There will always be youth that cannot or will not visit a clinic or seek reproductive health information from a youth center. Yet, these youth still need and want accessible sources for accurate reproductive health information. Hotlines provide an ideal channel for youth audiences. Reproductive health information can be personalised and clarified through hotlines. By providing one-on-one contact, hotlines offer an excellent opportunity to reinforce prevention messages such as "Delaying sexual activity is normal and healthy." Hotline counselors also can refer young people to appropriate reproductive health resources.

Advocacy in Population Programs (APROPO), a non-governmental organisation (NGO) in Lima, Peru, started a hotline on family planning and reproductive health in 1993 as part of a larger communication strategy that included a multimedia campaign and street theater.

The objectives of the hotline were to:

The primary audience for the hotline was young people aged 15 to 29, which represented about 85 percent of the callers. According to the 1993 DHS, adolescent girls in Peru were giving birth to one out of every four children. One reason for this high birth rate was that youth did not have access to information to make informed decisions on sexuality and reproductive health. Those who did have access to information either were not clear about the information given or given only limited information during a brief consultation. Since young clients were not likely to return to a clinic for clarification, an anonymous hotline counselor could clarify information and answer questions without being judgemental or embarrassing the caller.

APROPO hired a psychologist experienced in counseling youth about sexuality and reproductive health to be the director and main counselor for the hotline. She worked from 9:00a.m. to 6:00p.m. five days a week. In the first month 70 callers used the hotline. Due to heavy promotion through radio, TV, and print, the calls increased almost tenfold to 670 by the second month. By the end of the first year, the number increased to 9,107 calls, far beyond the estimated 2,500. After the first year, APROPO added more phone lines, hired more staff, and trained student interns. By 1995, counselors were averaging 120 calls a day and providing service to almost 30,000 callers - 75 percent more calls than expected.

How it worked

Radio and TV spots, street theater, stickers, flyers, and educational talks promoted the hotline. Some promotion was free. TV and radio personalities, curious about the hotline, interviewed staff about it. The hotline number appeared at the end of the TV spot for the Las Tromes national family planning campaign.

Long-distance calls are expensive for those who have little disposable income. APROPO was able to secure a toll-free 800 number for the first time in Peru, which also allowed hotline counselors to reach rural audiences.

The hotline provided ongoing monitoring for programme managers. Over time, it became clear that callers understood basic information and counselors were able to provide more in-depth information and any up-to-date information (such as new youth-friendly clinics.)

Results from Monitoring Data

METHODOLOGY: Counselors gathered data on each call and recorded them on tracking sheets. Due to anonymity, hotline counselors were not able to verify whether callers heeded advice.

Phone counselors helped 70 percent of callers with their problems and provided referrals for the majority of other callers.

Hotline usage peaked in 1996 at 30,014 calls. In 1998, 19,200 calls were taken, reinforcing the need for continued multiple venues of promotion.

During the five-year period, 75 percent of callers were women and 25 percent were men. On the 800 line, the breakdown was 60 percent women and 40 percent men.

Almost two-thirds (62 percent) of the callers were aged 15 to 24.

Most callers (45 percent) asked pregnancy-related questions compared to 16 percent who asked about services and 15 percent who had questions about sexuality. Other topics callers had questions about included STIs/HIV/AIDS, couple conflict, vaginal infections, and sexual dysfunction.

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