Promoting contraceptives to adolescents in Mexico? Make the campaigns fun

Monserrat, Ariantne and Isis and their children visit a
RED DKT clinic in the Iztapalapa borough of Mexico
City to find a contraceptive to space the birth of their
next child. Photo: David J. Olson

This was originally published on Global Health TV on March 21, 2017.

MEXICO CITY, Mexico — I met the three young women at a reproductive health clinic in Iztapalapa, the most populous and fastest-growing borough of Mexico City, with a population of 1.8 million on the eastern side of the capital city.

Ariatne and Isis, both 20 years old, each have one child. Monserrat was their aunt, but didn’t look much older. She had three children. All of them were looking for a way to space the birth of their next child. One of them wanted to wait five years; another, ten years.

All of them had chosen intrauterine devices (IUDs) as their contraceptive, one of them told me, “because they are comfortable and secure.”

Although unplanned pregnancy is a big problem in Mexico (and the rest of Latin America), good sexual and reproductive healthcare is hard to come by in Mexico, especially for adolescents, according to a recent study.

Almost three-quarters of pregnancies among adolescents aged 15-19 in the region are unplanned, according to the Guttmacher Institute, and about half of those end in abortion. Among all women 15-19 who need contraceptives, 36% of them are not using a modern method. The unmet need is highest in Central America, where 46% of sexually active adolescents who want to avoid pregnancy are not using modern contraceptives.

DKT México, a non-governmental organization that uses social marketing to prevent HIV and promote contraception in Latin America and the Caribbean, has learned some lessons about how to promote contraception to young people after success in promoting condom use but failing to do the same with contraceptives after they took a more traditional approach.

In 2015, DKT México launched a family planning campaign focused on increasing awareness of pregnancy among teenagers and young adults. They opted for a serious, medical campaign in traditional pharmaceutical company style — they talked in the negative and expounded on the myths of various contraceptive methods.

The campaign failed. Few young people attended their events or engaged their digital media. Their messages did not resonate with the audience they were trying to reach. This translated into poor contraceptive sales.

At the same time, they were having a highly successful Prudence condom campaign with well attended events a Facebook page with 2 million followers and a Twitter account with 47,500 followers. Their condom sales tripled between 2012 and 2016.

The contrast between the two campaigns strongly suggested that they had to apply the same fun strategy of openly talking about sex in their family planning work as they were doing in their condom work. So they made major changes to their campaign:

• They avoided talking in the negative and focusing on myths. Instead, they focused on the positive results of contraception.
• They realized that most Mexicans think of babies as a blessing from God, and it doesn’t help to talk of “unwanted” pregnancies, so they changed to “unplanned pregnancy."
• They shifted the focus to how these unplanned pregnancies can interrupt education, travel and careers, things about which young people care very much.
• They stopped using the term “family planning” and started talking about “life planning.” Young people do not think in terms of family planning; they are more interested in planning their education, careers and other life goals. This is true not only in Mexico but in other countries as well, something I wrote about here.

“In short, we stopped being preachy and started being fun, adopting the same entertaining messages and approaches we were using to market Prudence condoms at schools, concerts and fairs,” said Karina de la Vega Millor, director general of DKT México. “The main message became ‘Have sex, have fun, but use double protection against a sexually-transmitted disease or an unplanned pregnancy that will change the course of your life.’”

DKT México created “Planficame Esta” (“Plan me this”), a lively digital platform with a website, and a presence on Facebook, Instagram and YouTube.

“These tools give fun messages about the importance of having a life plan and avoiding pregnancy until you are ready, said Millor. “There are plenty of ribald jokes, frank discussions and flirty talk full of double entendres to engage our audiences. Our Facebook page now has more than 1.1 million followers, and more engagement than any Facebook page dedicated to contraception in all of Latin America.”  

The clinic I visited in Iztapalapa, where a majority of the residents are poor to middle class, is affiliated with RED DKT (DKT Network) which DKT started in Mexico a year ago to improve sexual and reproductive health and encourage use of long-acting reversible contraceptives like IUDs.

The bottom line is that DKT México learned from the mistakes of its first campaign. This new campaign promotes life planning, not family planning. It has resulted in more young people viewing DKT websites and social media platforms, sharing information with their friends and coming to DKT events and clinics to get information and products to help plan their lives.

And more of them are actually using contraception to avoid unplanned pregnancy. Millor says that DKT México has increased almost eight-fold its number of couple years of protection (the amount of contraception to protect a couple for one year) between 2012 and 2016. She said they estimate they contributed about 4% of all the couple years of protection in Mexico in 2016, according to DKT calculations. That may not sound like a lot until you realize that Mexico is the tenth most populous country in the world, with a population of 129 million.

DKT México is now expanding into Central America, the Caribbean and northern South America and it will apply the lessons it has learned in Mexico to these new countries.