An Online Peer Education and Family Planning Counseling Forum

Contraceptive use among women of reproductive age in Ghana is low—only 19 percent of those ages 14 to 49 living in urban areas use modern family planning methods. One-third have unmet family planning needs, and rates of unwanted pregnancy and unsafe abortion are high, particularly among youth. In the Ejisu-Juaben district of the Ashanti region, close to where this project is being implemented, 58 percent of women ages 15 to 19 were pregnant in 2009, and 37 percent had an abortion. Inadequate access to high quality information on family planning is a key barrier to contraceptive uptake among youth. Social stigma surrounding early sexual activity and family planning discourages youth from seeking sexual and reproductive health services, and limits exposure to accurate, objective information on family planning. Facing these constraints, many youth seek guidance from peers, who may provide incorrect or incomplete information. This can lead, in turn, to uninformed decision-making on family planning and contraceptive use.

The Solution

To improve youth access to high quality, unbiased information about reproductive health, the project team developed an online forum—“ShyOUT”—for Kwame Nkurumah University of Science and Technology (KNUST) students to discuss their questions and concerns related to sexual and reproductive health. Because access to the site is anonymous and responses are provided by trained peers, students can voice concerns and clarify areas of confusion without fear of judgment. Through the online forum, and other information dissemination activities such as radio shows and exhibitions, the project aims to educate youth on family planning options and enable them to make informed decisions.

The Strategy

Develop an online information-sharing and discussion forum. iSolve Africa created a forum for youth to engage in one-on-one discussions with peer educators and submit questions for group discussion. The forum provides resources such as educational materials; information on local youth-friendly clinics that offer family planning services; and announcements for conferences, trainings, and educational opportunities.

Train university students as peer educators. SCORA and ComAid trained 47 students at KNUST as peer educators, with assistance from staff at the campus office of the Planned Parenthood Association of Ghana and the family planning department of Komfo Anokye Teaching Hospital. During the two-day training, peer educators received information on family planning services and contraceptive methods, and were coached on how to respond to questions from other youth about reproductive health issues.
Share information and promote dialogue through the forum and other outreach. Peer educators moderate the forum and the project’s social media pages, answering questions and encouraging discussion on reproductive health topics. They also conduct a week-long, on-campus exhibition each semester to distribute educational materials and provide information on contraceptive methods. In addition, they organize monthly radio shows to engage youth.

Young people don’t want to be stigmatized for knowing about contraceptives or being open to using them, and are not comfortable discussing family planning with their elders. So it was critical for our platform to allow for questions to be submitted anonymously and for responses to come from peers.

—Project team member

Achievements

Youth are eager to become peer educators and to implement similar programs elsewhere. Students from diverse university departments participated in peer educator training, and most are still actively engaged in the project. Students at other universities in Ghana and other countries are also interested in the model, with some reaching out to project staff to ask about setting up their own forums.

The exhibition provided large numbers of youth with access to family planning information. Over 500 new users joined the online forum during the week-long exhibition. Attendees were excited about the project— peer educators often stayed at the exhibition late into the night, engaged in discussions with participating students.

Global networks are an asset to the project’s future success. The project team’s connections to the International Federation of Medical Students’ Associations and other reproductive health-related networks provide an important platform for expansion. One organization has already expressed interest in supporting the project’s continuation and growth.

Challenges

Traffic on the forum has been lower than expected. Students visit the project’s Facebook and Twitter pages frequently, but activity on the online forum has been light. Students and other stakeholders have suggested that making the forum available through smartphones or tablets might help to increase traffic and engagement. The project team plans to develop a mobile application for this purpose.

Women were difficult to engage through in-person outreach. At the exhibition, female students were more cautious than their male counterparts—they were reluctant to approach peer educators, openly ask questions, and obtain the contraceptives made available to them.

Key Learnings

Universities can be valuable partners for family planning initiatives. In an environment where most authority figures believe that youth should not be engaging in sexual activity or discussing family planning, university staff are unique in their support for this effort to increase youth access to reproductive health information. Many strongly recognize the need for an educational platform of this kind, with some even actively assisting in the creation and maintenance of the forum (for example, by training peer educators and conducting quality assurance of their responses to students).

Online forums provide some anonymity and can be more effective than person- to-person outreach in identifying and addressing misconceptions about family planning. During the in-person exhibition, students asked important but general questions on family planning—for example, on contraceptive methods available to them and advantages and disadvantages of these methods. They were less restrained when submitting questions to the online forum— focusing on particular concerns such as potential side effects of certain types of contraceptive methods. Young women in particular were more comfortable accessing reproductive health information through the forum, where they could submit questions and receive responses anonymously.

Next Steps

The project team plans to expand the forum and related activities to other universities where students have expressed interest. It also hopes to launch a text messaging service, which youth outside of the university setting could use to submit and receive answers to their reproductive health questions.