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Accessing family planning methods in India during COVID-19

By Diana Klatt. Originally Posted on www.medium.com.

COVID-19 has changed the way that we live our daily lives around the world. In India, households have been under lockdown since 25 March, forcing significant changes to healthcare seeking behavior. Leaving home to see a doctor or to go to the pharmacy has become more difficult and the pandemic has disrupted family planning products and services, despite it being a critical need and declared an essential service by the national government. While the pandemic may have impacted many aspects of our lives, people still need access to family planning services and products; having the global economy on pause doesn’t mean that sex has stopped.

Applying digital savvy and a strong understanding of consumer behavior at scale, Nivi can help users exercise greater choice, agency, and intent along their health journey, in short, better self-care. We are able to harness data to develop insights on how users interact with and acquire family planning products and services, as well as their behavior, knowledge, and thoughts about sexual and reproductive health. By understanding our users, their needs, and behaviors, we are able to work with our partners to provide curated services and products to target audiences. In doing such, we have been able to develop relationships to best support our partners and to best service and empower consumers to overcome barriers that are standing in their way to better health. As a response to barriers and gaps in services, Nivi has created online alternatives via e-pharmacies and digital consultations for askNivi users. Users now receive referrals for online services to fill the needs of going to the pharmacy and getting prescriptions and consultations from physicians, based on their conversations with the askNivi platform.

Who are Nivi users, and what do they need?

We’ve reached a lot of people and had a lot of conversations!

Between April 7th and July 10th, Nivi reached 12.6 million people in India with ad messaging, engaged 96,000 people in conversations about reproductive health services and COVID-19. AskNivi allows users to have conversations on many topics: COVID-19 prevention, accessing family planning services during COVID-19 lockdown, family planning methods, other sexual and reproductive health (SRH) topics, and the option to ask your own questions. Many users are interested in COVID-19 and how it impacts their lives — understandable as it’s something that’s on the front of everyone’s mind these days. Over half of the conversations users had with askNivi were about accessing family planning during COVID-19, discussing their current attitudes, desired information, and their preferences and behaviors regarding family planning services and products.

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Many users are currently finding family planning methods and services, which is great! But there are definitely barriers to access.

There were 2,000 users that directly engaged with the family planning during COVID-19 conversation, two-thirds of which were self-identified as males and nearly half of which were between 20 and 24 years old. Over two-thirds of these users indicated that they are currently using a safe family planning method (condoms, pills, or injections). However, over half of users indicated that they would like advice or a different type of family planning method than what they are currently using. In addition to preventative methods, users came to Nivi to learn more about emergency contraceptives and medical abortions and how to go about getting these services during these times. Through providing a safe space and being a reliable source of information for users, Nivi is able to both provide users with resources for all aspects of their family planning needs — OCP, ECP, and MA.

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Having all of this information is only useful if we can direct these users to the family planning services and products that they need — which is exactly what we are doing! In order to gauge where our users are and what they’re open to, we asked them about their family planning needs, their recent experiences at a pharmacy (within the last month), and if they would be interested in using online services to by-pass barriers standing in their way of getting the products they need.

And it turns out people are into the idea of using online services to get their family planning needs!

Despite the pandemic making it harder to leave the home, many were able to go out and get to a pharmacy. However, only half of those that got to a pharmacy in the last month were successful at getting their family planning needs met. A large portion of those that weren’t able to get their family planning products lacked a prescription, which is hard to get during this time of limited outside movement. Additional barriers were cost, concern about stock, fear of COVID-19, and transportation. Seeing half of users leave a pharmacy empty-handed is not what we want for people that are actively pursuing their self-care needs.

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While we cannot address all barriers, we can offer resources and advice to smooth the user’s self-care health journey by using online services to eliminate issues around lack of prescription, concern about stock, fear of COVID-19, and transportation. And it seems like Nivi users agree that these options are a good solution to access; two-thirds of users that engaged with COVID-19 conversations also explored options for online services and product access.

While we may not be able to address all barriers, we can address physical barriers, such as getting to a pharmacy, seeing a physician, or stock at a physical location. We tackle these issues by providing recommendations for e-pharmacies and online consultations with physicians. E-pharmacies provide ease of use and convenience for users, especially when it is physically not possible to visit a doctor for simple things like replenishment of contraceptives. As Nivi continues to engage users in these conversations, we hope to see more and more people being interested in using online services to access their family planning needs. We look forward to continuing spreading the message, working with our pharmacy and physician partners, and to making users’ self-care health journeys smoother.

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If you’d like to use askNivi to optimize your organization’s target audience engagement, contact us at partnerships@nivi.io!