The Next Generation "Smart Couple" Family Planning Campaign in Nepal, launched by the Johns Hopkins University Health Communication Capacity Collaborative (JHU-HC3) in August 2015, sought to reach young couples with one or two children in an effort to motivate their use of modern contraceptives so that family planning would become the "new normal". With the tagline "Parivar niyojan, smart banchha jeewan" ["Family planning makes a smart life"], the social and behaviour change communication (SBCC) campaign used a multi-channeled approach with newly married and with young parents. The campaign was a collaboration of: JHU-HC3; the Nepali Ministry for Health and Population (MOHP), Department of Health Services (DOH), National Health Education, Information and Communication Centre (NHEICC); Family Health Division (FHD); and the United States Agency for international Development (USAID).
The campaign was based on the key "teachable moments", or life-stage events, when couples can make "smart" family planning decisions in the first "1,000 days [three years] of marriage". These include their wedding, the birth of their first child, and the time when they have their desired number of children. The campaign message: Family planning offers practical solutions at each of these stages, and couples should consult their health provider to choose from among the various methods available.
Research influencing programme message development showed that people wanted the choice to manage their family size in order to provide children better care and nurture, a better home, and a better education. Campaign messaging was pre-tested. The name "Smart" was chosen because it is associated locally with new technology. "Couple" was used to represent mutual understanding in family planning decisionmaking, with the goal of, according to the project director, "placing the 'why' of family planning first, then offer[ing] family planning solutions as 'smart' means toward these ends." For example, spacing of three years is presented to new parents as a "smart" decision for enabling them to reach family aspirations, described by the message "Family Planning Makes a 'Smart' Life".
Outreach Nepal developed five television commercials in line with these themes. Corresponding radio commercials and billboard designs also portrayed the same storyline. In a country where social messages have traditionally been delivered in public service announcement (PSA) format, the campaign took a fully integrated communication approach. Media planning covered all major national TV channels (e.g., Nepal TV and Kantipur TV) in news and entertainment content, pulsed over time. Because radio is the most effective medium to reach rural and semi-urban populations, the media plan also included placements in national radio, network radio, and regional FM stations (e.g., Radio Nepal, Kantipur FM, and Image FM). Click here for the YouTube channel featuring health, family planning, and education messages (in Nepali). Outdoor advertising was placed along major national highways and in high-traffic locations in focal JHU-HC3 programme districts.
The campaign received endorsements from celebrities and was taken to local markets with four large-scale events. These health fairs featured national sitcom artists, using an infotainment approach with skits portraying the different life stages and incorporating smart family planning. Nationally known musicians performed between the drama segments - the campaign's anthem was "Hami haun ajaka smart dampati" ("We are today's smart couples") - drawing in young people and building excitement for the "brand". Over the course of four events, which were broadcast locally, crowd sizes grew from 5,000 to more than 30,000. The programme also included community events, with face-to-face communication and dramas for young people, newlyweds, expectant mothers, and new mothers. Systematic personal contacts were made among young, eligible couples at the grassroots level through household visits, through mothers' group meetings, and through linkage with child immunisation days.
The campaign increased its reach significantly through social media, mainly YouTube and Facebook. A Facebook photo-upload contest was launched around Valentine's Day 2016, leading to a lucky draw on April 12 (Nepali New Year's eve). The social media campaign was cross-promoted using the media, with strategic placement of articles in the national press and promotion by announcers and celebrity appearances on TV weekly shows.
Reproductive Health, Population, Youth
According to research data of the Nepal Demographic and Health Survey (2011), "while 56 percent of women of reproductive age are below 30 years of age, only 12 percent use family planning to delay the birth of their first child. Less than 32 percent use family planning to space their second child after the first birth and fewer than 13 percent are using family planning within two months after delivery." The strategy of "[e]stablishing early family planning behaviors to delay first birth, avoid unwanted postpartum pregnancy and space births successfully not only helps to improve maternal and child health outcomes in the short term, but will establish family planning use as a behavioral norm and, thus, affect longer-term fertility trends," according to JHU-HC3.
An independent survey by Sharecast Initiative Nepal in December 2015 showed that the nationwide campaign reached 58% of adults. Social media response was also strong, with reach of more than 5.6 million people (repeated). A video that HC3 posted on November 26 2015 had reached 562,800 people, and another video posted on November 10 2015 had reached 297,800 people as of May 2016. The photo contest attracted about 2,500 successful uploads. Furthermore, the campaign resulted in more than 81,000 eligible couples being contacted and more than 22,000 referrals for family planning services through JHU-HC3 community programmes in 13 districts. Anecdotally, many young couples now identify themselves as "smart couples".
JHU-HC3, USAID, the Government of Nepal, and Outreach Nepal