual Health 2 (W2A) Programme, funded by FCDO and led by International Planned Parenthood Federation (IPPF) has supported integrated sexual and reproductive health and rights (SRHR) services in countries across Africa and Asia. A key priority for W2A is reaching marginalized and people living in poverty with quality family planning (FP) and SRHR services. W2A utilizes client exit interviews (CEIs) to assess the extent to which the program is reaching people living in poverty, with the goal of matching the national poverty headcount. Results from the first round of CEIs showed that only 4 /14 W2A countries matched or surpassed the national poverty headcount. Community Health Workers (CHWs) were identified as key actors in influencing referrals for FP services for poor clients. Subsequently, W2A utilized geospatial maps, coupled with service delivery segmentation to refine population segmentation and identification. Multi-channel awareness and demand creation strategies were implemented. CHWs were reallocated and new ones recruited where appropriate, use of community-level public address (PA) systems was increased, and audio and video cards produced to enhance the work of the CHWs. Using W2A Uganda as an example, this presentation will show how poverty adaptations to the programme led to a significant increase in the reach of SRHR clients living in poverty in Uganda from 25% to 61% against a national headcount of 41%.

Humanity and Inclusion (HI) worked in South Sudan to reduce the significant barriers to contraceptive access faced by women and girls living with disabilities. A combination of locally-informed radio, music, community outreach, and focus group activities were conducted to raise awareness of the reproductive rights of people living with disabilities and to increase demand generation from this group. An endline, evaluation of the WISH Program showed an increase in the level of satisfaction by persons with disabilities with the attitudes demonstrated by Health Care workers when they accessed SRHR services. Over the course of the project, it was clear that working with Organisations of Persons with Disabilities (OPDs) was key to success, due to the crucial role they play in linking persons with disabilities with sexual and reproductive health (SRH) service providers at the facility, community level, and hard to reach areas.

UMATI under the WISH2ACTION program was implemented in 7 regions of Tanzania, targeting youths in the Hard-to-reach. Due to the operating environment where only out-of-school youths were allowed to receive comprehensive sexuality education, UMATI introduced a model known as the special youth weekend clinic (YWC). This model uses peer educators to mobilize young people during the week and motivate them to visit a youth weekend clinic on either Saturday or Sunday.


When young people attend the weekend clinic, they get sexual reproductive information and education provided by trained peer educators. SRH information and education are normally provided in an edutainment way which includes plays, music, drama, and sports. Because seeing is believing, peer educators use audio-visual cards with SRH materials from DMI to deliver education and information aimed at tackling the SRH and FP myths and misconceptions among the youth.


These are called UMATI special Youth Weekend Clinics because the provision of SRH/FP information and education is integrated with youth-friendly services (YFS). This makes it easier for youths that attend the weekend clinics because after they receive information on SRH, some of them want to get services that are provided by trained service providers on YFS.

Development Media International (DMI) delivered the mass media component of the WISH2ACTION campaign, using relatable characters and storylines to increase audience receptivity to what can be challenging messages on a sensitive subject. However, using characters and storylines that could resonate with audiences in seven countries and 29 languages, whilst maintaining fidelity to the core family planning themes, was a significant challenge.  
This presentation describes how DMI, with the help of local consortium partners, struck the balance between working at the scale demanded by WISH yet developed outputs that were attractive to and resonant with local audiences.  The final campaign consisted of 1,214 radio spots, broadcast 560,000 times, dubbed into 29 languages, on 134 radio stations and heard by 70 million listeners, in addition to 344 audio-visual episodes broadcast 8,000 times and seen by 74 million on TV and watched for over 1 minute by 2.5 million on Facebook. A subset of the audiovisual outputs targeting youth, called Temzu Town, was also distributed to youth groups via 15,000 memory devices that could be used to view the episodes on phones. Finally, 3,550 audio and 830 video talking cards were distributed to people living with disabilities and those living in severe poverty across Uganda and Zambia.
All radio outputs were written by African script-writers, trans-created by project teams in each country, and pre-tested directly with target audiences in over 250 rural focus groups. All media outputs were further presented to and approved by Ministries of Health in all countries.